Synergy between Oral Surgeon/Implantologist and Otolaryngologist to Prevent Sinus Complications

The proximity of the posterior maxilla to the sinus increases the risk of surgical complications. Collaboration between ENT specialists and oral surgeons allows accurate assessment and management. Obstruction of the sinus ostium should be treated preoperatively; mucosal thickening is not a true contraindication.

The anatomical proximity of the posterior maxilla to the maxillary sinuses presents a significant challenge in oral and implant surgery. Procedures such as dental implant placement, sinus lift, and extraction of upper molars carry an inherent risk of sinus membrane perforation, oroantral fistula, or chronic sinusitis. To minimize these complications, close interdisciplinary collaboration between the oral surgeon or implantologist and the otolaryngologist is essential. This synergy allows for comprehensive preoperative assessment, including radiographic imaging and endoscopic evaluation, to identify pre-existing sinus pathology that may compromise surgical outcomes. Furthermore, coordinated management plans can be developed to address obstructions of the ostiomeatal complex or the natural maxillary sinus ostium.

Although there is no clear evidence in the literature of definitive ENT contraindications to oral procedures that may affect the integrity of the Schneiderian membrane, a blockage of the maxillary ostium – with can lead to altered sinus ventilation or impaired drainage – is, in our prudent clinical approach, considered a condition that may increase the risk of complications and should be addressed prior to surgery. Conversely, many studies in the literature affirm that mucosal thickening does not pose a significant risk to oral procedures.

When complications do arise, early ENT involvement facilitates timely intervention and reduces the risk of chronic conditions. This multidisciplinary approach not only improves clinical outcomes but also enhances patient satisfaction and reduces medico-legal risks. As implantology continues to evolve, the integration of ENT expertise into treatment planning and execution should become a frequent practice, especially in complex cases involving the maxillary sinus.