Bone Regeneration After Sinus Floor Elevation in an Intact Sinus or a Sinus With Prior Large Membrane Perforation: A...

Area of Science:

• Oral and Maxillofacial Surgery
• Periodontology
• Regenerative Medicine

Background:

• Sinus floor elevation (SFE) is a common procedure to augment bone in the posterior maxilla.
• Sinus membrane integrity is often a concern during SFE, with perforations potentially impacting outcomes.
• Understanding bone regeneration after SFE with prior membrane perforation is crucial for predictable results.

Purpose of the Study:

• To evaluate and compare bone regeneration following SFE in rabbit models with and without previous large sinus membrane perforations.
• To assess the impact of an 8-week healing period post-perforation on subsequent SFE bone formation.

Main Methods:

• Intentional large perforations (≥5 mm) were created in rabbit sinus membranes, treated with a collagen matrix, and allowed to heal for 8 weeks.
• Sinus floor elevation was performed in both perforated and intact sinuses.
• Micro-computed tomography and histomorphometric analyses were conducted at 2 and 4 weeks post-SFE.

Main Results:

• No significant difference in the total amount of newly formed bone within the augmented area was observed between the perforated and intact sinus groups at 2 and 4 weeks.
• A significantly greater amount of new bone formed near the sinus membrane's middle in the intact sinus group compared to the perforated group.
• Augmented volume remained consistent, but the perforated group showed fewer subepithelial glands and denser collagen fibers in the sinus membrane.

Conclusions:

• A large sinus membrane perforation, followed by an 8-week healing period, does not negatively impact overall new bone formation after sinus floor elevation.
• The findings suggest that SFE can be successfully performed even after significant sinus membrane injury, provided adequate healing time.