The Incidence of Maxillary Sinus Membrane Perforation During Endoscopically Assessed Crestal Sinus Floor Elevation: A Pilot Study

摘要

Transcrestal sinus membrane elevation is a surgical procedure performed to increase thenbone volume in the maxillary sinus cavity. Because of visual limitations, the potential fornmaxillary sinus membrane perforations may be greater than with the lateral approachntechnique. The aim of this study was to macroscopically investigate ex vivo the occurrence ofnsinus membrane perforation during surgery using 3 transcrestal sinus floor elevationnmethods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used fornsimultaneous sinus membrane elevation, placement of graft material, and dental implants.nReal-time sinus endoscopy, periapical digital radiographs, and cone-beam computerizedntomography (CBCT) images were subsequently used to evaluate the outcome of eachnsurgical procedure. Perforation rates for each of the 3 techniques were then compared usingna significance level of P , .05. No statistically significant differences in the perforation rate (Pn?.79) were found among the 3 surgical techniques. Although the sinus endoscope noted anhigher frequency of perforations at the time of implant placement as compared withninstrumentation or graft insertion, the difference was not statistically significant (P紏.04). ThenCBCT readings were judged to be more accurate for identifying evidence of sinusnperforations than the periapical radiographs when compared with the direct visualizationnwith the endoscope. This pilot study demonstrated that a sinus membrane perforation cannoccur at any time during the sinus lift procedure, independent of the surgical method used.