Aspergillosis of the Maxillary Sinus Associated With Dental Implant
Aspergillosis is a fungal disease caused by the fungus Aspergillus; this disease frequently involves the lungs and occasionally the maxillary sinus. Aspergillosis in the maxillary sinus usually has the characteristics of a noninvasive form. It has been suggested that spores of aspergillus can be inhaled into the maxillary sinus via the osteomeatal complex or via an oroantral fistula after dental procedures, such as an extraction. However, maxillary aspergillosis related to implant installation has rarely been reported. This report regards unusual cases of maxillary aspergillosis associated with dental implant therapies in healthy patients. The cases were successfully treated with the surgical removal of the infected or necrotic tissues.
Representative histopathologic findings of maxillary sinus aspergillosis (case 1, a, b; case 2, c, d; case 3, e and f; case 4, g, h). Several inflammatory cells were observed around the maxillary sinus mucosa, and fungal masses (red arrows) were observed around the mucosa without mucosal invasion. Magnification ×100 (a, c, e, g). Numerous numbers of branching and septic hyphae were intricately entangled and aggregated. Magnification ×400 (b, d, f, and h).
Case 1. Chronic sinusitis with severe mucosal thickening and residual bone material observed at the previously grafted left maxillary sinus (a) and removed infected sinus mucosa (b).
Case 2. CT scan shows mucosal thickening and migrated dental implant in left maxillary sinus (a). Retrieved implant and inflammatory tissues in the sinus mucosa (b).
Case 3. CT scan image shows generalized mucosal thickening and radiopaque material at the center of right maxillary sinus (a), and the curetted specimen appears as a mixture of inflammatory sinus mucosa, grafted material, and calcified dark brown mass (b).
Case 4. CT scan image shows severe mucosal thickening and calcified radiopaque material on left maxillary sinus (a), and curetted specimens from maxillary sinus include inflammatory mucosa and calcified dark brown mass (b).
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