title: Severe bleeding after sinus floor elevation using the transcrestal technique: a case report.
abstract: OBJECTIVE
  To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique.
  
  
  METHODS
  Transcrestal SFE with simultaneous implant placement was performed in the maxillary right second premolar region of a healthy 70-year-old woman with no history of a bleeding disorder.
  
  
  RESULTS
  The patient reported to the emergency care unit a few hours after the surgery with ongoing bleeding and progressive swelling of especially the right side of the midface. The buccal swelling did not allow the patient to close her mouth and the discoloration extended to the sternum. A computed tomography scan showed pronounced swelling of the facial soft tissue and the right sinus cavity completely filled with blood. The patient was kept hospitalised for 3 days until regression of the swelling was attained and acceptable oral function was regained.
  
  
  CONCLUSIONS
  Transcrestal SFE is often recommended to the less experienced surgeon before the lateral window technique due to fewer complications and lower morbidity. The present case illustrates that severe complications may accompany transcrestal SFE. Although rare, clinicians performing SFE should be aware of this potential risk.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen O, Denmark. simon.storgaard@jensen.mail.dk
authors.forename: Simon Storgard
authors.initials: SS
authors.lastname: Jensen
authors.forename: Jacob
authors.initials: J
authors.lastname: Eriksen
authors.forename: Morten
authors.initials: M
authors.lastname: Schiodt
mesh_terms: D000368:Aged; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D005145:Face / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D010254:Paranasal Sinus Diseases / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology*; D059546:Sinus Floor Augmentation / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed