Removal of Inflammatory Tissue/Product by Sinus Membrane Puncturing during Lateral Sinus Augmentation in Asymptomatic Patients with Severely Opacified Sinuses: A Case Series

Won-Bae Park,Jung Soo Park,Seung-Il Shin,Hyun-Chang Lim,Ji-Young Han

doi:10.3390/app112411831

Won-Bae Park, Jung Soo Park + Show 3 more

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https://doi.org/10.3390/app112411831

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Abstract

It is generally recommended that severe sinus membrane (SM) thickening should be treated prior to maxillary sinus augmentation (MSA), but during lateral MSA, inflammatory tissue/product may be removed by puncturing the SM. The present case report demonstrates surgical experience of lateral MSA with simultaneous inflammatory tissue/product removal for sinuses with severe opacification. In three patients requiring dental implant placement in the posterior maxilla, severe SM thickening was observed, but they were asymptomatic. The SM was gently elevated, followed by puncturing the SM, removing inflammatory tissue via the punctured site, draining, and thorough saline irrigation. Then, bone grafting and implant placement were performed with extra care not to spread bone substitute material into the punctured area. The postoperative pain following this procedure was more severe as compared to conventional MSA. Nasal bleeding was reported for 2–3 days. All implants were successfully integrated and demonstrated adequate function. Tissue samples retrieved during the surgery showed advanced inflammatory cell infiltration. The follow-up cone-beam computed tomographic scans revealed a significant reduction in SM thickening. In conclusion, inflammatory tissue/product removal by puncturing the SM can be applied during lateral MSA. However, more data should be needed due to the empirical nature of the present outcomes.

Highlights

The level of postoperative pain and discomfort was more severe as compared to conventional lateral sinus augmentation
The incision line away from the implant-placed area was slightly dehisced in cases 1 and 2, but secondary wound closure was achieved over time
No inflammatory exudate and pus were discharged via the dehisced area

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Maxillary sinus pneumatization with alveolar bone loss limits the bone height for dental implants in proper lengths. To overcome such a situation, maxillary sinus augmentation (MSA) was introduced by pioneers, followed by a vast amount of clinical practice and research. Systematic reviews demonstrated long-term predictability of MSA, such as a high implant survival rate and a stable level of the peri-implant marginal bone [1,2,3]

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