Comparison of a Novel Trephine Drill with Conventional Rotary Instruments for Maxillary Sinus Floor Elevation

Abstract

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Intraoperative Complications During Sinus Floor Elevation with Lateral Approach: A Systematic Review

“…Among the retrieved publications, a total of 32 studies on sinus floor elevation with a lateral approach matching the inclusion criteria were selected for the subsequent analysis. The results of the electronic and manual searches are summarized in Fig 1. Twenty-one studies were classified as RCTs 27,29,31,32,[35][36][37][41][42][43][44][45][47][48][49][50][51][52][53][54]57 and 11 studies as prospective CCTs. 26,28,30,33,34,[38][39][40]46,55,56 The first included study was published in 2003 26 and the last one in 2014.…”

“…Rotary Instrument Antrostomy. Nineteen studies [26][27][28][29][30]35,36,[38][39][40]43,44,47,49,51,52,54,56,57 describing rotary instrument antrostomy were included, treating a total of 558 patients and 736 sinuses. The total number of sinus membrane perforations using this technique was 148 (20.1% [17.3 to 23.2]).…”

“…There were 195 patients treated with this technique, for a total of 251 sinuses, and 37 perforations occurred (14.7% [10.7 to 19.9]). In one study, 52 the antrostomic approach was performed by removing the buccal bone with a specially designed trephine bur in 25 sinuses (Group 1), and by consuming a bony window with a round bur in 25 sinuses (Group 2). Two perforations occurred by using the trephine bur (8.0% [1.4 to 2.7]) and eight perforations when performing the window erosion with conventional rotary instruments (32.0% [15.7 to 53.5]).…”

“…Sixteen studies [26][27][28][29]35,36,[38][39][40]43,48,49,52,54,56,57 did not consider the occurrence of hemorrhagic complications between the reported outcomes. The other 16 selected studies [30][31][32][33][34]37,41,42,[44][45][46][47]50,51,53,55 recorded the presence of intraoperative hemorrhagic complications: in one study, 30 two alveolar antral artery hemorrhages occurred while performing Tatum's technique with round burs.…”

“…Detailed information on the risk of bias in individual studies is reported in Tables 3 and 4. From the assessment performed with Cochrane Collaboration's tool, five RCTs 29,35,49,52,54 were shown to be at a high risk of bias, with two RCTs 32,41 showing an unclear risk of bias, while six RCTs 31,37,42,44,45,50 did not show a significant risk of bias. Regarding the RCTs evaluated with the modified Downs and Black tool and the CCTs, the overall scores ranged from 6 26 to 14 36,55,58-60 on a 19-point scale.…”