Perforation of the maxillary sinus membrane during sinus lift: a retrospective study of the frequency and possible risk factors
DMD
Professor, Department of Oral and Maxillofacial Surgery and Surgical Dentistry, Faculty of Dentistry, University of Bern (Bern, Switzerland).
DDS
Visiting Specialist of the Department of Maxillofacial Surgery and Surgical Dentistry, Faculty of Dentistry, University of Bern (Bern, Switzerland); implantology program instructor of San Sebastian University (Santiago, Chile).
DMD
Professor, Head of Department of Dental Radiology Department of Maxillofacial Surgery and Surgical Dentistry, Faculty of Dentistry, University of Bern (Bern, Switzerland).
DDS
The counselor Maxillofacial Surgery Department of Oral and Maxillofacial Surgery Clinic at the University of Copenhagen (Copenhagen, Denmark).
Purpose: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors.
Materials and Methods: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiographic variables potentially influencing the risk of sinus membrane perforation were evaluated and divided into patient-related factors (age, sex, smoking habit); surgeryrelated factors (type of surgical approach, side, units, sites, and technique of osteotomy); and maxillary sinus–related factors (presence and height of septum, height of residual ridge, thickness of lateral sinus wall, width of antrum, and thickness and status of sinus membrane).
Results: The following factors presented with at least a 10 % difference in rates of perforations: smokers (46.2 %) versus nonsmokers (23.4 %), simultaneous (32 %) versus staged (18.5 %) approach, mixed premolar-molar sites (41.2 %) versus premolar-only sites (16.7 %) versus molar-only sites (26.2 %), presence of septa (42.9 %) versus no septa (23.8 %), and minimum height of residual ridge ≤ 4 mm (34.2 %) versus > 4 mm (20.5 %). These same parameters, except minimum height of residual ridge, also showed an odds ratio above 2. However, none of the comparisons reached statistical significance.
Conclusion: The present study failed to demonstrate any factor that statistically significantly increased the risk of sinus membrane perforation during SFE using the lateral window approach.