One-sided nasal discharge or a foul smell after an upper-jaw implant deserves a dental and ear, nose and throat assessment. Implant-related odontogenic sinusitis involves a possible dental source as well as sinus disease. It cannot be diagnosed simply because an implant appears close to the sinus on a scan.
Whether the implant can stay is a separate decision from whether the sinus needs treatment. Published clinical series include retained implants, while other cases require removal of compromised implants or displaced material. Ask the teams to explain which findings place your case in one of those groups.
Confirm both sinus disease and its dental source
The international multidisciplinary diagnostic consensus assigns complementary roles: an ENT clinician confirms sinusitis, principally through nasal endoscopy, while the dental clinician confirms relevant dental pathology through examination and imaging. A symptom or a radiographic finding alone does not complete both parts.
Odontogenic sinusitis is often shortened to ODS. Odontogenic maxillary sinusitis may be called OMS. Tell the clinician about nasal blockage, postnasal drainage and any unusual smell. Report the side involved and the timing relative to implant placement or a sinus graft, including symptoms that began much later.
The dental assessment also needs to consider nearby natural teeth. An implant visible in the same region should not automatically become the presumed cause. The adjacent-tooth lesion guide covers a different diagnostic problem and explains why neighboring tooth findings need their own assessment.
A protruding implant is a different finding from infection
Sinus floor perforation and thickening of the Schneiderian membrane, the sinus lining, describe anatomical or imaging findings. They are not interchangeable with confirmed infectious sinusitis. The imaging question should identify the relevant disease, its extent and the status of drainage. A report may refer to the drainage region as the ostiomeatal complex, or OMC.
A 2022 follow-up study of mini implants supporting upper overdentures found perforation in some sinuses without severe patient-reported rhinosinusitis complaints. The study began with patients without sinus complaints and involved a specific one-piece mini-implant design. It does not establish a universally safe protrusion distance for conventional implants or eliminate the need to investigate symptoms.
Ask for the written report and complete imaging dataset. The CBCT interpretation guide addresses uncertainty near metal. An isolated screenshot should not substitute for the examination and full report.
Published treatment with the implant retained
Kim and colleagues' prospective study, published in a 2016 journal issue, followed 19 patients with implant-related sinusitis for two years. Four responded to conservative treatment, while 15 underwent endoscopic sinus surgery, with one requiring revision. The authors reported implant survival of 100% and no recurrent clinical sinusitis at the two-year assessment.
This is a real clinical example of sinus treatment without implant loss. It is a small, single-center series of patients already diagnosed with disease. Its treatment proportions are not the chance that any new implant recipient will need surgery, and implant retention should not be promised from that result.
What can change the preservation decision
A 2026 retrospective surgical series examined 45 patients, including 37 with implant-related complications. The authors considered implant stability and peri-implant bone findings alongside displaced material, sinus drainage obstruction and openings between the mouth and sinus. They used nasal, oral or combined operations according to the presentation.
A mobile or displaced implant presents a different question from a stable implant without surrounding radiographic bone destruction. Infected graft material also needs to be considered. An oroantral communication, abbreviated OAC, is an opening between the mouth and sinus. A persistent fistula may be described as OAF. Either finding needs explicit assessment rather than an assumption that sinus drainage alone will address it.
The recent series came from a surgical database, excluding patients who improved with medical treatment alone. Its outcome assessments were short term, and its institutional selection framework was not externally validated. It therefore cannot prove that one operation is best or tell a patient to remove an implant from a scan alone.
Agree who is treating which part
Endoscopic sinus surgery, or ESS, is also described as functional endoscopic sinus surgery, FESS. A dental or oral operation may address a local source while an ENT procedure addresses sinus disease and drainage. Ask why one approach or a combined approach is proposed for the findings in your case.
Record whether the plan aims to preserve the implant, remove compromised hardware or manage graft material. If antibiotics are prescribed, ask when the response will be reviewed and what unresolved source or drainage issue still needs attention. Do not keep repeating old prescriptions without reassessment.
Bring one shared history to both teams
Use the following record to reduce gaps between appointments. It is an editorial communication aid, not a diagnostic checklist or surgical selection algorithm.
| Information | What to bring or ask | Who should clarify it |
|---|---|---|
| Timeline | Implant and graft dates, earlier sinus problems and onset of current symptoms | Patient and treating clinics |
| Dental findings | Implant stability, adjacent tooth assessment and any suspected oral-sinus opening | Dental or oral surgical team |
| Sinus findings | Endoscopy report, CT dataset and drainage assessment | ENT and imaging teams |
| Treatment response | Previous treatment, what changed and who will arrange follow-up | Both teams through an agreed plan |
When to seek urgent care
Seek urgent medical advice if you feel very unwell, symptoms are worsening or usual pain relief is not helping. A weakened immune system is another reason for prompt assessment. These escalation points are included in NHS sinusitis guidance. Suspected implant-related disease also needs communication with the dental team.
Sources and editorial provenance
Sources checked and article prepared November 11, 2026. The displayed November 7, 2026 at 13:40 Europe/Kyiv is an assigned editorial timestamp. Actual first production publication is recorded separately. The 2016 prospective series is summarized from its abstract; the mini-implant study and recent surgical study were checked in accessible full text. The diagnostic consensus is expert guidance. Published clinical experiences belong to their authors. This educational article does not replace an individual assessment.
First production release recorded: . The date at the top is the editorial date.