Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study

Abstract

Purpose To analyze the sinus membrane perforation (SMP) rate and its potential risk factors during lateral window maxillary sinus floor elevation (LSFE). Materials and methods For patients with LSFEs at Department of Implantology, Stomatology Hospital, School of Medicine, Zhejiang Universitiy during January 2014 to December 2020, patient‐related risk factors (age/sex/smoking habit), surgery‐related risk factors (operator experiment/number of tooth units/technique of osteotomy/surgical approach), and maxillary sinus‐related risk factors (residual bone height/sinus membrane thickness/lateral wall thickness/maxillary sinus contours/presence of septa/blood vessels at the lateral maxillary sinus wall) were compared between perforated and nonperforated sites and were evaluated for their influence affecting SMP. Results The study sample comprised 278 LSFE procedures in 278 patients; a total of 47 LSFE procedures (16.91%) presented SMP. Four significant factors were identified: smoking habit (p < 0.001), thin (≤1.5 mm) sinus membrane (p = 0.027), maxillary sinus contours (p < 0.001), and presence of septa (p = 0.001). The SMP rate of irregular, narrow tapered, and tapering sinus contours was significantly higher than that of ovoid and square one (p < 0.05). Conclusion In general, smoking habit, thin sinus membrane, irregular, narrow tapered, and tapering sinus contours, and presence of septa may increase the risk of SMP during LSFE.

Repositioning of the bone window in lateral sinus floor elevation with simultaneous implant placement: A retrospective radiographic study

“…Piezoelectric surgery was first introduced to LSFE for its higher accuracy and lower perforation rate than a rotary bur, because of its ability to selectively cut bone tissue without damaging soft tissue (Vercellotti et al, 2001). However, the hypothesis that piezoelectric surgery had a lower perforation rate was only partially supported by several studies (Jordi et al, 2018; Scarano et al, 2015), while other studies showed that the instrument selection would not result in a difference in perforation rate (Geminiani et al, 2017; Pizzini et al, 2021; Shao et al, 2021). Nevertheless, the results of this study (test group: 25%; control group: 0; p = .037) did not support either of the above conclusions.…”

Complicações decorrentes do levantamento do seio maxilar

“…Histórico de alergias, sinusite crônica e traumas na região do terço médio da face, são algumas das características que podem modificar a integridade da membrana. Dessa maneira, através de uma anamnese apurada do paciente, é possível se obter uma prévia de como está a integridade da membrana sinusal (Shao et al, 2021;Varela-Centelles et al, 2016).…”

“…As possíveis causas de perfuração incluem o rompimento da membrana durante a osteotomia da janela ou com a fratura da janela óssea, elevação excessiva da membrana, presença de septos e/ou preenchimento excessivo de enxerto. Fatores de risco documentados incluem irregularidades do assoalho do seio nasal, cirurgia sinusal anterior devido ao tecido cicatricial e altura insuficiente da crista alveolar residual (Shao et al, 2021;Whyte & Boeddinghaus, 2019).…”

Association between smoking and Schneiderian membrane perforation during maxillary sinus floor augmentation: A systematic review and meta‐analysis

“…Membrane perforation was associated with instruments, surgical techniques, and anatomic factors, including sinus septa, Schneiderian membrane thickness, narrow-tapered sinuses, and limited residual bone height. [7][8][9][10] Septa were contributing the most common anatomic factor, 11 with an incidence of 28.4% on the perforation. 12 The quantity, location, and heights of sinus septa were different in person.…”