The Incidence of Maxillary Sinus Membrane Perforation During Endoscopically Assessed Crestal Sinus Floor Elevation: A Pilot Study

2012 ◽  
Vol 38 (4) ◽  
pp. 345-359 ◽  
Author(s):  
Antoanela Garbacea ◽  
Jaime L Lozada ◽  
Christopher A. Church ◽  
Aladdin J. Al-Ardah ◽  
Kristin A. Seiberling ◽  
...  
Keyword(s):  
Pilot Study ◽  
Maxillary Sinus ◽  
Surgical Procedure ◽  
Surgical Techniques ◽  
Graft Material ◽  
Sinus Floor Elevation ◽  
Membrane Perforation ◽  
Sinus Floor ◽  
Sinus Membrane Elevation ◽  
Sinus Membrane

Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P < .05. No statistically significant differences in the perforation rate (P = .79) were found among the 3 surgical techniques. Although the sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

Indirect Osteotome Maxillary Sinus Floor Elevation: An Update

2012 ◽  
Vol 38 (6) ◽  
pp. 799-804 ◽  
Author(s):  
Javier Romero-Millán ◽  
Luis Martorell-Calatayud ◽  
Maria Peñarrocha ◽  
Berta García-Mira
Keyword(s):  
Maxillary Sinus ◽  
Survival Rates ◽  
Graft Material ◽  
Sinus Floor Elevation ◽  
Posterior Maxilla ◽  
Membrane Perforation ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
Bone Height ◽  
Maxillary Sinus Floor Elevation

The objective was to review publications on indirect osteotome maxillary sinus floor elevation (OMSFE) procedures. Studies published between 1999 and 2010 on patients with a minimum of 1 year of follow-up were analyzed. Fourteen studies were included. Indirect OMSFE is indicated for a bone height of 6–8 mm. More bone height was gained when graft material was used. Schneiderian membrane perforation was the most frequent complication. Survival rates varied between 93.5% and 100%. Osteotome sinus membrane elevation is a predictable and effective procedure for placing implants in areas of the posterior maxilla with low bone height.

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

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

2019 ◽  
Vol 41 (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.

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.

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