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Lanis A, Gallucci G, Pedrinaci I. Full mouth oral rehabilitation of a severely worn dentition based on a fully digital workflow. J ESTHET RESTOR DENT 2023; 35:596-608. [PMID: 36715027 DOI: 10.1111/jerd.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To demonstrate the use of a complete digital workflow for a full mouth rehabilitation in a severely worn dentition. CLINICAL CONSIDERATIONS The present case report successfully rehabilitated a full-mouth case of a severely worn dentition based on the use of digital technologies, making the diagnosis and treatment process faster, accurate and less expensive. A long-lasting esthetic and functional result are showed after 30-months follow up. CONCLUSIONS An appropriate knowledge on dental erosion and oral rehabilitation, combined with a digital dentistry approach could lead the clinician to deliver a fast, accurate and predictable noninvasive restorative treatment in cases like the one described. CLINICAL SIGNIFICANCE Bruxism-based severely worn dentition is being found more often in population. In this situation, a detailed diagnosis and tailored treatment are mandatory to obtain a predictable treatment outcome. In this sense, the development of adhesive dentistry, new restorative materials and the incorporation of digital technologies can create a predictable synergy to rehabilitate these types of patients with a modern and less invasive approach.
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Affiliation(s)
- Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Section of Graduate Periodontology, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Mordini L, Patianna GP, Di Domenico GL, Natto ZS, Valente NA. The use of corticosteroids in the lateral sinus augmentation surgical procedure: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:776-791. [PMID: 36068078 PMCID: PMC10087261 DOI: 10.1111/cid.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The lateral maxillary sinus augmentation (MSA) procedure has good predictability in terms of the success of bone regeneration with a low incidence of postoperative infections, estimated between 2% and 5.6%. Although the use of antibiotics is an established and standardized prophylactic measure for MSA procedures, the addition of corticosteroids still varies among clinician preference and clinical judgment. PURPOSE The aim of this systematic review was to identify whether the administration of corticosteroids during the MSA surgical procedure affects postoperative symptoms including swelling, pain, and infection rate. MATERIALS AND METHODS A literature search through PubMed, EMBASE, Ovid MEDLINE, and Web of Science indices, according to PICO criteria, was conducted to identify whether MSA peri-operative use of corticosteroids reduces the incidence of complications and patient morbidity. A single arm meta-analysis was performed due to the lack of randomized controlled trials (RCTs) comparing groups treated with or without peri-operative corticosteroids. The intracluster correlation co-efficient (ICC) and design effect were calculated to adjust for the clustering design. RESULTS In the 37 studies included, a total of 1599 patients (378 Cort, 1221 No-Cort) were analyzed. Before and after taking account of clustering, there was statistically significant effect of corticosteroids on swelling, pain, wound dehiscence, trismus, and hematoma. The complication rates postoperatively were comparable between the two study groups, however slight differences existed in the incidence of active suppuration (1.7% [95% CI 0.7-3.9] Cort vs. 3.2% [2.2-4.5] No-Cort), wound dehiscence (3.9% [1.3-11.2] Cort vs. 2.1% [1.0-4.1] No-Cort) and trismus (2.7% [0.8-8.4] Cort vs. 1.4% [0.8-2.5] No-Cort). CONCLUSIONS Although the event rate of the 1-to-2-week postoperative complications did not differ between the two groups, the lack of conclusive data and research comparing peri-operative corticosteroid use makes it impossible to draw definitive conclusions and more evidence and studies designed for this specific purpose are needed.
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Affiliation(s)
- Lorenzo Mordini
- Department of Periodontology, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Giuseppe Pio Patianna
- Division of Oral Surgery, Unit of Dentistry, Dental School, Faculty of Medicine and Surgery, Vita Salute University and IRCCS San Raffaele, Milan, Italy
| | - Giovanna Laura Di Domenico
- Division of Oral Surgery, Unit of Dentistry, Dental School, Faculty of Medicine and Surgery, Vita Salute University and IRCCS San Raffaele, Milan, Italy
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nicola Alberto Valente
- Division of Periodontology, School of Dental Medicine, Department of Surgical Sciences, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy.,Department of Periodontology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York, USA
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Salgado-Peralvo AO, Garcia-Sanchez A, Kewalramani N, Barone A, Martínez-González JM, Velasco-Ortega E, López-López J, Kaiser-Cifuentes R, Guerra F, Matos-Garrido N, Moreno-Muñoz J, Núñez-Márquez E, Ortiz-García I, Jiménez-Guerra Á, Monsalve-Guil L. Consensus Report on Preventive Antibiotic Therapy in Dental Implant Procedures: Summary of Recommendations from the Spanish Society of Implants. Antibiotics (Basel) 2022; 11:antibiotics11050655. [PMID: 35625298 PMCID: PMC9138127 DOI: 10.3390/antibiotics11050655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 12/10/2022] Open
Abstract
Current patterns of preventive antibiotic prescribing are encouraging the spread of antimicrobial resistance. Recently, the Spanish Society of Implants (SEI) developed the first clinical practice guidelines published to date, providing clear guidelines on how to prescribe responsible and informed preventive antibiotic therapy (PAT) based on the available scientific evidence on dental implant treatments (DIs). The present document aims to summarise and disseminate the recommendations established by this expert panel. These were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were analysed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist templates and ranked according to their level of evidence. They were then assigned a level of recommendation using the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). Guidelines were established on the type of PAT, antibiotic and dosage of administration in the placement of DIs without anatomical constraints, in bone augmentation with the placement of DIs in one or two stages, placement of immediate DIs, sinus elevations, implant prosthetic phase, as well as recommendations in patients allergic to penicillin. Therefore, the PAT must be adapted to the type of implant procedure to be performed.
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Affiliation(s)
- Angel-Orión Salgado-Peralvo
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain;
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Correspondence: (A.-O.S.-P.); (Á.J.-G.)
| | - Alvaro Garcia-Sanchez
- Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, CT 06030, USA;
| | - Naresh Kewalramani
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Antonio Barone
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Surgical, Medical and Molecular Pathology and Critical Areas, Faculty of Dentistry, University of Pisa, 56126 Pisa, Italy
| | - Jose-María Martínez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain;
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
| | - Eugenio Velasco-Ortega
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - José López-López
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Odontostomatology, Faculty of Dentistry, University of Barcelona, 08907 Barcelona, Spain
| | - Rodrigo Kaiser-Cifuentes
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Faculty of Dentistry, Finis Terrae University, Santiago de Chile 7501015, Chile
| | - Fernando Guerra
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Faculty of Dental Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Nuno Matos-Garrido
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Jesús Moreno-Muñoz
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Enrique Núñez-Márquez
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Iván Ortiz-García
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
| | - Álvaro Jiménez-Guerra
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
- Correspondence: (A.-O.S.-P.); (Á.J.-G.)
| | - Loreto Monsalve-Guil
- Science Committee for Antibiotic Research of Spanish Society of Implants (SEI—Sociedad Española de Implantes), 28020 Madrid, Spain; (N.K.); (A.B.); (E.V.-O.); (J.L.-L.); (R.K.-C.); (F.G.); (N.M.-G.); (J.M.-M.); (E.N.-M.); (I.O.-G.); (L.M.-G.)
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41009 Seville, Spain
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Chew WCD, Kwek JWM, Anicete R, Low MY. Pediatric orbital cellulitis: Case report of an unusual etiology and pathogen. EAR, NOSE & THROAT JOURNAL 2022:1455613211064002. [PMID: 35023786 DOI: 10.1177/01455613211064002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Orbital cellulitis is an uncommon condition with risks to sight and life. As a complication of maxillofacial injuries, the literature suggests this is only possible with fractures or direct inoculation, and there are no reports to the contrary. Here, we make the first report of a possible etiology by which orbital cellulitis developed in a 14-year-old boy even without skin breach or bony fractures; as well as a rare causative pathogen. He presented with facial abscess and progressive orbital cellulitis after blunt facial trauma, requiring functional endoscopic sinus surgery with needle aspiration of facial abscess externally. Cultures showed growth of Streptococcus constellatus/Parvimonas micra, and he received further antibiotics with full recovery.The pathophysiology of orbital cellulitis in this patient is attributed to vascular congestion and local pressure from maxillofacial contusion and maxillary hemoantrum, with impaired paranasal sinus ventilation encouraging anaerobic bacterial growth. Further progression led to facial abscess formation and intraorbital spread with orbital cellulitis. The pediatric demographic is injury-prone, and self-reporting of symptoms can be delayed. Hence, increased suspicion of complicated injuries and orbital cellulitis may be required when managing maxillofacial contusions so that prompt treatment can be given.
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Affiliation(s)
- Wen Chao Daniel Chew
- Department of Otolaryngology, 37579KK Women's and Children's Hospital, Singapore, Singapore
| | - James Wei Ming Kwek
- Department of Otolaryngology, 37579KK Women's and Children's Hospital, Singapore, Singapore
| | - Rosslyn Anicete
- Department of Otolaryngology, 37579KK Women's and Children's Hospital, Singapore, Singapore
| | - Mei-Yi Low
- Department of Otolaryngology, 37579KK Women's and Children's Hospital, Singapore, Singapore
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Schlund M, Meeus J, Politis C, Ferri J. Management of sinus graft infection-a systematic review. Int J Oral Maxillofac Surg 2021; 51:690-698. [PMID: 34556376 DOI: 10.1016/j.ijom.2021.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/06/2021] [Accepted: 09/09/2021] [Indexed: 12/18/2022]
Abstract
Sinus graft infections are rare but serious complications, as they are associated with significant morbidity and sinus graft loss. The aim of this study was to systematically review the management of sinus graft infection in order to define which protocols should be implemented. The terms searched in each database were "sinus graft infection management", "maxillary sinus lift infection", "maxillary sinus graft infection", "maxillary sinus elevation infection", and "maxillary sinus augmentation infection". The management of the sinus graft infection was assessed. The outcomes evaluated were maxillary sinus health and dental implantation results. The initial search yielded 1190 results. Eighteen articles were included, reporting a total of 3319 patients and 217 sinus graft infections. Drainage was performed with an intraoral approach in 13 studies, an endoscopic approach in two studies, and a combined approach in three studies. In every study, a disease-free sinus was finally obtained in all patients, but the outcomes of the graft and the dental implant were more varied. It is not possible to define the best treatment protocol for sinus graft infections based on the published data, since the level of evidence is poor. Management is very heterogeneous. This review highlights the necessity of surgical treatment associated with antibiotic therapy.
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Affiliation(s)
- M Schlund
- Université de Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, Lille, France.
| | - J Meeus
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - C Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - J Ferri
- Université de Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, Lille, France
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On SW, Cho SW, Yang BE. A review of rare complications of maxillary sinus floor augmentation. J Korean Assoc Oral Maxillofac Surg 2019; 45:351-356. [PMID: 31966980 PMCID: PMC6955423 DOI: 10.5125/jkaoms.2019.45.6.351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 11/13/2022] Open
Abstract
Maxillary sinus floor augmentation (MSFA) is an essential procedure for implant installation in the posterior maxillary area with vertical alveolar bone deficiency. For the past several decades, MSFA has been refined in terms of surgical methods along with technical progress, accumulation of clinical studies, and development of graft materials and surgical instruments. Although some complications in MSFA are inevitable in clinical situations, management of those complications in MSFA has been well established thanks to many clinicians and researchers. Nevertheless, some rare complications may arise and can result in fatal results. Therefore, clinicians should be well aware of such rare situations and complications associated with MSFA. In this review, the authors present several rare complications regarding MSFA, along with corresponding management strategies through a thorough review of the literature.
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Affiliation(s)
- Sung Woon On
- Division of Oral and Maxillofacial Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.,Graduated School of Clinical Dentistry, Hallym University, Chuncheon, Korea.,Institute of Clinical Dentistry, Hallym University, Chuncheon, Korea
| | - Seoung-Won Cho
- Division of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.,Graduated School of Clinical Dentistry, Hallym University, Chuncheon, Korea.,Institute of Clinical Dentistry, Hallym University, Chuncheon, Korea
| | - Byoung-Eun Yang
- Division of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.,Graduated School of Clinical Dentistry, Hallym University, Chuncheon, Korea.,Institute of Clinical Dentistry, Hallym University, Chuncheon, Korea
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Akers JA, Johnson TM, Hill RB, Kawaguchi S. Rational Prophylactic Antibiotic Selection for Sinus Elevation Surgery. Clin Adv Periodontics 2019; 10:42-55. [PMID: 31609504 DOI: 10.1002/cap.10080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/03/2019] [Indexed: 01/26/2023]
Abstract
FOCUSED CLINICAL QUESTION For a generally healthy patient with no risk indicators for postoperative infection, what is the most appropriate perioperative antibiotic regimen for sinus elevation surgery in terms of reducing postoperative infection risk and minimizing untoward effects? CLINICAL SCENARIO A 38-year-old female patient in good general and periodontal health presents missing tooth #14 (Fig. ). She reports no systemic conditions, no history of sinusitis, and no allergies. Medications include acetaminophen and ibuprofen as needed for pain. The patient's dentition is minimally restored, with no active caries. Cone-beam computed tomography reveals a clear, pneumatized left maxillary sinus and inadequate bone volume to support dental implant placement (Fig. ). No septa or pathologic lesions are present, the ostium appears patent, and no thickening of the Schneiderian membrane is appreciable. The patient states that she wants to replace her missing molar without restoring adjacent teeth (Figs. and ). [Figure: see text] [Figure: see text] [Figure: see text] [Figure: see text].
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Affiliation(s)
- Joshua A Akers
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Richard B Hill
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA
| | - Sachiyo Kawaguchi
- Department of Periodontics, US Army Dental Health Activity, Joint Base San Antonio, San Antonio, TX
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Microflora of normal maxillary sinuses: does it justify perioperative antibiotic treatment in sinus augmentation procedures. Clin Oral Investig 2018; 23:2173-2177. [PMID: 30280325 DOI: 10.1007/s00784-018-2662-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/25/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To investigate bacterial flora of normal maxillary sinuses in order to facilitate perioperative antibiotic management in sinus augmentation procedures. MATERIALS AND METHODS Specimens of maxillary sinus mucosa were harvested during planned orthognatic surgery in 18 patients with no evidence of rhinosinusitis. The samples were processed according to hospital routine for aerobic and anaerobic cultures. RESULTS Ten maxillary sinuses were found sterile. Twenty-six (72%) maxillary mucosa specimens were culture-positive. Aerobes were recovered in 21 sinus samples (58%), predominantly as polymicrobial flora (18 cultures, 50% of all specimens), S. aureus in 2 sinuses of the same patient (6% of the samples), and Bacillus sp. in 1 sinus (3%). Anaerobes were isolated in 20 of 26 culture-positive specimens (56% of all sinus samples). They were recovered alone in 5 samples. Fifteen anaerobic cultures were polymicrobial (42% of all samples). Propionibacterium acnes was isolated from another 5 sinuses (14%) of 3 patients. CONCLUSIONS Our data support the policy of perioperative antibiotic prophylaxis in sinus augmentation procedures where Schneiderian membrane is perforated. CLINICAL RELEVANCE Evaluating the need of a perioperative antibiotic therapy in sinus augmentation procedures.
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