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Published on: June 20, 2018
Association between sinus septa and lateral wall thickness with risk of perforation during maxillary sinus lift
Baohua Yang1, Tiantian Wang1, Yuzhen Wen2
1Department of Stomatology, Zibo Central Hospital, Zibo City, Shandong Province, China.
Objective:
Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation.
Methods:
This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager.
Results:
Ten studies with 1865 patients undergoing 2168 "lateral" sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169/425 cases (39.76%) with sinus septa and 184/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I2 = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness.
Conclusions:
Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.
Insights
Sinus septa significantly increase the risk of perforation during sinus lift surgery, though evidence quality is very low. Lateral wall thickness did not show a clear association with perforation risk due to conflicting data.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Anatomical Research
Background:
- Sinus membrane perforation is a frequent complication during sinus lift procedures.
- Understanding anatomical risk factors is crucial for improving surgical outcomes.
Purpose of the Study:
- To investigate the influence of anatomical factors, specifically sinus septa and lateral wall thickness, on the risk of sinus membrane perforation during sinus lift surgery.
Main Methods:
- A systematic review and meta-analysis of studies published up to June 2024 was conducted.
- Data from 10 studies involving 1865 patients and 2168 sinus lift procedures were analyzed.
- Random-effects meta-analysis was used to determine the odds ratio (OR) for perforation based on the presence of septa.
Main Results:
- The overall incidence of sinus membrane perforation was 19%.
- Perforation occurred in 39.76% of cases with septa versus 12.33% without septa.
- Sinus septa were significantly associated with a 4.03-fold increased risk of perforation (OR: 4.03, 95% CI: 1.77, 9.19), with high heterogeneity (I2 = 87%).
- Evidence quality for septa was very low.
- Data on lateral wall thickness was too heterogeneous for meta-analysis, showing conflicting results.
Conclusions:
- The presence of sinus septa significantly elevates the risk of membrane perforation in maxillary sinus lift surgery, based on very low-quality evidence.
- Current evidence regarding the association between lateral wall thickness and perforation risk is conflicting, precluding definitive conclusions.
