Sinus Lift Surgery Research Articles

The influence of suturing and or gluing of perforated Schneiderian membrane during sinuslift procedure on the outcome: a retrospective study

The sinus lift procedure has become the most common method for maxillary bone augmentation. The most frequently observed intraoperative complication is the perforation of the Schneiderian membrane. Various treatment options have been proposed for managing these perforations, including the use of resorbable membranes, centrifugated blood products as PRF, or PRGF, suturing, and fibrin glue application. While long-term studies exist for the use of resorbable membranes to close perforations, there is limited data on the long-term outcomes of suturing or gluing the perforated sinus membrane. The aim of this retrospective study is to evaluate the long-term outcomes of suturing and/or applying fibrin glue to repair perforated sinus mucosa during sinus floor elevation procedures. Between 2005 and 2009, a total of 692 patients underwent 923 sinus lift surgeries, and Schneiderian membrane perforation occurred in 202 sinus floor elevations (21.98%) across 168 patients. The main documented causes of perforations, which ranged from 2 to 10 mm in diameter, were the presence of septa, followed by thin and adherent membranes. Of the perforations, 100 (49.5%) were treated with microsurgical suturing combined with fibrin glue, 78 (38.6%) were treated with fibrin glue alone, and 24 (11.9%) were treated exclusively with suturing. Sinus grafting was performed using autogenous bone in combination with a biomaterial, following the layering technique. All surgeries resulted in primary healing without complications, enabling all patients to undergo restoration as planned. The long term clinical and radiological evaluations of 44 randomly selected patients who followed the recall program up to 10 years post operative confirmed the effectiveness of this treatment approach.

Analysis of bone quality formation in sinus lifts with immediate implants

Sinus lift surgeries are part of the daily practice of dentists. This study evaluates the long-term structure of the bone placed in sinus lifts through the fractal dimension. We conducted a retrospective study on a sample of 35 patients with 51 sinus lifts performed using a lateral window approach and filling material placement. We radiologically analyzed the graft bone to observe its evolution up to one and a half years after the surgical procedure. The obtained results were the average area of the sinuses analyzed was 1401.96 mm2, with a mean area occupied by the filling material of 297.75 mm2. Significant differences are observed when comparing the fractal dimension values obtained on the initial day and one year after prosthesis loading. Similarly, when comparing the values of the area occupied by the biomaterial at the start day and one year after prosthesis loading, significant differences are also obtained (p-value < 0.001). In conclusion, the filling material used in the lateral window sinus lift procedure undergoes significant resorption and shows changes in the fractal dimension.

Accuracy of graft volume assessment for sinus lift surgeries using automatically driven virtual patient

Accuracy of graft volume assessment for sinus lift surgeries using automatically driven virtual patient

Maxillary sinus lift augmentation: A randomized clinical trial with histological data comparing deproteinized bovine bone grafting vs graftless procedure with a 5-12-year follow-up.

Different protocols and procedures for sinus lift and implant placement are available, generally involving the use of grafts to increase the tissue volume and/or prevent the Schneiderian membrane from collapsing. Among xenografts, deproteinised bovine bone graft (DBBP) is frequently used in sinus lift procedures. Leaving an ungrafted space following membrane elevation has proven to have a bony regenerative potential as well. This study aimed to compare the clinical and histological features of sinus lift surgery performed with or without biomaterials. Patients with severe maxillary posterior atrophy (residual bone height 2-6 mm and residual crest thickness ≥4 mm), and in need of sinus lift surgery to allow the placement of three implants were enrolled and randomly divided into two groups. They underwent sinus lifts with DBBP (control) or with a graftless technique (test) and immediate placement of two implants (a mesial and distal one). After 6 months, a bone sample was retrieved from the area between the previously inserted fixtures, and a third, central implant was placed. The collected bone samples were analyzed morphologically and histomorphometrically. The patients were provided with prosthetic restorations after 6 months and followed up for 5-12 years. Ten patients were enrolled in the test and nine in the control group. The 6-month follow-up showed in the control group an average augmentation of 10.31 mm (±2.12), while in the test group it was 8.5 mm (±1.41) and a success rate of 96.3% in the control and 86.7% in the test group (p > 0.05). The histological analysis evidenced the presence of new bone tissue surrounded by immature osteoid matrix in the test group, and a variable number of DBBP particles surrounded by an immature woven bone matrix in the control group. The results of the present trial indicate that, with residual bone height of 2-6 mm and residual crest thickness ≥4 mm, sinus lift surgery with or without biomaterials followed by implant restoration, produces similar clinical and histological outcomes.

Influence of Schneiderian Membrane Perforation on Implant Survival Rate: Systematic Review and Meta-Analysis.

Background: Maxillary sinus lift is a well-documented and accepted technique in the rehabilitation of the posterior maxilla. Schneiderian membrane perforation is the most common complication and may occur in between 7% and 56% of cases. Different materials and techniques have been described to achieve reparation of the perforation. The aim of this study was to establish whether the perforation of the Schneiderian membrane and its repair during maxillary sinus lift surgery results in a lower implant survival rate compared to those cases where the membrane has not been perforated. Materials and methods: A systematic review and meta-analysis of studies assessing the survival rate of implants placed in regenerated sinus using the lateral window approach, where the perforation of the Schneiderian membrane occur, was carried out. Statistical analysis was performed with Open Meta-Analyst, calculating the odds ratio of implants placed in perforated sinuses and non-perforated sinuses. Results: Ten articles were included in the qualitative analysis and seven articles in the quantitative analysis or meta-analysis. A total of 1224 maxillary sinus augmentation surgeries were performed without perforation of the Schneiderian membrane and 2725 implants were placed; 62 implants failed during the follow-up period with an overall survival rate of 97.7%. In 480 perforated sinuses, 1044 implants were placed, of which 30 failed; the overall survival rate was 97.1%. There were no significant differences between the implant survival rate of the implants in the two groups (OR = 0.78; CI = 0.49-2.23; p = 0.28 and I2 heterogeneity: 0%, p = 0.44). Conclusions: Schneiderian membrane perforation, as long as it is repaired, does not appear to negatively influence implant survival rate. Membrane perforation should not be considered a reason to abort the procedure or an absolute contraindication to implant placement.

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis.

Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, that no longer creates any known concerns. The effectiveness PRF's has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed "Summary of findings" tables and used GRADE to evaluate the evidence. Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for ensuring predictable success periodontal regenerative procedures.

The use of an innovative technique for perforations of the mucous membrane of the maxillary sinus during the sinus lift operation

Introduction. To date, according to WHO, the number of people with a complete absence of teeth is greater than 8% of all the people worldwide. Loss of teeth due to complications of caries treatment, chronic periodontitis and trauma leads to atrophy of the alveolar ridge and that of soft tissues in this area, which in turn complicates the rehabilitation of the patients. According to the literature, in the first year after tooth extraction, the volume of the bone tissue of the alveolar ridge decreases by 40–60%, which greatly complicates the subsequent orthopedic rehabilitation of the patients. Currently, the «gold standard» for increasing the volume of the bone tissue of the alveolar ridge of the upper jaw in the distal section is the sinus lift operation. However, according to the literature, when sinus lift operation is performed, Schneider’s membrane perforation occurs in 7–23% of cases, which in terms, leads to the inability to complete the operation and complications in cases with total perforations of membrane.Purpose of the study. To evaluate the complex rehabilitation of patients with partial secondary absence of teeth and severe atrophy in the lateral sections of upper jaw using the «envelope technique» during open sinus lifting.Materials and methods. In 2020–2022, during a clinical study at the clinic of the Department of maxillofacial and plastic surgery of the Moscow State Medical University named after A.I. Evdokimov, 54 patients who had a history of PPI interventions in the ENT department were treated. All patients underwent bilateral open sinus lifting using enamel matrix proteins or the «envelope technique» for perforation of the Schneider membrane. After 9–12 months, a comprehensive rehabilitation of patients based on dental implants was carried out.Results. The number of extensive (total) perforations of the Schneider membrane in the study group of patients was 50%. As a result of the use of the patented «envelope technique» with the use of enamel matrix proteins, no postoperative complications were observed in patients with total perforation of the Schneider membrane. Taking into account the planned orthopedic design, 292 dental implants were installed in all patients.Conclusion. The method is effective and safe, allowing to rehabilitate patients with missing teeth and severe atrophy in the lateral part of the upper jaw, in case of intraoperative total perforation of the Schneiderian membrane.

Texture Analysis of Hard Tissue Changes after Sinus Lift Surgery with Allograft and Xenograft

In the realm of dental surgery, implants are essential for replacing missing teeth. To facilitate implant placement, techniques such as bone grafting and sinus lifts are utilized to augment the volume of atrophied alveolar bone in candidates for dental implants. Typically, patients undergo a period of recovery following bone grafts before proceeding with implant placement. This study investigates the efficacy of Cone Beam Computed Tomography (CBCT) in measuring the residual bone volume and assessing bone quality after the healing phase. A texture analysis was conducted on CBCT scans from 42 patients requiring maxillary sinus lift reconstruction. These patients were categorized into two groups based on the type of grafting material used: Xenograft or allograft. The study analyzed the distribution of various texture parameters and conducted a Mann-Whitney U test to identify significant statistical differences between the groups. Results indicated non-normal distributions for specific variables such as Area_S(1,0) and S(1,0)SumOfSqs, while others like S(1,0)Entropy displayed normal distributions. The findings revealed no significant statistical differences in the primary outcomes between the xenograft and allograft groups. However, the average values of the gray shades of pixels in the allograft group were statistically significantly higher compared to the xenograft group, suggesting differences in bone texture post-procedure.

Effectiveness of Autologous Platelet Concentrates in the Sinus Lift Surgery: Findings from Systematic Reviews and Meta-Analyses.

Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended.

Association between sinus septa and lateral wall thickness with risk of perforation during maxillary sinus lift surgery: A systematic review and meta-analysis.

Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation. This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager. Ten studies with 1865 patients undergoing 2168 "lateral" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness. Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.

Elimination of defects in the Schneiderian membrane during sinus lift operations

Evaluation of the effectiveness of a new method of plasty of an extensive defect in the mucous membrane of the Schneiderian membrane, which occurs during the sinus lift operation, using an artificial collagen membrane and a developed method for fixing it. A total of 188 patients took part in the study, all of these patients underwent an open sinus lift operation with simultaneous or delayed implantation. Operations were performed under balanced anesthesia. Six months after the operation, according to computed tomography, the height of the formed bone regenerate was estimated. In the area of each missing tooth, the initial bone height and the resulting bone grafting were assessed. Then we compared the average values before and after the operation, the average height difference before and after the operation. In 19 patients during the sinus lift there was an accidental extensive rupture of the mucous membrane of the maxillary sinus. Elimination of the mucosal defect was carried out according to our patented method. All 188 patients were diagnosed with partial loss of teeth with bone tissue deficiency in the distal maxillary sinus. The height of the alveolar process in the projection of missing teeth ranged from 0.5 mm to 5 mm. Delayed dental implantation was performed when the height of the alveolar bone was less than 3 mm, direct when the presence of 3-5 mm. After 6 months, dental implants were installed in the reconstruction zone, after another 6 months - rational prosthetics. The proposed method of plastic surgery has the following advantages. Firstly, it allows to eliminate the defect of the mucous membrane together with an increase in the height of the alveolar ridge. Secondly, after this method, the integrity of the mucous membrane will be restored. Thirdly, with an alveolar bone height of 3 mm or more, dental implants should also be installed.

Comparison of two graft procedures in a bilateral sinus lift by MRI and histomorphometric analysis: a case report

Magnetic resonance imaging (MRI) was shown to be a viable method for graft healing evaluation. Platelet-rich fibrin (PRF) was found to speed up bone graft healing process. Sinus lift surgery outcomes after healing period are usually performed with computerized tomography that is not capable to describe graft vascularization and exposes patient to ionizing radiation. The objective of this study is to propose contrast-enhanced magnetic resonance imaging (CE-MRI) as a promising method for the in vivo assessment of sinus lift grafting procedures. A bilateral sinus augmentation surgery was performed. Left sinus was grafted only with bovine deproteinized bone mixed in a 1:1 ratio with autologous bone, in the right sinus, the same biomaterials with the addition of platelet-rich fibrin (PRF) were applied. CE-MRI was performed to evaluate angiogenesis before surgery and at 11, 25, 53, and 104 days after surgery. At 6 months (T0) and after 10 years (T1), before dental implants insertion, bone biopsies were performed and analysed quantitatively. Left sinus graft showed a centripetal pattern of angiogenesis, with the central region remaining unvascularized at 104 days post-surgery. Right side showed a wider and homogeneous vascularization from 25 days after surgery. At T0 new bone formation was only peripheral in the left sinus, whereas it developed both peripherally and through biomaterial in the right sinus. At T1 particles of biomaterial were still present in left sinus, while in right sinus they were not. CE-MRI offers quantitative parameters to evaluate vascularization of biomaterials. The addition of PRF promotes an early development of a widespread vascular system.

Maxillary Sinus Lift Procedures: An Overview of Current Techniques, Presurgical Evaluation, and Complications.

A maxillary sinus lift procedure is indicated if a dental implant needs to be placed in the posterior maxilla with limited bone available to accommodate a dental implant. Both open and closed sinus lifting procedures are reliable approaches for increasing the bone volume needed to support proper implant positioning. However, these methods can lead to several complications. In addition to the general complications commonly linked to oral surgery, such as swelling or hematoma, the primary complication in open sinus lifting is typically the perforation of the Schneiderian membrane during osteotomy. Detailed and extensive presurgical evaluation is crucial to minimize such complications. The objective of this study was to delineate contemporary trends in sinus lift surgery, with a specific emphasis on different techniques of sinus lift procedure, anatomical and surgical factors, presurgical evaluation, bone grafting, and the practical implications of these factors in implant dentistry cases involving a deficient posterior maxilla. In conclusion, while both osteotome and lateral window techniques can assist clinicians in addressing the complexities of implant placement in a deficient posterior maxilla, bone height before implantation remains a critical factor in determining the success and longevity of implants.

Trends in Maxillary Sinus Filling Using a Lateral Surgical Approach

Dental rehabilitation using osseointegrated implants is a routine for dentists. Maxillary sinus lift surgery is essential in expanding the indications for dental implants, as it re-establishes adequate bone volume for the installation of implants in the ideal areas in the middle posterior portion of maxillae that have undergone the physiological process of pneumatization. This article describes the chronology of this technique and its increase over time.

Clinical efficacy of titanium prepared platelet rich fibrin in periodontal regeneration: A systematic review and meta-analysis

Background: Periodontal regeneration therapies frequently involve autologous platelet concentrates (APCs). They can be used in sinus lift surgeries and socket preservation, among other clinical settings. Platelet rich fibrin (PRF) membrane has been used to treat gingival recession in individuals or groups of individuals using a coronally progressed or lateral pedicle flap. In the treatment of mixed periodontic endodontic lesion/furcation defect, PRF functions as a healing and interpositional biomaterial, filling a cystic cavity. PRF is known to help the bone regeneration process. In the last few years, efforts have been made to enhance the PRFs characteristics and quality. One of them is titanium platelet rich fibrin (T-PRF). Third-generation platelet concentrate no longer contains silica, and its preparation in glass vacuum containers, no longer creates any known concerns. The effectiveness PRF's has been evaluated in connective tissue and bone repair. The aim of this study is to compare T-PRF to other platelet concentrates and different treatment modalities for periodontal regenerative procedures. Methods: A protocol of this systematic review have been registered in prospero (CRD42022293545). The online database searched were PUBMED, COCHRANE for published articles up to November 2022 without language restrictions. Studies in trial registers, handsearching, bibliographic references of relevant articles were also checked. Data collection and analysis was done by individual authors. Independent eligibility assessments were conducted by four review authors. Then, using the standard Cochrane methodology, four review authors extracted the data and evaluated the risk of bias for individual studies. We developed "Summary of findings" tables and used GRADE to evaluate the evidence. Results: Three studies were included for meta-analysis. Results of meta-analysis supported that T-PRF is effective for correction of both hard and soft tissue defects. Conclusions: The overall qualitative and quantitative analysis suggest that T-PRF has superior structural properties and thicker fibrin network for periodontal regenerative procedures.

Clinical evaluation of antral septal maxillary sinus floor elevation by the disk-up sinus reamer

Objective: To investigate the clinical effect of disk-up sinus reamer (DSR) in maxillary sinus floor elevation with maxillary sinus septum. Methods: Twenty-four patients were included between January 2019 to January 2020 in Department of Oral Implantology, The Affiliated Hospital of Qingdao University. There were 10 males and 14 females with the age of (39.3±11.7) years old (range 22-56 years). Pre-operative(T0) cone-beam CT (CBCT) was taken for measurement and analysis. All patients were divided into group E (easy situations, septum located anterior to the zygo-matic process), group M (moderate situations, septum located pos-terior to the zygo-matic process) and group D (difficult situations, sagittally oriented septum). The maxillary sinus floor was grafted through the crestal approach by DSR and implants were placed simultaneously. Permanent repair was performed 6-8 months after operation. All patients underwent CBCT before surgery, after surgery immediately (T1), 6 months after surgery(T2), 1 year after surgery(T3), 2 year after surgery(T4). The residual bone height (RBH) and the vertical bone height (VBH) were analyzed. The mucosal perforation rate, implant survival rate were counted. Results: All the 24 patients completed the Maxillary sinus lift surgery successfully and 24 implants were placed simultaneously. All patients had no headache, dizziness. The mucosal perforation rate was 0. The survival rate of implants during the healing period was 100%(24/24). The RBH was (5.81±2.56) mm pre-operation, the VBHT1, VBHT2, VBHT3 and VBHT4 were (11.82±1.09), (10.98±0.52), (10.66±0.44) and (10.40±0.33) mm, respectively. The differences between the groups by pairing test were statistically significant (F=187.70, P0.001), expect VBHT3 and VBHT4 (P=0.071). Bone resorption and remodeling mainly occurred 1 year after surgery. One patient developed peri-implantitis 18 months after surgery. Conclusions: With the RBH of implant site>2 mm and existence of maxillary sinus septum, using DSR for sinus floor elevation has a high success rate. It can obtain enough bone height and complete the simultaneous implantation to form a good osseointegration. The DSR is simple, safe and controllable, and can shorten the operation time.

A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation.

The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 ± 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 ± 0.126, and test group with a mean of 0.092 ± 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.

Evaluation of the effect of direct sinus lift surgery on maxillary sinus volume by Mimics software.

Sinus lift surgery allows sufficient volume of bone to be created in the posterior part of the maxilla. The aim of this study was to investigate the changes in maxillary sinus volume after a sinus lift and the rate of increase in ridge height at the site of the graft. Eleven patients were chosen for sinus lift from among those who were referred to the radiology department for implant placement in the posterior region of the maxilla and whose bone height at the posterior of the maxilla was less than 4 mm on the cone-beam computed tomography (CBCT) image. The sinus volume was measured after importing the CBCT file in DICOM format into Mimics software. After determining the sinus volume, the patients underwent sinus lift surgery, and the amount of material used during the surgery was measured. After the time required to repair the area, the CBCT image was taken again. Then, the changes in the volume of the maxillary sinus and the increase in the height of the maxillary ridge at the surgical site were calculated. Then, the second stage of the surgery was performed to place the implant at the implant site. For an average of 1.40 cm3 of material, the rate of increase in ridge height was 10.52 mm, and the average change in sinus volume was 1.19 cm3. CBCT images and Mimics software have many applications in examining and predicting parameters before and after sinus lift surgery.

Sinonasal Complications Following the Sinus Lift Procedure.

Background: Although the incidence of postoperative acute and chronic rhinosinusitis in patients undergoing a sinus lift procedure is relatively high, a paucity of rhinology literature examines the management of and outcomes for this patient population. The objective of this study was to review the management and postoperative care of sinonasal complications and identify possible risk factors that should be considered prior to and following sinus augmentation. Methods: We identified sequential patients who had undergone a sinus lift procedure and were referred to the senior author (AK) at a tertiary rhinology practice for intractable sinonasal complications and reviewed their charts for demographic data, history of illness including prereferral treatment, examination findings, imaging results, treatment modalities, and culture results. Results: Nine patients were initially treated medically without improvement and subsequently underwent endoscopic sinus surgery. The sinus lift graft material remained intact in 7 patients. Two patients had extrusion of the graft material into the facial soft tissues, resulting in facial cellulitis requiring graft removal and debridement. Seven of the 9 patients had predisposing factors that could have prompted referral to an otolaryngologist for optimization prior to sinus lifting. The mean follow-up was 10 months, and all patients had full resolution of symptoms. Conclusion: Acute and chronic rhinosinusitis is a complication of the sinus lift procedure and is more commonly seen in patients with preexisting sinus disease, anatomic sinonasal obstruction, and Schneiderian membrane perforation. Preoperative evaluation by an otolaryngologist may improve outcomes in patients at risk of sinonasal complications from sinus lift surgery.

CBCT assessment of the integration of xenograft mixed with plasma rich in growth factors (PRGF) in direct maxillary sinus lift surgery: Case series study

CBCT assessment of the integration of xenograft mixed with plasma rich in growth factors (PRGF) in direct maxillary sinus lift surgery: Case series study