Postoperative Perforation of the Schneiderian Membrane in Maxillary Sinus Augmentation: A Case Report

2014 ◽  
Vol 40 (S1) ◽  
pp. 375-379 ◽  
Author(s):  
Kyu-Hong Jo ◽  
Kyu-Ho Yoon ◽  
Jeong-Kwon Cheong ◽  
In-Seong Jeon
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Graft Material ◽  
Sinus Augmentation ◽  
Intraoperative Complication ◽  
Schneiderian Membrane ◽  
Membrane Perforation ◽  
Maxillary Sinus Floor ◽  
Systemic Antibiotics ◽  
Sinus Membrane

Perforation of the Schneiderian membrane constitutes a major intraoperative complication of maxillary sinus floor elevation with graft materials, but postoperative perforation of the sinus membrane is very rare. This case report demonstrates that conservative treatment involving drainage and the administration of systemic antibiotics can be used to successfully treat postoperative sinus membrane perforation with infection of the graft material.

scholarly journals Clearance of Bone Substitute in Gel Form Accidentally Dispersed into the Sinus Cavity during Transcrestal Maxillary Sinus Floor Elevation: Two-Case Report

Sinusitis ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 132-140
Author(s):  
Fabio Bernardello ◽  
Teresa Lombardi ◽  
Claudio Stacchi
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Bone Substitute ◽  
Intraoperative Complication ◽  
Sinus Floor Elevation ◽  
Sinus Cavity ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Sinus Membrane ◽  
Maxillary Sinus Floor Elevation

Sinus membrane perforation is the most frequent intraoperative complication occurring during maxillary sinus floor elevation. Although numerous techniques for perforation management are present, grafting material dissemination may still occur, representing a potential trigger factor leading to acute or chronic sinusitis. This case report describes two cases of xenogeneic bone substitute in gel form accidentally dispersed into the sinus cavity during maxillary sinus floor elevation with a transcrestal approach. In both cases, immediately postoperative radiographic imaging showed an important amount of gel graft dislodged into the sinus cavity as a consequence of hidden perforations that remained undetected during surgery. Patients were monitored for 6 months after surgery and reported no signs or symptoms related to possible sinus disease. Control radiographs showed no sinus membrane hypertrophy and/or presence of residual disseminated gel, confirming complete clearance of the accidentally dispersed graft through the ostiomeatal complex. In order to minimize postoperative complications, bone substitutes in gel form could represent an interesting alternative to granular grafts for their easier clearance from the maxillary sinus cavity in case of accidental dissemination during sinus augmentation procedures.

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

Membranes ◽  
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.

scholarly journals Complications During Maxillary Sinus Augmentation Associated with Interfering Septa: A New Classification of Septa

2017 ◽  
Vol 11 (1) ◽  
pp. 140-150 ◽  
Author(s):  
Tassos Irinakis ◽  
Valentin Dabuleanu ◽  
Salwa Aldahlawi
Keyword(s):  
Bone Loss ◽  
Maxillary Sinus ◽  
Retrospective Chart Review ◽  
Marginal Bone Loss ◽  
New Classification ◽  
Sinus Augmentation ◽  
Membrane Perforation ◽  
The Impact ◽  
Sinus Membrane

Purpose: A new classification of maxillary sinus interfering septa based on its orientation is presented along with its relationship to the prevalence and severity of sinus membrane perforations. Additionally, the impact of membrane perforation on post-operative complications and marginal bone loss during the first year of loading is evaluated. Materials & Methods: Retrospective chart review of 79 consecutive sinus lift procedures with lateral window technique and 107 implants. Preoperative Cone Beam Computed Tomography (CBCT) images were evaluated for the incidence and the direction of maxillary septa. Chart notes were examined for the incidence of membrane perforation and postoperative complications. Measurements of mesial and distal marginal bone levels and average bone resorption adjacent to each implant were calculated in intraoral radiographs taken at implant placement and during follow up appointments. Results: Interfering septa were identified in 48.1 percent of sinuses. 71.1 percent of them had the septum oriented in a buccal-lingual direction (Class I). The overall incidence of membrane perforation was 22.8 percent, and the presence of an interfering septum on CBCT scan was found to be significantly associated with the occurrence of a sinus membrane perforation (P<0.001). The mean implant marginal bone loss for sinuses, which did not experience a membrane perforation, was 0.6±0.8mm, compared with 0.9 ± 0.9 mm for the sinuses that did experience a perforation (P = 0.325). Conclusion: Septa should be identified, classified and managed with a meticulous attention to technical details. A classification based on the septal orientation is proposed since the orientation of the septa can complicate the surgical procedure and requires modification of the surgical technique.

scholarly journals Minimally Invasive Sinus Membrane Elevation Techniques: A Literature Review

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Rucha Shah
Keyword(s):  
Minimally Invasive ◽  
Surgical Approaches ◽  
Bone Augmentation ◽  
Sinus Augmentation ◽  
Membrane Perforation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Invasive Techniques ◽  
Sinus Membrane Elevation ◽  
Sinus Membrane

Sinus augmentation surgery has become a well-accepted pre-prosthetic procedure for placement of endo-osseous implants in compromised posterior edentulous maxilla. Various procedures for bone augmentation have been used to achieve sufficient bone volume for dental implants with the lateral and crystal surgical approaches being the most common. But these bone augmentation methods, including the conventional lateral maxillary approach and sinus elevation by osteotome, have several limitations. Sinus membrane perforation is one of the most common complications of the sinus lift procedure. Thus, to overcome these limitations various minimally invasive techniques have been introduced. These techniques cause minimal postoperative pain, faster recovery and are more economical due to shorter remission period. Hence, the aim of this review article is to discuss the various minimally invasive maxillary sinus floor elevation techniques introduced.

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