Split-Thickness Flap for the Management of a Maxillary Sinus Wall Bony Fenestration During Lateral Window Sinus Augmentation: Case Reports and Technical Surgical Notes

Testori, Tiziano; Yu, Shuangying; Scaini, Riccardo; Rosano, Gabriele; Tavelli, Lorenzo; Fabbro, Massimo Del; Francetti, Luca; Wang, Hom‐Lay

doi:10.11607/prd.5571

Cited by 3 publications

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“…Owing to various improvements in surgical techniques and instruments, anatomical variations, such as sinus septa and variant posterior superior alveolar artery, can be managed appropriately (Maridati et al, 2014; Okada & Kawana, 2019). However, sinus floor defects remain a challenging issue to manage, particularly when the buccal flap and Schneiderian membrane are largely adherent (Testori et al, 2022). In addition, the incidence of radiographic sinus floor defects in this study was 1.9% (38/2039), which is comparable to that reported by Zijderveld et al (2008) (2%, 2/100).…”

Section: Discussionmentioning

confidence: 99%

“…In this procedure, should bone defects be present at the crestal level, it is necessary to modify the flap reflection to a split‐thickness design and move the crestal incision toward the palate (1–2 mm away from the bone defects), guided by preoperative CBCT. In recent years, several researchers have also used this technique in a few cases with sinus floor defects (Nevins & Wang, 2019; Testori et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…However, specifics regarding the management of sinus floor defects during LSFE have rarely been reported in the literature. A previous case report has suggested the use of the split‐thickness flap technique to resolve this problem (Nevins & Wang, 2019; Testori et al, 2022). Moreover, long‐term clinical outcomes have not yet been reported, and the technical details of this procedure are yet to be described systematically.…”

Section: Introductionmentioning

confidence: 99%

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Lateral sinus floor elevation in patients with sinus floor defects: A retrospective study with a 1‐ to 9‐year follow‐up

Wen

Wei

Zhang

et al. 2023

Clinical Oral Implants Res

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ObjectivesWe aimed to retrospectively evaluate the long‐term clinical outcomes of lateral sinus floor elevation (LSFE) in patients with sinus floor defects.Materials and MethodsBetween 2008 and 2020, patients with sinus floor defects were recruited after confirmation on preoperative cone‐beam computed tomography (CBCT). The split‐thickness flap technique with a palatal crestal incision was used to manage tissue adhesion in the bone defects area. A resorbable collagen membrane was used to close the sinus floor defects from the crestal side before bone substitute placement. Of 58 implants, 47 (81.0%) were placed after an 8‐month healing period, whereas 11 were placed simultaneously. Patients were followed up by radiography and clinical examination for 1–9 years. Finally, the cumulative survival rate (CSR) of implants, surgical complications, and marginal bone loss (MBL) were recorded and analyzed.ResultsIn total, LSFE was performed in 36 sinuses (35 patients) with sinus floor defects, of which surgery was completed in 35 sinuses (97.2%) in the first attempt. Schneiderian membrane perforations (SMP) occurred in 10/36 (27.8%) sinuses; nine were repaired carefully, whereas one surgery was suspended due to complicated SMP, and successful re‐entry LSFE was performed 4 months later. After a follow‐up period of 1–9 years, the CSR was 96.5% at the 1‐year, 3‐year, 5‐year, and 7‐year follow‐ups and 64.3% at the 8‐year follow‐up.ConclusionWithin the limitations of this study, sinus floor defects seem not to compromise LSFE therapy after appropriate management and long‐term clinical outcomes are predictable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lateral sinus floor elevation in patients with sinus floor defects: A retrospective study with a 1‐ to 9‐year follow‐up

Wen

Wei

Zhang

et al. 2023

Clinical Oral Implants Res

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show abstract

“…After this healing period, it is possible to repeat the sinus augmentation. However, after the abortion of the technique and flap closure, the buccal bony wall of the sinus usually will not reform; hence, the surgeon has to perform a split‐thickness flap in order to detach the mucosal flap by the sinus membrane 82 …”

Section: Intraoperatory Complicationsmentioning

confidence: 99%

“…However, after the abortion of the technique and flap closure, the buccal bony wall of the sinus usually will not reform; hence, the surgeon has to perform a split-thickness flap in order to detach the mucosal flap by the sinus membrane. 82 To summarize, the following clinical recommendations have been…”

Section: Difficulty Scores Based On Risk Of Perforationsmentioning

confidence: 99%

How to avoid intraoperative and postoperative complications in maxillary sinus elevation

Testori

Tavelli

Scaini

et al. 2023

Periodontology 2000

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Maxillary sinus floor elevation, via the lateral approach, is one of the most predictable bone augmentation procedures performed in implant dentistry. but both intra‑ and postoperative complications can occur, and some of them are severe. Our aim is as follows: To review the pertinent literature on the topic, especially assessing the risk factors related to complications. To give clinical recommendations to minimize intra‑ and postoperative complications with the ultimate scope of improving the standard of clinical care and patient safety.

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Human platelet‐derived growth factor‐BB (rhPDGF‐BB) with collagen matrix for sinus elevation without using a bone graft

Ghassib,

Saleh,

Wang

2023

Clin Adv Periodontics

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BackgroundThis case report involves a 38‐year‐old male who presented to the clinic after experiencing complications from a tooth extraction, including a dislodged root segment in the sinus, a sinus wall fenestration on the palate, a residual bone height (RBH) of 3 mm, and inadequate healing of the soft tissue. He presented for implant placement.MethodsRecombinant human platelet‐derived growth factor‐BB (rh‐PDGF‐BB) was applied to a wound dressing material and placed in the sinus cavity alongside a 4.8 × 10 mm dental implant (Straumann SP, Straumann, Andover, MA, USA.). As documented in the literature, a graftless sinus lift via a lateral window was performed using a split‐thickness flap technique to elevate the sinus membrane, re‐establish its integrity, and restore its barrier function.ResultsAn 8‐month cone beam computed tomography assessment showed a 6.2 mm vertical bone gain and complete implant coverage.ConclusionThis approach provided a successful alternative to shorten treatment duration and achieve favorable radiographic outcomes during early healing.Key PointsThe use of rhPDGF‐BB and a collagen matrix in a sinus lift procedure emerges as a practical therapeutic option when grafting might lack predictability and notably consume more treatment time, while also achieving the desired bone height when used with a simultaneously placed implant.

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Split-Thickness Flap for the Management of a Maxillary Sinus Wall Bony Fenestration During Lateral Window Sinus Augmentation: Case Reports and Technical Surgical Notes

Cited by 3 publications

References 0 publications

Lateral sinus floor elevation in patients with sinus floor defects: A retrospective study with a 1‐ to 9‐year follow‐up

Lateral sinus floor elevation in patients with sinus floor defects: A retrospective study with a 1‐ to 9‐year follow‐up

How to avoid intraoperative and postoperative complications in maxillary sinus elevation

Human platelet‐derived growth factor‐BB (rhPDGF‐BB) with collagen matrix for sinus elevation without using a bone graft

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