mucous retention cyst

[Kenneth Abramovitch]

Bernard,

I like most others do not have first hand experience actually placing any
implants with a sinus lift procedure in such an area but I am skeptical
about the prognosis.  Certainly I only offer an opinion as I am not aware of
any J.O.S. reports or related literature on the subject.

Most mucous retention cysts are associated with inflammation; sometimes just
from rupture of an antral seromucinous gland due to allergic sinusitis and
other times from sinus infections with related bacteria and their toxins in
the vicinity.  And some of these pseudocysts may even be related to past
dental infection (perio or pulpal).  So placing an implant in an area with
active infalmmation (admittedly to varying and sometimes unknown degrees)
can be expected to have some affect on the success of grafting bone in an
area where the inflammatory process is to be discouraged and the healing
process encouraged.  The size of a mucous retention (pseudo)cyst may be an
indication of how much inflammation may be present and this may give some
indication of the prognosis.

Really, we need to have more research data to qualify an opinion one way or
another.  There are differing opinions now, but based on the knowledge of
the pathophysiology, I am more reluctant to suspect a high success rate of
sinus lifts inferior to mucous retention cysts.  If this procedure is done,
I would certainly recommend informing in the informed consent that if they
have a mucous retention cyst and that this could negatively affect the
prognosis of the procedure.

Ken



At 12:19 PM 8/5/99 -0400, you wrote:
>Dear Oradlisters:
>
>        One of my referring doctors would like to do a sinus elevation on a
>patient for purposes of later placing an implant.  The patient has a mucous
>retention phenomenon/cyst on the floor of the sinus directly above the area
>of the proposed elevation.  Does anyone have any experience with this or
>know anyone who does?  The bottom line is: Is the presence of the mucous
>retention phenomenon/cyst a (relative) contraindication to the proposed
>procedure and should the clinician expect to encounter any particular
>problems as a result of its presence?  Thank you.
>
>
>Bernard Friedland
>Asst. Prof. & Head, Division of Oral & Maxillofacial Radiology
>Department of Oral Medicine & Diagnostic Sciences
>Harvard School of Dental Medicine
>188 Longwood Avenue
>Boston, MA 02115
>
>617-432-4295
>
>bernard_friedland at hms.harvard.edu
>