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

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.

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

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00201 ◽

2014 ◽

Vol 40 (S1) ◽

pp. 375-379 ◽

Cited By ~ 1

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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Incidence of and Factors Associated with Sinus Membrane Perforation During Maxillary Sinus Augmentation Using the Reamer Drilling Approach: A Double-Center Case Series

The International Journal of Periodontics & Restorative Dentistry ◽

10.11607/prd.2525 ◽

2016 ◽

Vol 36 (4) ◽

pp. 549-556 ◽

Cited By ~ 7

Author(s):

Alberto Monje ◽

Florencio Monje-Gil ◽

Miguel Burgueño ◽

Raúl Gonzalez-Garcia ◽

Pablo Galindo-Moreno ◽

...

Keyword(s):

Maxillary Sinus ◽

Case Series ◽

Sinus Augmentation ◽

Factors Associated ◽

Maxillary Sinus Augmentation ◽

Membrane Perforation ◽

Sinus Membrane

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The Effects of Sinus Membrane Pathology on Bone Augmentation and Procedural Outcome Using Minimal Invasive Antral Membrane Balloon Elevation

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00253 ◽

2014 ◽

Vol 40 (3) ◽

pp. 285-293 ◽

Cited By ~ 8

Author(s):

Efraim Kfir ◽

Moshe Goldstein ◽

Itzhak Abramovitz ◽

Vered Kfir ◽

Ziv Mazor ◽

...

Keyword(s):

Maxillary Sinus ◽

Significant Proportion ◽

Retrospective Chart Review ◽

Minimal Invasive ◽

X Rays ◽

Sinus Lift ◽

Sinus Augmentation ◽

Implant Placement ◽

Asymptomatic Patients ◽

Sinus Membrane

Membrane pathology tends to complicate the postprocedural course of open sinus lift by ostio-meatal complex (OMC) obstruction and consequent acute sinusitis. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology undergoing maxillary sinus floor augmentation and simultaneous implant placement using the minimal invasive antral membrane balloon elevation (MIAMBE) method. This study was a retrospective chart review of MIAMBE procedures performed in the presence of significant sinus membrane pathology. Sixteen patients with maxillary sinus membrane thickening in well-ventilated OMC as determined by dental computerized tomography underwent sinus augmentation and simultaneous implant placement using the MIAMBE technique. All 16 procedures were successfully concluded without significant procedural or postprocedural complications or implant failure. Post MIAMBE membrane pathology regressed or disappeared in 8 patients (50%) or remained unchanged in 6 patients (37.5%), while in 2 patients the sinus membrane pathology was limited to evaluation by periapical X rays. Sinus augmentation using the MIAMBE technique can be performed safely in asymptomatic patients in the presence of sinus membrane pathology if the OMC is not obstructed. In a significant proportion of these cases, complete resolution of the membrane pathology after MIAMBE is observed. When compared to open sinus lift, OMC obstruction is less likely to occur when employing the MIAMBE method.

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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.

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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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