The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study.
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.
Loma Linda University School of Dentistry, Loma Linda, CA, USA. agarbacea@llu.edu
Antoanela
A
Garbacea
Jaime L
JL
Lozada
Christopher A
CA
Church
Aladdin J
AJ
Al-Ardah
Kristin A
KA
Seiberling
W Patrick
WP
Naylor
Jung-Wei
JW
Chen
D000328:Adult; D000368:Aged; D018786:Bone Substitutes / Q000627:therapeutic use; D002102:Cadaver; D002130:Calcium Phosphates / Q000627:therapeutic use; D004396:Coloring Agents; D054893:Cone-Beam Computed Tomography / Q000379:methods; D015921:Dental Implants; D017886:Durapatite / Q000627:therapeutic use; D019723:Endoscopes / Q000009:adverse effects; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000293:injuries*; D008751:Methylene Blue; D008875:Middle Aged; D009297:Nasal Mucosa / Q000000981:diagnostic imaging / Q000293:injuries*; D010027:Osteotomy / Q000009:adverse effects / Q000295:instrumentation; D010865:Pilot Projects; D016300:Radiography, Bitewing / Q000379:methods; D019252:Radiography, Dental, Digital / Q000379:methods; D059546:Sinus Floor Augmentation / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D020535:Video-Assisted Surgery
D018786:Bone Substitutes; D002130:Calcium Phosphates; D004396:Coloring Agents; D015921:Dental Implants; C485817:beta-tricalcium phosphate; D017886:Durapatite; D008751:Methylene Blue