Management of Schneiderian membrane perforations during maxillary sinus floor augmentation with lateral approach in relation to subsequent implant survival rates: a systematic review and meta-analysis

Abstract Background This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival. Material and methods This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed. Results Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair. Conclusions Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Download Full-text

Clinical Effectiveness of the Lateral Approach of the Maxillary Sinus Floor Augmentation using Different Gadgets with Simultaneous Implant Placement: A Systematic Review with Meta-Analysis

Indian Journal of Science and Technology ◽

10.17485/ijst/2017/v10i10/96310 ◽

2017 ◽

Vol 10 (10) ◽

pp. 1-11

Author(s):

Ahmed Mortada Fikry ◽

Amr Zahran ◽

Moamen Sheba ◽

Magdy Mostafa ◽

◽

...

Keyword(s):

Systematic Review ◽

Maxillary Sinus ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Lateral Approach ◽

Implant Placement ◽

Sinus Floor Augmentation ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

Maxillary Sinus Floor Augmentation

Download Full-text

PRF-Solution in Large Sinus Membrane Perforation with Simultaneous Implant Placement-Micro CT and Histological Analysis

Membranes ◽

10.3390/membranes11060438 ◽

2021 ◽

Vol 11 (6) ◽

pp. 438

Author(s):

Horia Mihail Barbu ◽

Stefania Andrada Iancu ◽

Violeta Hancu ◽

Daniel Referendaru ◽

Joseph Nissan ◽

...

Keyword(s):

Maxillary Sinus ◽

Micro Ct ◽

Implant Placement ◽

Membrane Perforation ◽

Sinus Floor Augmentation ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

The Mean ◽

Maxillary Sinus Floor Augmentation ◽

Sinus Membrane

Background: The purpose of the study was to analyze the efficacy of platelet-rich fibrin (PRF) as a single augmentation material for complicated cases of maxillary sinus floor elevation, resulting from membrane perforation or previous infections. Methods: Implant insertion in the posterior region of the maxilla was simultaneously performed with maxillary sinus floor augmentation. Schneiderian membrane elevation can be accompanied by extremely serious sinus membrane perforation, due to accidental tearing or intended incision for mucocele removal. PRFs were placed in the sinus cavity both for membrane sealing and sinus floor grafting. Radiological, histological and micro-CT analyses were performed. Implant survival was assessed every 6 months for 1 to 4 years, with a mean follow up of 1.8 years, after prosthetic loading. Radiological examinations were performed on CBCT at 9 and 12 and 36 months postoperatively and revealed improved degrees of radiopacity. Results: 19 implants were simultaneously placed in the course of nine maxillary sinus floor augmentation surgeries, with successful outcomes in terms of bone grafting and implant integration. New bone formation was evidenced 12 months postoperatively on radiological examination, micro-CT analysis, and histological analysis of a harvested bone segment from the augmented maxillary sinus. The mean gain in bone height of the sinus floor augmentation was 6.43 mm, with a maximum of 9 mm. The mean amount of vital bone obtained from histologic assessment was 52.30%, while bone volume/tissue volume ratio in micro-CT 3D had a mean of 50.32%. Conclusions: PRF may be considered as an alternative treatment for a single surgery of sinus augmentation with simultaneous implant placement, even in complicated cases with significant sinus membrane tearing.

Download Full-text