Effect of Sinus Membrane Perforation on Dental Implant Integration: A Retrospective Study on 128 Patients

Abstract

A common complication of sinus augmentation is perforation of the sinus membrane during augmentation and/or implant placement. This retrospective study examines the effect of sinus membrane perforation with regard to graft survival and implant integration. A total of 175 sinuses were augmented with 115 of the membranes being reported intact at the time of surgery. A total of three infections occurred in patients who sustained perforated sinuses and one infection occurred in a patient who had an intact sinus. All four infections resolved after culture sensitivity and placement of the patient on an appropriate antibiotic for 10 days. Of 438 dental implants placed in the augmented sinuses, five implants failed, four of which were associated with perforated sinuses and and which was not associated with a perforated grafted sinus.

The clinical and radiographic outcomes of Schneiderian membrane perforation without repair in sinus elevation surgery

“…In a study conducted by Oh and Kraut, out of 175 reported sinus surgeries 60 (34%) had a Schneiderian membrane perforation . The authors reported three postoperative infections in perforated sinuses, which were resolved by the administration of antibiotics, with an implant success rate of 97% .…”

“…The most common complication of lateral sinus augmentation is perforation of the Schneiderian membrane with a reported incidence of 10%‐60% . Different risk factors for perforations have been suggested, such as chronic sinus pathology, smoking, operator error, limited residual bone height, presence of sinus septa, and overfilling at the time of graft placement …”

Effect of Sinus Membrane Perforation on the Survival of Implants Placed in Combination With Osteotome Sinus Floor Elevation

“…From this point of view, the size of membrane perforations may play a role on the long-term survival of dental implants placed into the augmented sinus area. 13 In our study, all dental implants in 6 patients with perforated sinuses were osseointegrated successfully in the observation. The results of our limited study revealed that perforation during the OSFE procedure was not a risk factor for implant survival.…”

“…7,14 Some studies report abandoning sinus lifting procedure because of the wide perforation. 12,13,15 However, Schneiderian membrane perforation is not an absolute indication for abandoning the procedure unless the membrane is largely destroyed. 8,14 At present, few studies describe the effect of sinus membrane perforation in implants placed in combination with OSFE, and it will lead to the failure of implants.…”

An Alternative Strategy to Manage a Large Perforation of the Schneiderian Membrane by Staged Re-entry into the Maxillary Sinus: Observed Clinical and Histological Changes of the Regenerated Schneiderian Membrane

“…A critical objective of sinus membrane repair is to prevent extravasation of the graft material into the sinus cavity. Schneiderian membrane perforations can be repaired with use of a bioresorbable collagen membrane (Figure 2A) autologous fibrin glue, demineralized freeze-dried human lamellar bone sheet, oxidized regenerated cellulose, sutures and with platelet rich plasma [9,[11][12][13][14][15]17,18,23,30,31,[35][36][37].…”