title: Membrane perforation in sinus floor elevation - piezoelectric device versus conventional rotary instruments for osteotomy: an experimental study.
abstract: OBJECTIVE
  Sinus membrane perforation is the most common intraoperative complication of maxillary sinus floor elevation (MSFE) procedures and frequently causes postoperative problems. Piezoelectric devices have been claimed to reduce the frequency of membrane perforations although no clear evidence supports this view.
  
  
  METHODS
  Ten surgeons with different expertise levels performed 80 MSFEs in selected lamb heads, with rotary and piezoelectric instruments following standard protocols. After the procedures, specimens were coded and perforations or tears determined through a microscope.
  
  
  RESULTS
  No significant differences in terms of thickness either of the sinus lateral wall (xi -xj  = 73.2; 95% confidence interval [CI] = 45.3-191.8) or the membrane (xi -xj  = 24.2; 95% CI = -29.4 to 77.9) were identified between the specimens allocated to each group. Nine membrane perforations (11.2%) occurred during the study, all within the lower expertise group. Membrane elevation by hand instruments caused five perforations (40%) in the rotary instrument group and one in the piezoelectric group. Expert surgeons produced no membrane perforations, the size of the antrostomy that was smaller in the piezoelectric group being the only significant difference between the rotary and piezoelectric groups.
  
  
  CONCLUSIONS
  The use of piezoelectric material for MSFE reduces the frequency of membrane perforation among surgeons with a limited experience.
authors.affiliation: Senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; postgraduate student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Seoane
authors.forename: Javier
authors.initials: J
authors.lastname: López-Niño
authors.forename: Lucía
authors.initials: L
authors.lastname: García-Caballero
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Seoane-Romero
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Tomás
authors.forename: Pablo
authors.initials: P
authors.lastname: Varela-Centelles
mesh_terms: D000818:Animals; D010027:Osteotomy / Q000295:instrumentation*; D012756:Sheep; D059546:Sinus Floor Augmentation / Q000009:adverse effects*