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Membrane perforation in sinus floor elevation - piezoelectric device versus conventional rotary instruments for
Juan Seoane1, Javier López-Niño, Lucía García-Caballero
1Senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; postgraduate student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; PhD student, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; senior lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain; lecturer, Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n, Santiago de Compostela, A Coruña, Spain.
Purpose:
Sinus membrane perforation is the most common intraoperative complication of maxillary sinus floor elevation (MSFE) procedures and frequently causes postoperative problems. Piezoelectric devices have been claimed to reduce the frequency of membrane perforations although no clear evidence supports this view.
Materials And Methods:
Ten surgeons with different expertise levels performed 80 MSFEs in selected lamb heads, with rotary and piezoelectric instruments following standard protocols. After the procedures, specimens were coded and perforations or tears determined through a microscope.
Results:
No significant differences in terms of thickness either of the sinus lateral wall (xi -xj = 73.2; 95% confidence interval [CI] = 45.3-191.8) or the membrane (xi -xj = 24.2; 95% CI = -29.4 to 77.9) were identified between the specimens allocated to each group. Nine membrane perforations (11.2%) occurred during the study, all within the lower expertise group. Membrane elevation by hand instruments caused five perforations (40%) in the rotary instrument group and one in the piezoelectric group. Expert surgeons produced no membrane perforations, the size of the antrostomy that was smaller in the piezoelectric group being the only significant difference between the rotary and piezoelectric groups.
Conclusions:
The use of piezoelectric material for MSFE reduces the frequency of membrane perforation among surgeons with a limited experience.
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