Abstract
BackgroundUntil now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion. Although the procedure remains highly predictive, the perforation of the Schneiderian membrane might compromise the stability of the augmented bone and implant success due to chronic sinus infection. The aim of this retrospective cohort study was to show that a membrane tear, if detected and surgically properly addressed, has no influence on the survival of dental implants and bone resorption in the augmented area.MethodsThirty-one patients with 39 perforations could be included in this evaluation, and a control group of 32 patients with 40 sinus lift procedures without complications were compared regarding the radiographically determined development of bone level, peri-implant infection, and implant loss.ResultsImplant survival was 98.9% in the perforation group over an observation period of 2.7 (± 2.03) years compared to 100% in the control group after 1.8 (± 1.57) years. The residual bone level was significantly lower in the perforation group (p = 0.05) but showed no difference direct postoperatively (p = 0.7851) or in the follow-up assessment (p = 0.2338). Bone resorption remained not different between both groups (p = 0.945). A two-stage procedure was more frequent in the perforation group (p = 0.0003) as well as peri-implantitis (p = 0.0004).ConclusionsWithin the limits of our study, the perforation of the Schneiderian membrane did not have a negative impact on long-term graft stability or the overall implant survival.
Highlights
Until now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion
To evaluate the impact of early-onset complications during implant insertion on the implant success, Becker et al published a follow-up study evaluating the first year after a sinus lift procedure [11], which did not reveal a negative impact on implant survival after an observation period of
In contrast to these results, a study by Nolan et al retrospectively re-assessed a total of 359 sinus augmentation procedures with a perforation rate of 41.8% (150 patients) at least 1 year after implant loading and reported a graft failure rate of 6.7%, in which 70.8% of membranes were perforated
Summary
Sinus floor elevation represents the gold standard procedure in the atrophic maxilla in order to facilitate dental implant insertion. The procedure remains highly predictive, the perforation of the Schneiderian membrane might compromise the stability of the augmented bone and implant success due to chronic sinus infection. The aim of this retrospective cohort study was to show that a membrane tear, if detected and surgically properly addressed, has no influence on the survival of dental implants and bone resorption in the augmented area. To evaluate the impact of early-onset complications during implant insertion on the implant success, Becker et al published a follow-up study evaluating the first year after a sinus lift procedure [11], which did not reveal a negative impact on implant survival after an observation period of. A highly significant connection was shown in a study by Schwartz-Arad et al [5], but these complications reportedly had no impact on implant survival
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