Can We Predict Maxillary Sinus Mucosa Perforation?

This study was carried out to evaluate the prevalence of sinus mucosa perforation occurred during maxillary sinus mucosa elevation surgery, its relation to objective conditions and to the causative medical history, and its influence on postoperative sinusitis, as well. One hundred and forty-six sinus lift procedures have been evaluated in 118 patients. The prevalence of the sinus mucosa perforation was evaluated and subdivided into four groups according to its size and way of treatment. No relation was observed between the perforation and the presence of sinus septa, smoking, radiographic thickening and cyst-like lesions of the maxillary sinus, and previous sinus allergy (P<0.05). Despite of high prevalence of the perforation of the mucosa (56.16%), no signs of bone graft infection or maxillary sinusitis were noted in any of our patient.

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HOSPITAL INTERVENTION IN SEVERE SINUS INFECTION AFTER BONE GRAFT

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00301 ◽

2020 ◽

Author(s):

Jéssica Lemos Gulinelli ◽

Karine Teixeira ◽

Thiago Calcagnotto ◽

Caio Bellato ◽

Marcus Satoru Kasaya ◽

...

Keyword(s):

Bone Graft ◽

General Anesthesia ◽

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Hospital Setting ◽

Bovine Bone ◽

Sinus Lift ◽

Initial Infection ◽

Sinus Infection ◽

Collagen Membranes

This study presents the case of a patient who required antrostomy under general anesthesia to treat a sinus lift complication. The patient was a 43-year-old woman with no systemic abnormalities, who underwent maxillary sinus lift surgery associated with mineralized bovine bone graft. The Schneiderian membrane was perforated during the procedure and the rupture was treated with collagen membranes to close the wound and contain the biomaterial, preventing its dispersion. The patient developed a maxillary sinus infection seven days after the surgery. This infection was initially treated with 875 mg of amoxicillin combined with 125 mg of clavulanic acid. Although the initial infection did not worsen, the patient developed maxillary sinusitis. Thirty days after the onset of the initial infection, the patient underwent an intraoral surgery under local anesthesia to remove the biomaterial and clean the sinus cavity. Despite this procedure, maxillary ostial patency was still compromised and antrostomy was performed endoscopically in a hospital setting under general anesthesia. This procedure resolved the sinus infection. Then, 12 months after hospitalization, the patient was treated with another sinus graft surgery without postoperative complications. The treatment of sinus infections due to graft surgery may require early and active intervention with antibiotics, graft removal, and antrostomy to prevent major complications.

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Implant Placement after Closure of Oroantral Communication by Sinus Bone Graft Using a Collagen Barrier Membrane in the Shape of a Pouch: A Case Report and Review of the Literature

Medicina ◽

10.3390/medicina57060626 ◽

2021 ◽

Vol 57 (6) ◽

pp. 626

Author(s):

Jae-Ha Baek ◽

Byung-Ock Kim ◽

Won-Pyo Lee

Keyword(s):

Bone Graft ◽

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Collagen Membrane ◽

Implant Placement ◽

Barrier Membrane ◽

Membrane Perforation ◽

Oroantral Communication ◽

Sinus Membrane ◽

Posterior Area

Oro-antral communication (OAC) acts as a pathway for bacteria between the maxillary sinus and oral cavity, and is a common complication after the removal of a dental implant or extraction of a tooth from the maxillary posterior area. In the case of an untreated OAC, oro-antral fistula develops and becomes epithelialized. We aimed to introduce a treatment for OAC closure via a sinus bone grafting procedure using bone tacks and a collagen membrane with an allograft. The procedure was performed by applying an absorbable membrane made in pouch form. This membrane acted as a barrier for closing the large sinus membrane perforation. Bone tacks were used to fix the membranes. Subsequently, the maxillary sinus was filled with the allograft, and the absorbable membrane was reapplied. Primary closure was achieved by performing a periosteum-releasing incision for a tension-free suture. After 6 months, sufficient bone dimensions were gained without any occurrence of maxillary sinusitis or recurrence of OAC. Additional bone grafts and implantation could be performed to rehabilitate the maxillary posterior area. We conclude that this technique might be a useful treatment for reconstructing the maxillary posterior area with simultaneous sinus bone graft and OAC closure.

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Floating septum technique: easy and safe method maxillary sinus septa in sinus lifting procedure

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-019-0233-1 ◽

2019 ◽

Vol 41 (1) ◽

Cited By ~ 1

Author(s):

Junho Jung ◽

Bo-Yeon Hwang ◽

Byung-Soo Kim ◽

Jung-Woo Lee

Keyword(s):

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Sinus Lift ◽

Sinus Floor Elevation ◽

Schneiderian Membrane ◽

Safe Method ◽

Membrane Perforation ◽

Sinus Lifting ◽

Maxillary Sinus Septa ◽

Sinus Floor

Abstract Background The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa. Methods After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum. Results There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis. Conclusions This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

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Goat Model for Direct Visualizing the Effectiveness of Detaching Sinus Mucosa in Real Time During Crestal Maxillary Sinus Floor Elevation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00102 ◽

2017 ◽

Vol 43 (4) ◽

pp. 247-253

Author(s):

Jiadong Fan ◽

Pin Hu ◽

Yanfeng Li ◽

Fuli Wang ◽

Xinming Dong ◽

...

Keyword(s):

Maxillary Sinus ◽

Real Time ◽

Ex Vivo ◽

Sinus Lift ◽

Sinus Floor Elevation ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

Maxillary Sinus Floor Elevation ◽

Sinus Mucosa ◽

Space Volume

The procedure of crestal maxillary sinus floor elevation presents a great challenge to the field of implant dentistry. Due to the limited visualization in this procedure, the effectiveness of detaching sinus mucosa could not be assessed in real time. We recently developed an ex vivo goat sinus model by cutting the goat residual skulls along four lines determined from computerized tomography (CT) scans, extracting the maxillary premolar or molar teeth, and preparing implant socket in the maxilla. The generated ex vivo goat sinus models exposed the maxilla and the whole maxillary sinus mucosa, thus enabling real-time observation of detaching maxillary sinus mucosa via directly visualizing the working situation of sinus lift tool in the models and directly measuring the length of detached mucosa and space volume generated under the elevated sinus mucosa. One commercially available umbrella-shaped sinus lift curette was used to detach the maxillary sinus mucosa to evaluate the effectiveness of the ex vivo goat sinus models. The results showed that this curette could detach the sinus mucosa 3.75 mm in length in the mesiodistal direction and 2.81 mm in the buccal-palatal direction. Moreover, a space volume of 52.7 μl could be created under the elevated sinus mucosa in the goat ex vivo models. All the experimental results suggested that this ex vivo goat sinus model might be useful in the evaluation of improved or newly designed sinus lift tools for elevating the maxillary sinus mucosa via the crestal approach.

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Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

The Journal of Laryngology & Otology ◽

10.1258/00222150360600878 ◽

2003 ◽

Vol 117 (4) ◽

pp. 273-279 ◽

Cited By ~ 9

Author(s):

Ahmed Bassiouny ◽

Ahmed M. Atef ◽

Mahmoud Abdel Raouf ◽

Safaa Mohamed Nasr ◽

Magdy Nasr ◽

...

Keyword(s):

Image Analysis ◽

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Quantitative Methods ◽

Maxillary Sinusitis ◽

Functional Endoscopic Sinus Surgery ◽

University Hospital ◽

Sinus Surgery ◽

Chronic Maxillary Sinusitis ◽

Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

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Penetration of Erythromycin Stearate into Maxillary Sinus Mucosa and Secretion in Chronic Maxillary Sinusitis

Acta Oto-Laryngologica ◽

10.3109/00016487709123970 ◽

1977 ◽

Vol 84 (1-6) ◽

pp. 292-295 ◽

Cited By ~ 18

Author(s):

M. Paavolainen ◽

A. Kohonen ◽

T. Palva ◽

O. V. Renkonen

Keyword(s):

Maxillary Sinus ◽

Maxillary Sinusitis ◽

Chronic Maxillary Sinusitis ◽

Sinus Mucosa ◽

Erythromycin Stearate

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Maxillary sinus lift technique without the use of bone graft in geriatric patients

Medicina Oral Patología Oral y Cirugia Bucal ◽

10.4317/medoral.17644089 ◽

2016 ◽

pp. S38-38

Author(s):

B Ordonez Sousa ◽

M Garcia Palomo ◽

FJ Gomez Palomo ◽

A Jimenez Guerra ◽

A Espana Lopez ◽

...

Keyword(s):

Bone Graft ◽

Maxillary Sinus ◽

Geriatric Patients ◽

Sinus Lift

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Association between Cone-Beam Computed Tomography and Histological and Immunohistochemical Features in Periapical Lesions Correlated with Thickened Maxillary Sinus Mucosa

Medicina ◽

10.3390/medicina57080840 ◽

2021 ◽

Vol 57 (8) ◽

pp. 840

Author(s):

Alexandra Dumitrescu ◽

Maria-Alexandra Martu ◽

Alexandru Nemtoi ◽

Ana Sirghe ◽

Liliana Chelaru ◽

...

Keyword(s):

Computed Tomography ◽

Maxillary Sinus ◽

B Lymphocytes ◽

Cone Beam Computed Tomography ◽

Maxillary Sinusitis ◽

Cone Beam ◽

Periapical Lesions ◽

Significant Difference ◽

The Mean ◽

Sinus Mucosa

Background and Objectives: Odontogenic sinusitis is a frequently underestimated pathology with fewer symptoms in patients with periapical lesions, periodontal disease, or iatrogenic foreign bodies in the maxillary sinus. The aim of our study was to determine the correlation between maxillary sinusitis and periapical lesions using cone-beam computed tomography (CBCT) imaging and histological and immunohistochemical investigations. Materials and Methods: A total of 1450 initial patients diagnosed with maxillary sinusitis in the Ear-Nose-Throat (ENT) Department, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, Romania, were treated with anti-inflammatory drugs. Of these, 629 still had unresolved symptomatology and were later referred to the Dental Medicine departments for further investigations. Only 50 subjects with periapical lesions in the premolar/molar maxillary area were included in the present study. All the periapical lesions were observed on CBCT and classified using the Periapical Status Index (PSI) and the mean maxillary sinus mucosa thicknesses (MSMT). The enrolled patients underwent surgical procedures with the excision of periapical lesions. The excised samples were submitted to the histological and immunohistochemical investigations. Results: The 50 patients presented periapical lesions of their maxillary teeth in 328 dental units. There was a higher prevalence of periapical lesions in men than in women (chi-square test). We observed a significant difference between the mean MSMT of individuals with periapical lesions compared to those without (p < 0.01). Mean MSMT was 1.23 mm for teeth without periapical lesions and 3.95 mm for teeth with periapical lesions. The histopathological study identified 50% cases with periapical granulomas, 10% cases with periapical granulomas with cystic potential, and 40% cases as periapical cysts. Immunohistochemical stainings showed that CD4+ helper and CD8+ cytotoxic T lymphocytes, along with CD20+ B lymphocytes and CD68+ macrophages, were diffusely distributed in all periapical cysts and in some periapical granulomas, but CD79α+ plasma cells characterized especially periapical granulomas. Conclusions: The current study observed a significant correlation between CBCT maxillary mucosa thickness and type of periapical lesion. Chronic inflammatory lympho-histiocytic infiltrate predominates in periapical lesions, supporting the idea that lesion progression is determined by a humoral-type (CD20+ and CD79α+ B lymphocytes) but also by a cellular-type (CD4+ and CD8+ T lymphocyte population) immune mechanism.

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