The Incidence of Maxillary Sinus Membrane Perforation during Endoscopically Assessed Crestal Sinus Floor Elevation: A Pilot Study.
AUTHOR
-- By Garbacea A,
Lozada J, Church C, Al-Ardah A, Seiberling K, Naylor P, Chen JW.
Transcrestal
sinus membrane elevation is a surgical procedure performed to increase the bone
volume in the maxillary sinus cavity. Because of visual limitations, the
potential for maxillary sinus membrane perforations may be greater than with
the lateral approach technique.
The aim of this study was to macroscopically
investigate ex vivo the occurrence of sinus membrane perforation during surgery
using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver
heads, with 40 intact sinuses, were used for simultaneous sinus membrane
elevation, placement of graft material, and dental implants. Real-time sinus
endoscopy, periapical digital radiographs, and cone-beam computerized
tomography (CBCT) images were subsequently used to evaluate the outcome of each
surgical procedure.
Perforation rates for each of the 3 techniques were then
compared using a significance level of P < .05. No statistically significant
differences in the perforation rate (P = .79) were found among the 3 surgical
techniques.
Although the sinus endoscope noted a higher frequency of
perforations at the time of implant placement as compared with instrumentation
or graft insertion, the difference was not statistically significant (P = .04).
The CBCT readings were judged to be more accurate for identifying evidence of
sinus perforations than the periapical radiographs when compared with the
direct visualization with the endoscope.
This pilot study demonstrated that a
sinus membrane perforation can occur at any time during the sinus lift
procedure, independent of the surgical method used.
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