Orbital and maxillary sinus wall fractures as a late complication of endosteal implants

A 63-year-old woman applied to us with a complaint of ecchymosis on the left half of her face and left subconjunctival hemorrhage after talking on her cell phone. There was no history of trauma or known medical diseases, but the patient had multiple endosteal implants, nine of them from 12 years ago, and a recent one on her left maxilla from last year. After detailed anamnesis, it is learned that the patient was not using any bisphosphonate treatment, but she was on Vitamin D treatment due to Vitamin D deficiency and using mirtazapine and alprazolam for anxiety. However, her T-score calculated for osteoporosis was above −2.5. All of the maxillofacial examinations were normal except for suspicious step deformity in the palpation of the left infraorbital rim. However, on the computed tomography imaging, it showed that there were fractures on the left lateral and infraorbital wall and left inferior maxillary sinus wall. MRI imaging ruled out any possible fracture caused by an aneurysmal bone cyst. With all these findings and careful examinations, the cause of these fractures was considered a late complication of her dental implants.