Management of the Complications of Maxillary Sinus Augmentation

Abstract

Dental implant rehabilitation of the posterior maxillary region has always been a challenging issue due to both alveolar ridge atrophy and sinus pneumatization. Maxillary sinus augmentation is a well-known and predictable procedure in vertical deficiencies of the posterior maxilla. To date, various techniques have been described based on the physiology of intrasinus bone repair to obtain better outcomes. Nevertheless, these procedures could also be associated with several intra-and postoperative complications such as perforation of the sinus membrane, hemorrhage, infection, graft resorption, and loss of the graft or implants. The aim of this chapter is to review the contemporary methods for maxillary sinus augmentation and to present both recommendations for prevention and management of the associated complications.

The assessment of the effect of the size of lateral‐antrostomy in graftless balloon elevation of the maxillary sinus membrane with simultaneous implant placement (a randomized controlled clinical trial)

“…The designated clinical trial aimed to assess the effect of downsizing the size of the antrostomy side‐window, meanwhile ensuring the tenting effect of the standardized elevated sinus membrane over the simultaneously inserted implants, to determine whether preserving the maximum amount of the lateral wall bones would enhance the quantity of the newly formed bone. Sindel and colleagues 11 and Bathla and colleagues 12 appraised the lateral cortical window as an abundant osteogenic source that delivers profuse blood supply, bone morphogenic proteins, and the cellular essentiality to the underlying graft.…”

Synthetic putty and simultaneous short implant placement in crestal sinus lifting procedures: 13–36 months follow-up - a case series

“…Most frequent complications of lateral window approach are perforations of the Schneiderian membrane and bleeding. Others include the obstruction of the antral meatal ostium complex, dislocation of the implant into the sinus cavity, perforations in the buccal flap, and less frequently, injury to the infra-orbital nerve (Sindel et al 2018). The main challenge of the crestal sinus procedure is the uncertainty of a possible perforation of the Schneiderian membrane because the sinus lifting procedure is performed blindly due to the impossibility to visualize the sinus floor (Sindel et al 2018).…”

“…Others include the obstruction of the antral meatal ostium complex, dislocation of the implant into the sinus cavity, perforations in the buccal flap, and less frequently, injury to the infra-orbital nerve (Sindel et al 2018). The main challenge of the crestal sinus procedure is the uncertainty of a possible perforation of the Schneiderian membrane because the sinus lifting procedure is performed blindly due to the impossibility to visualize the sinus floor (Sindel et al 2018). The incidence of membrane perforations in crestal sinus lift has been reported to range between 4-25 percent, while such complication has been described in 25-44 percent of external sinus lifting cases making the crestal approach a less risk for perforation (Sindel et al 2018).…”

“…The main challenge of the crestal sinus procedure is the uncertainty of a possible perforation of the Schneiderian membrane because the sinus lifting procedure is performed blindly due to the impossibility to visualize the sinus floor (Sindel et al 2018). The incidence of membrane perforations in crestal sinus lift has been reported to range between 4-25 percent, while such complication has been described in 25-44 percent of external sinus lifting cases making the crestal approach a less risk for perforation (Sindel et al 2018). The benefit from crestal approach is that it can achieve gain in bone height comparable with the lateral window approach, while maintaining the benefits of the less invasive trans alveolar approach (Mazor et al2013).…”