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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2013 April;24(1):21-31
Intentional violation of the maxillary sinus membrane during transalveolar sinus floor augmentation is not detrimental to treatment success. A large case series
Toscano P., Toscano C.
Private Practice, Vicenza, Italy
Aim: This study aimed at evaluating the outcomes of a technique for the rehabilitation of the posterior maxilla, involving a controlled perforation of the schneiderian membrane during crestal approach to maxillary sinus, that allows to accomplish a safe elevation procedure with simultaneous implant placement.
Methods: A total of 165 implants were inserted in 110 patients according to a crestal approach for maxillary sinus augmentation. A modified Summers technique was adopted. During the creation of the implant site, after fracturing the sinus floor with the first osteotome a small laceration of the sinus mucosa was induced. Grafts composed of anorganic bovine bone were inserted in the site, followed by the placement of 10- to 13-mm long implants, whose tip extended into the sinus space sealing the mucosa laceration. The blood coagulum from the wounded mucosa improved the graft consistence and favored the formation of a plug around the implant. Prosthetic phase occurred after 5 months.
Results: Three implant failed within two months of placement, yielding an overall implant survival of 98.2%. The mean follow-up was 22.5 months (range 6 to 48 months). All the remaining implants were stable and peri-implant soft tissues were healthy throughout the observation period. Peri-implant bone loss was 0.54±0.22 mm after one year. No biological or biomechanical complications occurred throughout the study.
Conclusion: In the presence of sinus membrane perforation, a proper surgical technique may allow to achieve excellent clinical outcomes without the occurrence of adverse events.