Intraoperative Complications During Sinus Floor Elevation with Lateral Approach: A Systematic Review

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Surgical Complications

Background:

• Sinus floor elevation with a lateral approach is a common procedure in dental implantology.
• Understanding intraoperative complications is crucial for improving surgical outcomes.
• Various surgical techniques and devices are employed for lateral antrostomy.

Purpose of the Study:

• To analyze the incidence of intraoperative complications during lateral sinus floor elevation.
• To investigate the correlation between surgical techniques and complication rates.

Main Methods:

• A systematic review of 21 randomized clinical trials and 11 prospective controlled clinical trials.
• Searched electronic and manual databases for studies on sinus floor elevation.
• Assessed risk of bias using Cochrane and Downs and Black tools.

Main Results:

• Sinus membrane perforation (15.7%) and vascular-related hemorrhage (0.4%) were the primary complications.
• Rotary instruments had a higher perforation rate (20.1%) compared to ultrasonic devices (10.9%) and bone scrapers (6.0%).
• Erosion of the lateral antral wall with ultrasonic devices showed the lowest perforation rate (4.7%).

Conclusions:

• Sinus membrane perforation is the most frequent intraoperative complication in lateral sinus floor elevation.
• Thinning the sinus lateral wall with ultrasonic devices or bone scrapers may reduce perforation risk.
• Further high-quality randomized clinical trials are needed to investigate intraoperative complications.