CASE REPORT Aspergillosis of the maxillary sinus associated with a zygomatic implant

Background. The use of a specially designed implant to be anchored in the zygomatic bone has been proposed in the literature as an alternative to bone grafting in the prosthetic rehabilitation of the severely resorbed maxilla, an option that has few postoperative complications. However, some complications can arise, such as the fungal infection the authors describe in this article. Case Description. The authors report a case of aspergillosis of the maxillary sinus after zygomatic implant placement. Twelve months after placement of the implant, the patient returned with symptoms of sinusitis, and a computed tomographic scan showed failure in zygomatic implant osseointegration and a radiopaque mass in the left maxillary sinus. The implant was removed, as was a friable brownish-yellow mass from the sinus. Histopathological analysis revealed a noninvasive hyphal mass compatible with Aspergillus. At a 12-month follow up, the patient experienced no recurrence of fungal sinusitis. Conclusion and Clinical Implications. Zygomatic implant placement is a safe surgical procedure. Nevertheless, postoperative maxillary sinus infections by bacteria, virus and fungus can occur and therefore need to be considered in the diagnosis of infection in the vicinity of dental and maxillofacial implants.