title: Changes in Sinus Membrane Thickness After Lateral Sinus Floor Elevation: A Radiographic Study.
abstract: OBJECTIVE
  To radiographically monitor sinus membrane swelling after lateral sinus floor elevation surgery at short and long healing periods.
  
  
  METHODS
  For 26 patients seeking posterior maxillary implant-supported reconstruction, 32 lateral sinus floor elevations were performed using Piezosurgery. Sinus membranes were grafted using synthetic calcium phosphate bone substitutes, and graft volume was measured in cubic centimeters for each case. Cone beam computed tomography (CBCT) examination was conducted preoperatively in all patients and for each grafted sinus at 1 day (n = 8), 2 days (n = 9), 3 days (n = 8), or 7 days (n = 7) after surgery. Control CBCT was then performed for all patients at 3, 6, and 12 months after surgery. Sinus membrane thickness was measured on cross-sectional CBCT images at nine standardized points per sinus, before lateral sinus floor elevation and at all postoperative examinations.
  
  
  RESULTS
  Mean sinus membrane thickness was 0.73 mm before surgery, and 5 mm, 4.1 mm, 5.9 mm, and 7 mm, respectively, at 1, 2, 3, and 7 days after surgery. First week combined postoperative CBCT measurements of membrane thickness was 5.4 mm, then 1.3, 0.68, and 0.39 mm at 3, 6, and 12 months, respectively, after surgery. Membrane thickness significantly increased the first week after surgery and gradually decreased significantly at 3, 6, and 12 months in all groups (P < .001). First-week postoperative measurements showed a significant increase in membrane thickness at 3 days compared with the 1- and 2-day results (P < .001) and at 7 days compared with all other time points (P < .001). Membrane thickness at 2 days did not change significantly compared with 1-day measurements. Larger graft volume was positively correlated with an increase in membrane thickness after surgery at all time points (n = 32; r = 0.527; P < .001).
  
  
  CONCLUSIONS
  After lateral sinus floor elevation surgery, transient swelling of sinus membrane is observed. It reaches a peak value 7 days after surgery and completely resolves over months. This swelling is correlated to the extent of sinus floor elevation.
authors.forename: Christian
authors.initials: C
authors.lastname: Makary
authors.forename: Alberto
authors.initials: A
authors.lastname: Rebaudi
authors.forename: Abdallah
authors.initials: A
authors.lastname: Menhall
authors.forename: Nada
authors.initials: N
authors.lastname: Naaman
mesh_terms: D019412:Anatomy, Cross-Sectional / Q000379:methods; D018786:Bone Substitutes / Q000627:therapeutic use; D002130:Calcium Phosphates / Q000627:therapeutic use; D054893:Cone-Beam Computed Tomography / Q000379:methods; D004487:Edema / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008443:Maxillary Sinus / Q000000981:diagnostic imaging*; D009297:Nasal Mucosa / Q000000981:diagnostic imaging*; D059745:Piezosurgery / Q000379:methods; D011446:Prospective Studies; D059546:Sinus Floor Augmentation / Q000379:methods*; D014945:Wound Healing / Q000502:physiology
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates; C020243:calcium phosphate