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J Periodontol. 2010 Jan;81(1):167-71. doi: 10.1902/jop.2009.090190.

The effect of piezoelectric use on open sinus lift perforation: a retrospective evaluation of 56 consecutively treated cases from private practices.

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Private practice, Washington, DC, USA.



The lateral window approach to maxillary sinus augmentation is a well-accepted treatment option in implant dentistry. The most frequent complication reported with traditional techniques has been the perforation of the Schneiderian membrane, with perforation rates ranging from 11% to 56%. The purpose of this retrospective, consecutive case series from two private practices was to report on the rate of Schneiderian membrane perforations and arterial lacerations when a piezoelectric surgical unit was used in conjunction with hand instrumentation to perform lateral window sinus elevations.


Clinical data (Schneiderian membrane perforation, Underwood septa, and laceration of the lateral arterial blood supply to the maxillary sinus) were obtained retrospectively from two private practices and pooled for analysis. The information was collated after an exhaustive chart review. Fifty-six consecutively treated lateral window sinus lifts were performed on 50 partially or completely edentate patients.


Zero perforations of the Schneiderian membrane occurred during the piezoelectric preparation of the lateral antrostomies, whereas two perforations were noted during subsequent membrane elevations using hand instrumentation. In both instances, membrane perforations were associated with sinus septa. The overall sinus perforation rate was 3.6%. Arterial branches of the posterior superior alveolar artery were encountered in 35 cases, and there were zero instances of arterial laceration.


This retrospective case series from clinical private practices confirmed that a lateral window approach to sinus elevation incorporating piezoelectric technology in conjunction with hand instrumentation was an effective means to achieve sinus elevation while minimizing the potential for intraoperative complications. Further prospective and randomized controlled studies are warranted to qualify these observations.

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