The 'double-barrel' approach to the removal of dental implants from the maxillary sinus

The purpose of this article is to present a new surgical technique - the double-barrel approach - employed for the extraction of dental implants from the maxillary sinus, and to compare it with the classic canine fossa puncture (CFP). The surgical steps in the performance of the double-barrel approach (DBA) are systematically described. In order to compare the two techniques (CFP versus DBA), a prospective, randomized study was carried out between 2004 and 2011, comparing the length of duration of the procedure and the incidence of adverse effects. The average duration was 6.3 ± 5.2 min for the DBA group and 14.8 ± 8.4 min for the CFP group (P=0.0001, Mann-Whitney test). Nevertheless, the incidence of adverse effects within the first postoperative week did not differ between the two groups. We have demonstrated that the double-barrel approach is faster, has the same incidence of adverse effects, provides excellent visualization, and permits a more accurate withdrawal of implants in comparison with the classic CFP. It is minimally invasive, requires no sutures, and minimizes the risks to local vascular and neural structures.