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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation

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Managing Antral Wall Discontinuities in Sinus Elevation Surgery.

Joseph F Capetillo¹, Thomas M Johnson², Dane T Swenson³

¹Department of Periodontics, United States Army Dental Health Activity, Fort Hood, TX.

Clinical Advances in Periodontics

|February 18, 2020

Summary

Antral wall discontinuity (AWD) can increase the risk of Schneiderian membrane perforation during sinus elevation surgery. Preoperative identification of AWD is crucial for surgical planning and patient safety.

Keywords:

Allografts Schneiderian membrane dental implants maxillary sinus palate

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Area of Science:

Dentistry
Oral Surgery
Radiology

Background:

Schneiderian membrane perforation (SMP) is a common complication during sinus elevation surgery.
Antral wall discontinuity (AWD) may increase the likelihood and severity of SMP.

Observation:

A case of AWD in the palatine process of the maxilla during sinus elevation is presented.
The osseous defect was managed, and the Schneiderian membrane was dissected.
Postoperative cone-beam computed tomography (CBCT) showed favorable sinus augmentation.

Findings:

AWD, characterized by the fusion of the Schneiderian membrane with the maxillary periosteum, is identifiable on preoperative CBCT.
This condition can elevate the incidence and severity of SMP during sinus elevation procedures.

Implications:

Preoperative assessment of antral wall integrity is essential.
The presence of AWD may necessitate surgical plan modifications or contraindicate sinus elevation surgery.