Maxillary Sinus Membrane Perforation Research Articles

Repair of schneiderian membrane perforation through membrane fixation with simultaneous implant placement: a case report.

Perforation of the maxillary sinus membrane is a common complication during maxillary sinus elevation. Intraoperative perforation of the maxillary sinus membrane may complicate the procedure and indirectly lead to implant failure. Timely repair of the perforated maxillary sinus membrane can effectively improve the implant survival rate. This case describes a method of repairing a maxillary sinus membrane perforation with a suture-attached collagen membrane and shows stable repair results at a 31-month follow-up.

Clinical Outcomes of Maxillary Sinus Floor Perforation by Dental Implants and Sinus Membrane Perforation during Sinus Augmentation: A Systematic Review and Meta-Analysis.

The aim of the present systematic review was to investigate the clinical outcomes after the perforation of the maxillary sinus by dental implants, or after maxillary sinus membrane perforation during sinus lift procedure. Twenty-nine publications were included. Failure rates of implants in cases where perforation of sinus floor had happened (11 studies) was generally low, and only one case of transient sinusitis was reported. The estimated failure rate of these implants was 2.1% (SE 1.0%, p = 0.035). There were 1817 implants (73 failures) placed in augmented sinuses in which the sinus membrane was perforated and 5043 implants (274 failures) placed in sinuses with no perforated membrane, from 18 studies. The odds of implant failure difference between the groups were not significant (OR 1.347, p = 0.197). log OR of implant failure between perforated and non-perforated membrane groups did not significantly change with the follow-up time (-0.004/month; p = 0.500). In conclusion, implant failure rate is generally low either for implants penetrating in the floor of the maxillary sinus or implants placed in augmented sinuses in which the sinus membrane was perforated. The prevalence of postoperative infection/sinusitis is low, and it may depend either on the dimensions of the perforation or on the anatomical predisposition.

Analysis of the Prevalence, Location, and Morphology of Maxillary Sinus Septa in a Northern Chinese Population by Cone Beam Computed Tomography.

Purpose The purpose of this study is to survey the prevalence and morphology of the maxillary sinus septum, which might increase the rate of maxillary sinus membrane perforation during maxillary sinus floor elevation surgery, among northern Chinese, and to further analyze the relationship between gender, age, edentulous type, and prevalence of maxillary sinus septa. Methods The cross-sectional retrospective study was based on an analysis of Cone Beam Computed Tomography (CBCT) images of maxillary sinus which had been obtained from patients who visited radiology department of Beijing Stomatology Hospital of Capital Medical University (Beijing, China) during the period from January 2019 to December 2019. The data of demographic characteristic, prevalence, position, direction, and morphology of maxillary sinus septum were collected and further analyzed by SPSS version 25.0.1 and R version 3.5.1 software program. Results 595 patients were included in this study, and 1190 maxillary sinuses were analyzed and the incidence rate of the sinus septum was 46.9%. 399 (33.5%) sinuses had one or more septa in 279 (46.9%) patients. In addition, maxillary sinus septa incidence showed no significant differences among gender, age, and edentulous type. The segment second molar had the highest incidence rate of septa. Conclusion In this study, a higher incidence of the maxillary sinus septum was found in the northern Chinese, and its distribution varied with its position, morphology, and direction.

The Comparison of Methods for Bone Reconstruction in the Anterior Wall of the Maxillary Sinus (an Experimental Study).

The aim of the study was to compare various methods used for the bone reconstruction in the anterior wall of the maxillary sinus during sinus lift surgery; in addition, we aimed to study the effect of maxillary sinus membrane perforation on the healing process.Materials and MethodsThe experiments were carried out using the North Caucasian sheep. Maxillary sinus lift surgery was performed on the animals under general anesthesia. The skin and muscle fascia were dissected layer-by-layer providing the optimal conditions for bone preparation; then, three bone windows were made on each side of the head. Two windows were sawn out with a spherical bur, the third window — with a hollow bur and part of the anterior wall was taken out. On one side, the mucous membrane of the maxillary sinus was pulled and perforated; on the other side, the sinus lift was performed with no membrane perforation. On each side, one window was left uncovered, the second was closed with a collagen membrane, and the third was closed with a bone cover. After 30 and 60 days, the sheep were taken out of the experiment in groups of three; samples were collected from the operated areas and examined using computed microtomography and histology.ResultsAccording to the histological study, the bone repair process developed normally regardless of the surgery technique. The process started with the appearance of granulation tissue and connective tissue cords; in the final stages, cellular differentiation, pronounced osteoblastic activity, and inter-beam formation were seen.The most active regeneration was observed in the areas where the bone defects were closed with a collagen membrane, and especially in the windows made with no perforation of the maxillary sinus membrane. The microtomographic and histological tests proved that perforation of the mucous membrane during the sinus lift operation impaired bone tissue regeneration.ConclusionThe obtained results suggest that the most promising way to close a bone defect in the anterior wall of the maxillary sinus is the use of a collagen membrane; therefore, we recommend choosing this approach for sinus lift surgery.

The influence of different forms of sinus membrane perforation on the prevalence of postoperative complications in lateral window sinus floor elevation: A retrospective study.

Maxillary sinus membrane perforation (SMP) during lateral window sinus floor elevation (SFE) might be associated with postoperative complications (PC). To evaluate the prevalence of PC and clinical implant outcome for different forms of SMP with lateral window SFE. The prevalence of PC such as maxillary sinusitis, graft necrosis and wound infection was retrospectively evaluated for 434 lateral window SFE (334 patients) with 331 SFE (241 patients) without and 103 SFE (93 patients) with SMP. SMP was additionally classified into four subgroups regarding to membrane perforation size (small-moderate [<10 mm] vs. large [>10 mm]) and membrane biotype ([BT] thin vs. thick). Additionally, patient- and surgery-related risk factors affecting PC and the 1-year implant survival rate were evaluated for SFE without and with SMP and subgroups. A significantly higher prevalence including significant odds ratios of PC such as maxillary sinusitis (10/103 [9.7%] vs. 4/331 [1.2%]; p < 0.021; OR: 8.85; p < 0.021) and graft necrosis (7/103[6.8%] vs. 1/103[0.3%]; p < 0.017; OR:7.43; p < 0.017) was found for SFE with than without SMP. The SMP subgroup with large size and thin BT involved significantly (p < 0.005) more PC (15/20[75%]) than all other SMP subgroups (5/20[25%]). For the risk factors evaluated the univariate analysis demonstrated differences of PC for the presence versus absence of SMP (p < 0.001) and for thin versus thick sinus mucosa (p < 0.038; p < 0.006) but not for sex, smoking, sinus septa and surgical stage. In the multivariate risk factors analysis, PC were significantly related to risk factors such as large size with thin BT (OR:18.049; p < 0.007). The 1-year implant survival rate did not differ between SFE without (99.5%) and with SMP (99.1%), regardless of successfully repaired subtype of SMP. The synopsis of perforation size and membrane biotype is crucial in differentiating different forms of SMP assessing and anticipating different prevalences of PC in lateral window SFE.

Repairing Maxillary Sinus Membrane Perforations, Iatrogenic or Intentional: Two Case Reports

Maxillary sinus augmentation is a common and predictable procedure utilized to gain vertical alveolar bone height to allow for successful placement of dental implants in the deficient posterior maxilla. The surgical techniques, however, may be associated with intraoperative complications, the most common of which is Schneiderian membrane perforation and, less commonly, bleeding and the loss of an implant into the sinus cavity. In the current report, we present two cases with unique complications. A large perforation which was discovered after the graft material had been placed was successfully managed by carefully removing the graft material from both sides of the perforation and sealing the perforation with a resorbable membrane and a tack fixation. The second case involved a patient who presented with an implant that had migrated into the sinus during an unsuccessful transcrestal sinus lift. The case was successfully treated by locating and removing the implant through an intentional membrane perforation, repairing the perforation, and placing a new implant with simultaneous grafting. Management and repair of maxillary sinus membrane perforations that are either intentionally or iatrogenically created can be predictable procedures with favorable outcomes if thoughtful evaluation and treatment are provided. Managing such complications at the time of occurrence avoids unnecessary additional surgical procedures that might prove to be even more complicated.

Closure of an oroantral fistula with a bone fragment during surgical extraction of an impacted maxillary second premolar: A case report

Maxillary sinus membrane perforation commonly occurs during extraction, mostly during an impacted tooth extraction. If left untreated, maxillary sinus perforation can cause several complications. Here, we describe a closure technique of an oroantral fistula using a bone fragment. During the extraction of an impacted maxillary second premolar, the tooth fell into the maxillary sinus. The tooth was removed from the sinus using a transantral approach. A bone fragment of the tooth was obtained and placed in the extraction socket via the transantral entrance and fixed with fibrin glue (Greenplast; Green Cross, Yongin, Korea) to close the oroantral fistula. After 5 months, an immature bone was formed in the sealed area where the bone graft was placed, without any complications.

COMPARATIVE STUDY BETWEEN THE USE OF AMNIOTIC MEMBRANE AND FIBRIN GLUE FOR THE REPAIR OF PERFORATED MAXILLARY SINUS (AN EXPERIMENTAL STUDY)

Introduction: Maxillary sinus membrane perforation is the most common intraoperative complications associated with the sinus lifting procedure. There are various sutureless techniques used in repairing of perforated sinus membrane including; collagen membrane, fibrin sealants, cyanoacrylate adhesives,amniotic membrane and fibringlue. Objectives: The aim of this study was to compare between the use of amniotic membrane and fibrin glue in healing of perforated maxillary sinus in rabbits. MATERIALS AND METHOD: This study was conducted on ten adult healthy male rabbits, with an average weight between 2-3 kgs. A split mouth design was implemented. In each rabbit, the right sinus membrane window was repaired by fibrin glue (group I), while the left sinus membrane window was repaired by amniotic membrane (group II). Results: Histological results revealed that amniotic membrane enhanced faster reepithelialization of maxillary sinus membrane and bone healing where the amount of the newly formed bone observed in group II was greater than that of group I. Histomorphometric analysis showed the increase in the bone surface area mean percentage in group II in comparison to group I. Conclusion: According to the results of the present study, it was concluded that the amniotic membrane is effective in the repair of perforated sinus membrane with superior potentiality than fibrin glue especially in the early stage.

Histomorphometric Analysis of Maxillary Sinus Grafts: A Pilot Study.

This pilot study evaluated and compared the degree of new bone formation following maxillary sinus graft (MSG) using three different bone graft materials. Patients with an edentulous posterior maxilla (unilateral or bilateral) were included in this study and underwent a two-stage procedure. Each sinus was randomly assigned one of the three graft materials: anorganic bovine bone mineral (ABBM), anorganic equine bone mineral (AEBM), or mineralized cancellous bone allograft (MCBA). Bone core samples were obtained from the lateral wall of the grafted sites at least 8 months after MSG. Bone quality was evaluated during bone core retrieval. The samples were histomorphometrically analyzed using Kruskal-Wallis and Dunn-Bonferroni tests at the significance level of α = .05. A total of 28 sinuses (14 unilateral and 7 bilateral) from 21 subjects, with a mean age of 61.5 (range, 33-75) years, were included in the study. Twenty-eight bone cores (ABBM [n = 9], AEBM [n = 9], and MCBA [n = 10]) were obtained at a mean healing time of 9.1 (range, 8-12) months. Six maxillary sinus membrane perforations (≤ 5 mm) were noted and repaired during surgery (21.4%). Histomorphometric analysis of the harvested bone cores revealed statistically significant differences in the percentage of vital bone (VB%), residual bone materials (RBM%), and connective tissue/marrow (CT%) among the different graft materials (Kruskal-Wallis; P < .05). The VB% in the MCBA group (32.0% ± 12.4%) was significantly greater than those in the ABBM (10.9% ± 8.9%) and AEBM (9.1% ± 5.9%) groups (P < .05). The RBM% in the MCBA group (5.5% ± 5.7%) was, however, significantly less than those in the ABBM (34.3% ± 12.1%) and AEBM (38.9% ± 5.3%) groups (P < .05). There were no significant differences in VB% and RBM% between ABBM and AEBM (P = 1.0). Newly formed bone and residual graft materials were integrated into the surrounding tissue with no sign of inflammation or foreign-body reaction. Within the confines of the study, MCBA has significantly greater new bone formation than ABBM and AEBM. AEBM showed comparable histomorphometric results in all parameters (VB%, RBM%, CT%) to ABBM.

Potential risk factors for maxillary sinus membrane perforation and treatment outcome analysis.

Most common complication of sinus floor elevation (SFE) is sinus membrane perforation (SMP). To investigate the correlation between SMP and potential risk factors and to evaluate SMP treatment outcomes. This study included patients who had undergone a SFE at Division of Oral Surgery and Orthodontics, Medical University of Graz from 2013 to 2017. Analysis of patients' records and CBCT focused on patient-related risk factors (sinus contours, thickness of membrane and lateral sinus wall, interfering septa, crossing vessels, former oroantral communication) and intervention-related risk factors (surgical approach, sides, number of tooth units, and sites). The outcome of SMP treatment was analyzed in the recalls. In all, 121 patients underwent 137 SFE. There were 19 cases of SMP (13.9%). Two significant factors were identified: maxillary sinus contours (P = .001) and thickness of the sinus membrane (P = .005). The sinus membrane perforation rate was highest in narrow tapered sinus contours and when the sinus membrane was thinner than 1 mm. Among 19 cases with SMP, no complications were seen upon recall. Maxillary sinus contours and sinus membrane thickness seem to be relevant factors for SMP. Sinus membrane perforations were successfully treated by coverage with collagen membrane.

Histomorphometric Analysis of Maxillary Sinus Grafts: A Pilot Study.

This pilot study evaluated and compared the degree of new bone formation following maxillary sinus graft (MSG) using three different bone graft materials. Patients with an edentulous posterior maxilla (unilateral or bilateral) were included in this study and underwent a two-stage procedure. Each sinus was randomly assigned one of the three graft materials: anorganic bovine bone mineral (ABBM), anorganic equine bone mineral (AEBM), or mineralized cancellous bone allograft (MCBA). Bone core samples were obtained from the lateral wall of the grafted sites at least 8 months after MSG. Bone quality was evaluated during bone core retrieval. The samples were histomorphometrically analyzed using Kruskal-Wallis and Dunn-Bonferroni tests at the significance level of α = .05. A total of 28 sinuses (14 unilateral and 7 bilateral) from 21 subjects, with a mean age of 61.5 (range, 33-75) years, were included in the study. Twenty-eight bone cores (ABBM [n = 9], AEBM [n = 9], and MCBA [n = 10]) were obtained at a mean healing time of 9.1 (range, 8-12) months. Six maxillary sinus membrane perforations (≤ 5 mm) were noted and repaired during surgery (21.4%). Histomorphometric analysis of the harvested bone cores revealed statistically significant differences in the percentage of vital bone (VB%), residual bone materials (RBM%), and connective tissue/marrow (CT%) among the different graft materials (Kruskal-Wallis; P < .05). The VB% in the MCBA group (32.0% ± 12.4%) was significantly greater than those in the ABBM (10.9% ± 8.9%) and AEBM (9.1% ± 5.9%) groups (P < .05). The RBM% in the MCBA group (5.5% ± 5.7%) was, however, significantly less than those in the ABBM (34.3% ± 12.1%) and AEBM (38.9% ± 5.3%) groups (P < .05). There were no significant differences in VB% and RBM% between ABBM and AEBM (P = 1.0). Newly formed bone and residual graft materials were integrated into the surrounding tissue with no sign of inflammation or foreign-body reaction. Within the confines of the study, MCBA has significantly greater new bone formation than ABBM and AEBM. AEBM showed comparable histomorphometric results in all parameters (VB%, RBM%, CT%) to ABBM.

Versatility and Importance of Bichat\'s Fat Pad in Dentistry: Case Reports of Its Use in Occlusal Trauma

The knowledge of the anatomy surrounding Bichat's fat pad, as well as its clinical applications, is essential to indicate and to safely perform its removal. This surgery is indicated not only for esthetic purposes, but also for functional reasons. When used properly, Bichat's fat pad is composed of stem cells that have a similar phenotype to adipose stem cells, useful in the treatment of pathologies and/or complications, such as maxillary sinus membrane perforation, oroantral/oronasal communications, peri-implantitis, ulcers, fibrosis of the oral mucosa, soft tissue reconstruction, among others. Due to its location, it is prone to suffer clinically significant pathologies, as well as constant trauma. The aim of this study is to report two clinical cases and subsequent follow-ups, where bichectomy was performed to avoid dental trauma to mucosal tissues during the masticatory function. Also, literature review on the application of Bichat's fat pad in dentistry is provided. Two female patients (20 and 24 years) reported discomfort and constant pain in the oral mucosa caused by dental trauma. At the clinical examination, patient presented augmented and injured mucosa. The surgical sequence of Bichat's fat pad removal, as well as the extra-/intraoral photographic follow-up (8, 15, 30, and 180 days) of the patients is described. In order to indicate and/or accomplish surgical procedures involving Bichat's fat pad, it is fundamental to know its anatomy and possible applications, not only for esthetic purposes, but also for functional purposes. The patients showed evident improvements following the removal of Bichat's fat pad. Application of Bichat's fat and its removal should be evaluated, being an alternative in patients who constantly undergo mucosal injury during masticatory function.

Assessment of the effectiveness of platelet rich fibrin in the treatment of Schneiderian membrane perforation.

The objective of this study is to evaluate the effect of Platelet rich fibrin (PRF) treatment of maxillary sinus membrane perforation on bone formation and new vascular supply and the success of dental implant survival rate. The dataset for this retrospective study consists of patients who received sinus augmentation using the lateral wall technique. A total of 16 patients (20 sinuses) the patients without sinus membrane perforation (10 maxiller sinus area with sinus floor augmentation) and with Schneiderian perforation (10 maxiller sinus area repairing with PRF and augmented sinus floor area) were included in this study. The bone height was measured by comparing the preoperative and postoperative dental CBCT scans. Histological sections were evaluated for possible vasculogenesis augmented sinuses area. In both groups, it was observed that the possible vasculogenesis augmented sinuses area increased. Implant survival rates in both groups found that one hundred percent and any bone loss around implants were not observed. An apparent increase in alveolar bone height was observed and measured in CBCT scans. PRF can be considered as an alternative material for repairing sinus perforations because it is fully autogenous and easy manipulated.

Preparation of large maxillary sinus membrane perforation using a collagen membrane: retrospective clinical study

Preparation of large maxillary sinus membrane perforation using a collagen membrane: retrospective clinical study

Effect of Maxillary Sinus Membrane Perforation on Implant Survival Rate: A Retrospective Study.

The aim of this retrospective study was to evaluate implant survival rates (ISRs) for implants placed in grafted sinuses where a membrane perforation occurred during augmentation using exclusively anorganic bovine bone (ABB) by means of clinical and radiographic examinations. Histologic information of five biopsy specimens taken from large membrane perforations is also presented. Consecutive patients who underwent sinus augmentation procedures at a private practice Dental Institute between 2004 and 2013 were collected from a computer database. The following profiles were selected for data analysis: computed tomography prior to treatment; perforated membrane information according to size: not perforated, small (≤ 5 mm), medium (> 5 and < 10 mm), or large (≥ 10 mm); sinuses grafted exclusively with ABB and lateral window covered with a collagen membrane (CM); and implant survival after at least 2 years of functional loading placed in augmented sinuses. Implants were considered survivals in the absence of infection, mobility, or pain. The sample in this retrospective study comprised 531 patients; 214 required bilateral sinus augmentation, and 317 required unilateral sinus augmentation (total = 745 sinuses). A total of 1,588 implants were placed. From 745 augmented sinuses, 237 (31.8%; 523 implants) were perforated during the procedure. Among these, 48 perforations were large (20.2%; 107 implants), 67 (28.3%; 150 implants) were medium, and 122 were small (51.5%; 266 implants). Of 523 implants placed in perforated sinuses, 15 were lost (ISR = 97.1%). Comparison of the ISRs for small (97.7%), medium (97.3%), and large (95.3%) perforations with 1,065 implants placed in nonperforated sinuses (ISR = 97.7%) was not statistically significant. The histomorphometric analysis of the five biopsy specimens showed 24.52% ± 6.99% of new bone, 24.32% ± 6.42% of marrow space, and 51.2% ± 3.75% of the remaining ABB. The difference in ISR for implants placed in perforated and nonperforated sinuses was not statistically significant. Within the limits of the histologic data, histomorphometric results with 24.52% ± 6.99% of new bone formation in sinuses with large perforations showed similar bone formation compatible with nonperforated sinuses described in the literature. The authors attributed the high ISR shown in perforated sinuses in this study to the proper management of the perforations.

Incidence of and Factors Associated with Sinus Membrane Perforation During Maxillary Sinus Augmentation Using the Reamer Drilling Approach: A Double-Center Case Series.

Maxillary sinus membrane perforation has been reported as the most common intraoperative complication during sinus augmentation, potentially leading to postoperative infection and consequent loss of graft or even implant failure. Numerous anatomical factors have been demonstrated to affect membrane tearing. However, careful use of proper instrumentation, such as a reamer, seems to play an important role in minimizing the incidence of these complications. Hence, the aim of the present study was to (1) investigate the reliability of reamer drilling for lateral window preparation; (2) examine the incidence of membrane perforation; and (3) study the factors that might influence membrane perforation. Results from this study showed the safety and effectiveness of using a reamer to perform lateral window approach sinus augmentation. The sinus membrane perforation rate was found to be 12.5%. A slightly higher perforation rate was noted in thinner maxillary lateral walls (< 1.25 mm). The authors concluded that reamer drilling is a safe and effective alternate technique for opening the lateral window wall when the lateral wall thickness is ≥ 1.25mm.

Mini-invasive Implant Placement in Combination with Maxillary Sinus Membrane Perforation During Transcrestal Sinus Floor Elevation: A Retrospective Study.

The aim of this retrospective study was to report preliminary outcomes of a modified technique for transcrestal sinus floor elevation with simultaneous implant placement. A total of 165 implants were placed in 110 patients using a modified Summers technique. During implant site preparation, after fracturing the sinus floor, a small perforation of the membrane was made using the first osteotome. After grafting with anorganic bovine bone mixed with venous blood, standard-length implants were inserted. The prosthetic phase occurred after 4 to 5 months. Patients were followed for at least 2 years after loading. During the follow-up, sinus condition was assessed by cone beam computed tomography. Periapical radiographs were taken to assess graft height and peri-implant bone levels. Three implants failed within 2 months of placement, yielding an overall implant survival of 98.2%. The mean follow-up was 38.3 months (range: 28 to 60 months) from placement. All other implants were stable and peri-implant soft tissues were healthy throughout the observation period. Peri-implant bone loss averaged 0.62 ± 0.26 mm after 1 year of function. No biologic or biomechanical complications occurred. No evidence of graft material dispersion into the sinus space was detected, except for two cases that resolved spontaneously. After 1 year of loading the graft height averaged 4.8 ± 1.3 mm above the sinus floor level. In the presence of sinus membrane perforation, the proposed modified osteotome technique may allow a predictable rehabilitation of the atrophic posterior maxilla by means of standard length implants without the occurrence of adverse events.

An Alternative Strategy to Manage a Large Perforation of the Schneiderian Membrane by Staged Re-entry into the Maxillary Sinus: Observed Clinical and Histological Changes of the Regenerated Schneiderian Membrane

Maxillary sinus membrane perforation or tear is the most common complication of the sinus grafting procedure. Repair of the sinus membrane is usually accomplished at the time of the sinus graft procedure and often results in uneventful postoperative complications. However, complications may still arise, especially with large sinus membrane perforations or complete tears that could lead to an infection of the maxillary sinus and other anatomic areas of the maxillofacial complex that could result in bone graft and dental implant failure. An alternative strategy and method to repair the Scheiderian membrane that results in a newly formed fibrotic sinus membrane is described that permits completion of dental implant treatment.

A technique for the treatment of maxillary sinus membrane perforations occurred during endodontic surgery: a prospective comparative evaluation

ObjectivesThe aim of this study was to evaluate the use of PRGF in endodontic surgery to treat sinus membrane perforation. Materials and methodsA total of 20 patients (ten per group) were included. In the control group the lesion of the sinusal membrane was treated with collagen sponge. In the test group PRGF was used to close the communication with the sinus cavity. Results and conclusionsThe use of PRGF resulted in better postoperative quality of life parameters if compared to the negative control group. Perceived pain was significantly lower in the test group than in the control one for the first six days after intervention.

Effect of Maxillary Sinus Membrane Perforation on Vital Bone Formation and Implant Survival: A Retrospective Study

The maxillary sinus augmentation procedure (SAP) using the lateral window technique has been documented to be a highly predictable procedure. However, the most common intraoperative complication has been reported to be maxillary sinus membrane perforation (MSMP). The present study evaluates the percentage of vital bone and implant survival in sinuses that had perforations repaired during surgery versus a non-perforated sinus group. Data were obtained retrospectively from an Institutional Review Board-approved anonymous database at New York University, Kriser Dental Center, Department of Periodontology and Implant Dentistry, New York, New York, from 23 patients who had undergone SAP with a total of 40 treated sinuses. Sinuses were grafted with mineralized cancellous bone allograft, anorganic bovine bone matrix, or biphasic calcium phospate. Perforation complications occurred in 15 sinuses with 25 non-perforated sinuses. All perforations were repaired during surgery with absorbable collagen membrane barriers. Histologic cores were taken from all treated sinuses 26 to 32 weeks after surgery. The implant success rate of 79 placed implants was recorded. The average percentage of vital bone was 26.3% ± 6.3% in the perforated (repaired) sinuses versus 19.1% ± 6.3% in the non-perforated sinuses. The differences were statistically significant (SS). The implant success rate was 100% (35 of 35) compared to 95.5% (43 of 45) in the perforated/repaired vs. non-perforated sinuses, respectively. There was no SS difference in implant failure rates. The augmented sinuses in this study that exhibited MSMPs that occurred during the SAP (which were treated during surgery) show SS greater vital bone percentages compared with the non-perforated sinus group. There were no SS differences in implant survival in the perforated versus non-perforated groups. In this study, sinus MSMPs, when properly repaired during surgery, do not appear to be an adverse complication in terms of vital bone production or implant survival.