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Anatomical and Surgical Findings and Complications in 100 Consecutive Maxillary Sinus Floor Elevation Procedures

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Purpose

To investigate the prevalence of anatomical and surgical findings and complications in maxillary sinus floor elevation surgery, and to describe the clinical implications.

Patients and Methods

One hundred consecutive patients scheduled for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean age of 50 years (range, 17 to 73 years). In 18 patients, a bilateral procedure was performed. Patients were treated with a top hinge door in the lateral maxillary sinus wall, as described by Tatum (Dent Clin North Am 30:207, 1986). In bilateral cases, only the first site treated was evaluated.

Results

In most cases, an anatomical or surgical finding forced a deviation from Tatum's standard procedure. A thin or thick lateral maxillary sinus wall was found in 78% and 4% of patients, respectively. In 6%, a strong convexity of the lateral sinus wall called for an alternative method of releasing the trapdoor. The same method was used in 4% of cases involving a narrow sinus. The sinus floor elevation procedure was hindered by septa in 48%. In regard to complications, the most common complication, a perforation of the Schneiderian membrane, occurred in 11% of patients. In 2%, visualization of the trapdoor preparation was compromised because of hemorrhages. The initial incision design, ie, slightly palatal, was responsible for a local dehiscence in 3%.

Conclusion

To avoid unnecessary surgical complications, detailed knowledge and timely identification of the anatomic structures inherent to the maxillary sinus are required.

Section snippets

Patients and Methods

For this prospective study, 100 consecutive patients scheduled for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean age of 50 years (range, 17 to 73 years). In 18 patients, a bilateral procedure was performed. All sinus floor elevations were performed by the same surgeon.

Only the first unilateral site was evaluated according to the anatomical findings and complications. All patients were treated in the Department of Oral and

Results

In most cases, an anatomical or surgical finding forced a deviation from the standard procedure of Tatum.1 A thin or thick lateral maxillary sinus wall was found in 78% and 4% of patients, respectively.

In these cases, the initial trapdoor preparation differed. The lateral wall was defined as thin if, after reflection of the mucoperiosteum, the Schneiderian membrane already shone dark grayish-bluish through the sinus wall. A maxillary sinus wall was considered thick if it measured at least 2.3

Thin or Thick Lateral Maxillary Sinus Wall

After loss of the maxillary teeth and reduction of the masticatory forces acting on the maxilla, the sinus wall gradually becomes thinner as a result of the increased size (or volume) by pneumatization of the maxillary sinus.13 The duration of edentulism is decisive for the extent of alveolar-ridge resorption and antral pneumatization of the alveolar process.14 Increased antral pneumatization starting after tooth loss seems to result especially from the basal bone loss caused by a reinforcement

References (31)

  • E. Elian et al.

    Distribution of the maxillary artery as it relates to sinus floor augmentation

    Int J Oral Maxillofac Implants

    (2005)
  • P. Solar et al.

    Blood supply to the maxillary sinus relevant to sinus floor elevation procedures

    Clin Oral Implant Res

    (1999)
  • D. Flanagan

    Arterial supply of the maxillary sinus and potential for bleeding complication during lateral approach sinus elevation

    Implant Dent

    (2005)
  • Y. Uchida et al.

    Measurement of maxillary sinus volume using computerized tomographic images

    Int J Oral Maxillofac Implants

    (1998)
  • G.R. Velloso et al.

    Tridimensional analysis of maxillary sinus anatomy related to sinus lift procedure

    Implant Dent

    (2006)
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