Glossary

An access hole in implant dentistry is an opening in the artificial tooth (crown) of a screw-retained dental implant. This opening provides access to the abutment or screw prosthesis, hence its name. Typically, the access hole is placed on the lingual or occlusal surface, but may be placed elsewhere depending on the preference of the attending surgeon. Because the access hole easily allows food and bacteria to become trapped inside the implant, it must be covered after the completion of the dental implant procedure. If this isn’t done properly, bacteria can cause the implant to become infected, which is likely to result in rejection and potentially bone loss if the underlying jawbone is affected. Many dental professionals use plumber’s tape or cotton pellets, however, plumber’s tape is often considered the better choice. It is self-adhering, so it packs down onto itself easily and forms a tight seal that protects the implant.

The principle maxillary sinus ostium (PMO) and accessory sinus ostium (i.e., accessory ostium) are the anatomical structures of the middle meatus that are referred to as the osteomeatal complex. This complex contributes to the final drainage pathway of the anterior ethmoidal, maxillary and the frontal sinuses. The principle maxillary sinus ostium is present throughout the population; however, the accessory ostium is not. The accessory ostium only occurs in 30 to 40 percent of the population.

Typically, the maxillary sinus is located close to the alveolar ridge of the first molar and second premolars; therefore, it is not uncommon to find the roots of the first and second molars in the maxillary antrum. However, when these teeth are lost, the sinus expands into the remaining alveolar bone. As time passes, the floor of the sinus becomes the crest of the remaining alveolar ridge; thus, the level of the bone and the floor of the nasal cavity may be nearly identical. In a case such as this, before dental implants can be placed, bone grafts may be necessary.

See: Ostium (maxillary sinus)

Accessory ostium, also referred to as accessory sinus ostium or just sinus ostium, are a common anatomical variation in humans. However, they may be due to a sinusal disease.They are described as bony dehiscences that are covered with mucosa that allow nasal fluids to leak into other areas of the sinus. Despite this, no connection has been found between the presence of accessory ostium and the increase in rhinitis or sinusitis symptoms in patients who have them. The cause of accessory sinus ostium may also be attributed to maxillary sinusitis, obstruction of the primary ostium, or anatomical or pathological abnormalities in the middle meatus. These conditions may cause the rupture of membranous areas, resulting in accessory ostium. Knowledge of the structures within the maxillary sinus is important in determining whether the patient will need a bone graft prior to the implant. In rare cases, implant hardware can become displaced in the sinus cavity.