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Schneiderian membrane perforation repair using a crosslinked collagen membrane: a retrospective cohort study
Daya Masri1,2, Ehud Jonas3,4, Omar Ghanaiem3,4
1Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. dr.dayamasri@gmail.com.
Objectives:
Perforation of the Schneiderian membrane (SM) is a common intraoperative complication of sinus augmentation. This study aimed to evaluate risk factors for SM perforation, and to compare clinical outcomes between patients with SM perforation repaired using crosslinked collagen membranes (CLM) compared to those with an intact SM.
Methods:
A retrospective cohort study was conducted at a single tertiary medical center. Data was collected on patients requiring sinus augmentation via lateral approach prior to implant placement. The collected data included demographics, surgical details, implant outcomes, radiographic analysis, and presence of SM perforation. In cases of perforation a CLM was used to repair the SM. Statistical analysis was performed to evaluate risk factors for perforation and whether SM perforation repair using CLM influenced early implant failure (EIF). A p-value < 0.05 was considered significant.
Results:
Data on 194 individuals who underwent 278 lateral approach sinus augmentation procedures was collected. SM perforation occurred in 66 (23.74%) sinuses. Treatment of SM perforation using CLM yielded similar results to sinuses without perforations: EIF and the augmented gained bone did not correlate with SM perforation. Younger patients, and thick SMs (> 3 mm) had significantly lower risk of perforation.
Conclusions:
Older age and thinner SMs are risk factors for sinus membrane perforations. No significant differences in bone gain and EIF were found between perforated and intact membranes.
Clinical Relevance:
Schneiderian membrane perforation repair using crosslinked collagen membrane provides comparable results to sinus augmentations without perforations, demonstrating its effectiveness in preventing complications.
Insights
Sinus membrane perforations during augmentation are common. Repairing them with crosslinked collagen membranes (CLM) shows similar bone gain and early implant failure rates compared to intact membranes, indicating CLM effectiveness.
Area of Science:
- Oral and Maxillofacial Surgery
- Periodontology
- Dental Implantology
Background:
- Perforation of the Schneiderian membrane (SM) is a frequent complication during sinus augmentation procedures.
- Identifying risk factors and effective management strategies for SM perforation is crucial for successful implant outcomes.
Purpose of the Study:
- To identify risk factors associated with SM perforation during lateral approach sinus augmentation.
- To compare clinical outcomes, including early implant failure (EIF) and bone gain, between patients with SM perforation repaired by crosslinked collagen membranes (CLM) and those with intact SMs.
Main Methods:
- A retrospective cohort study involving 194 patients and 278 sinus augmentation procedures.
- Data collection included patient demographics, surgical details, SM status (perforated or intact), CLM use for repair, and implant outcomes.
- Statistical analysis was performed to determine risk factors for perforation and compare outcomes between groups.
Main Results:
- SM perforation occurred in 23.74% of the procedures.
- Younger age and thicker SMs (>3 mm) were associated with a significantly lower risk of perforation.
- No significant differences in EIF or augmented bone gain were observed between sinuses with CLM-repaired perforations and intact SMs.
Conclusions:
- Older age and thinner SMs are identified as risk factors for sinus membrane perforations.
- Repair of SM perforations with CLM is an effective technique, yielding comparable clinical outcomes to sinus augmentations without perforations.
