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Objectives: To evaluate prevalences, affecting risk factors and efforts for repair mechanism for different forms of sinus membrane perforations (SMP) during sinus floor elevation (SFE) using the lateral window technique (LWT).Material and methods: For 334/434 patients, SFE undergoing LWT prevalence of SMP was retrospectively evaluated including a subselection based on membrane perforation size (<10 mm: small-moderate/≥10 mm: large) and biotype (BT; thick BT/thin BT) into four subgroups (SMP1: thick BT/small-moderate; SMP2: thin BT/ small-moderate; SMP3: thick BT/large; SMP4: thin BT/large). For the various subgroups, patient-and surgery-related/anatomic risk factors affecting SMP were evaluated and the scope of sinus membrane repair (SSMR) mechanisms rated with 1 (easy) to 5 (complex) was compared.Results: For 103/434 SMP (27.6%) in 93/334 patients (30.8%) the prevalence of various forms of SMP differed significantly (p < 0.001) among the four subgroups.SMP4 with a prevalence of 45.6% (n = 47) was the most frequent type, while SMP3 had low prevalence with 4.85% (n = 5). Small/moderate SMPs with thick (SMP1: n = 26) or thin BT (SMP2: n = 23) were seen in 26.2% and 23.3%, respectively. Univariate analysis showed significant differences between subgroups with large perforations (SMP3/SMP4) and those with small/moderate perforations (SMP1/SMP2) regarding anatomic risk factors such as residual ridge height (p = 0.023) and history of previous oral surgical interventions (OSI; p = 0.026).Most evidently, multivariate analysis showed that induction of large SMP with thin biotype (SMP4) was significantly affected by the presence of sinus septa (p < 0.022, OR: 2.415), reduced residual ridge height (p < 0.001, OR: 1.842), and previous OSI (p < 0.001, OR: 4.545). SSMR differed significantly (p < 0.001) between SMP4 (4.62 ± 0.49) and the subgroups SMP1 (1.11 ± 0.32), SMP2 (1.08 ± 028), and SMP3 (2.2 ± 0.55). Conclusion:The most frequently found type of SMP had characteristics of thin biotype and large size associated with risk factors such as sinus septa, reduced residual

For clinical implant and prosthesis outcome no statistical significant mean differences were noted for distally cantilevered 4-ISFMP supported by distal implants placed in tilted or axial direction.

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Purpose Evaluating the extent of and the factors affecting marginal bone level (MBL) alterations and consecutively implant success and implant health for implants placed in staged maxillary sinus floor (SF) augmentation. Materials and Methods A 5‐year prospective, cohort study was conducted on 85 patients with 124 maxillary sinus augmentation procedure and 295 implants placed. Peri‐implant MBL alterations (reductions) were evaluated radiographically at the first year, third year, and fifth year postloading follow‐ups and were considered to patient‐related risk factors (age, gender, diabetes mellitus, smoking, rheumatic disorders, and history of periodontal disease [PD]), to clinican/surgically related risk factors (membrane perforations, sinus site, and residual ridge height), to implant/prosthesis‐related features (implant length, diameter, location, keratinized gingiva, and restoration gap), and to the plaque score. Additionally, implant and prostheses survival/success rate and peri‐implant health (mucositis/peri‐implantitis) were assessed. Results About 267/295 implants (drop‐out:n9 pat; 28 implants: 9%) were followed for 5 years (survival/success: 99.3%/96.5%), presenting significant (P < .001) differences of MBL alterations (−1.45 ± 0.38 mm) over time. The univariate analysis demonstrated differences of MBL alterations for smokers versus nonsmokers (P = .005), for patients with versus without history of PD (P = .001), and presence versus absence of plaque (P = .041). In the 5‐year multivariate analysis, MBL alteration was influenced by time (P = .001) and was related to risk factors as smoking (P = .001; odds ratio [OR] = 6.563) and history of PD (P = .015; OR = 4.450). Significant ORs for MBL alterations were also found for a restoration gap used for a full‐arch dentures (P = .001; OR = 8.275) associated with reduced (≤3 mm) residual ridge height (P = .015; OR = 1.365). The overall 5 year incidence of peri‐implant mucositis and peri‐implantitis was 25.3% and 3.7% at implant level and 30.3% and 6.6% at patient level, respectively. Conclusions Apart from the high success rate and healthy status of implant placed in staged SF seen, MBL alteration increased over time and was negatively affected predominately by patient‐specific risk factors such as smoking status and previous history of periodontitis.