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The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure
Shih-Cheng Wen1, Yen-Hua Lin2, Yeuh-Chao Yang2
1Private Practice, Taipei County, Taiwan, China.
Objectives:
Schneiderian membrane perforation is one of the main complications during sinus augmentation. The reasons may be associated with surgical technique, septum, inadequate ridge height, and membrane thickness. However, reports that used cone-beam computed tomography (CBCT) to quantify the thickness of sinus membrane were limited. The aims of this retrospective study were: to study the correlation between membrane thickness and perforation rate during transcrestal sinus lift and to propose a classification system of sinus membrane thickness based upon CBCT data.
Material And Methods:
One hundred and twenty-two subjects who received dental implant restorations over posterior maxilla with a total of 185 transcrestal sinus lift procedures between years 2010 to 2013 were selected consequently. Each patient selected had to have taken CBCT in the initial examination and immediately after surgery. The membrane thickness, perforation rate, residual bone height, and elevated bone height were recorded and processed for statistical analysis.
Results:
The mean thickness of the Schneiderian membrane was 1.78 ± 1.99 mm. There was a significant correlation between membrane thickness and perforation rate (P < 0.05), and the perforation rate was higher in thicker (≥3 mm) and thinner membrane (≤0.5 mm). Among the thickness group, Class B (between ≥1 and <2 mm) had the lowest perforation rate. No significant difference was between the perforation and the membrane morphology. A negative relationship between residual bone height and membrane thickness was found. Trend showed that in the thicker and the thinner residual bone height, the higher the perforation rate would be.
Conclusions:
There was a significant correlation between membrane thickness and perforation rate. The perforation rate was lowest when the thickness was 1.5-2 mm.
Insights
Schneiderian membrane thickness impacts sinus lift success. Thicker or thinner membranes increase perforation risk, with the lowest rates observed between 1.5-2 mm, suggesting a critical thickness for successful sinus augmentation.
Area of Science:
- Dentistry
- Oral Surgery
- Radiology
Background:
- Schneiderian membrane perforation is a common complication in sinus augmentation procedures.
- Factors influencing perforation include surgical technique, septa, bone height, and membrane thickness.
- Limited data exists on quantifying sinus membrane thickness using cone-beam computed tomography (CBCT).
Purpose of the Study:
- To investigate the correlation between Schneiderian membrane thickness and perforation rates during transcrestal sinus lifts.
- To develop a classification system for sinus membrane thickness based on CBCT data.
Main Methods:
- A retrospective study of 122 subjects (185 transcrestal sinus lifts) between 2010-2013.
- CBCT scans were analyzed for membrane thickness, perforation rate, residual bone height, and elevated bone height.
- Statistical analysis was performed to determine correlations.
Main Results:
- The mean Schneiderian membrane thickness was 1.78 ± 1.99 mm.
- A significant correlation between membrane thickness and perforation rate was found (P < 0.05).
- Perforation rates were higher for membranes ≥3 mm and ≤0.5 mm thick, with the lowest rate in the 1-2 mm thickness group (Class B).
Conclusions:
- Schneiderian membrane thickness is significantly correlated with perforation rates during transcrestal sinus lifts.
- Optimal membrane thickness for minimizing perforation risk appears to be between 1.5-2 mm.
