The clinical and radiographic outcomes of Schneiderian membrane perforation without repair in sinus elevation surgery

Won-Bae Park, Ji-Young Han, Philip Kang, Fatemeh Momen-Heravi
Clinical Implant Dentistry and related Research 2019, 21 (5): 931-937

BACKGROUND: The aim of this comparative study was to evaluate the clinical outcome of nonrepair of the perforated maxillary sinus membrane compared to the nonperforated cases.

MATERIALS AND METHODS: A retrospective comparative study was performed by identifying all lateral window sinus augmentation procedures, which were done during a defined period. Demographic data, systemic diseases, and smoking habits of patients were recorded. Thickness of the Schneiderian membrane and the amount of residual bone before surgery were measured by cone-beam computed tomography (CBCT). In case of perforation, no attempt was made to repair the membrane. Alloplast was used for bone augmentation. The thickness of the Schneiderian membrane and gained bone height were recorded using CBCT at the time of prosthesis delivery.

RESULTS: Sixty-three patients with 65 sinuses were included in this retrospective study. The rate of sinus perforation was 39%. There was a significant association between the presence of sinus pathoses before surgery and the occurrence of Schneiderian membrane perforation (P = 0.03). The Schneiderian membrane was significantly thicker in patients with perforation compared to the patients without perforation (P < 0.001). There was no correlation between the size of the perforation and the thickness of the Schneiderian membrane. Most of the perforations (83%) occurred at the mesial and middle part of the lateral window. The Schneiderian membrane thickness was decreased significantly in both groups after the sinus elevation procedure (P < 0.05). The bone graft height was stable over the follow-up period in both groups (P > 0.05). There was no implant failure in any of the groups.

CONCLUSIONS: Nonrepair of the Schneiderian membrane perforation did not adversely affect the clinical and radiographical outcomes. There were higher intraoperative and postoperative complications in the nonrepair group.

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