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J Oral Maxillofac Surg. 2014 Jan;72(1):47-52. doi: 10.1016/j.joms.2013.07.020. Epub 2013 Sep 24.

Correlation between Schneiderian membrane perforation and sinus lift graft outcome: a retrospective evaluation of 359 augmented sinus.

Author information

1
Attending Surgeon, Division of Oral and Maxillofacial Surgery, Montefiore Medical Center, Bronx, NY.
2
President, EXTRAPOLATE, LLC, Delray Beach, FL.
3
Chairman, Department of Dentistry; Director, Oral and Maxillofacial Surgery Residency Program, Montefiore Medical Center, Bronx, NY. Electronic address: chrclark@montefiore.org.

Abstract

PURPOSE:

The aim of this study was to estimate the incidence of sinus membrane perforation in maxillary sinus augmentation surgery using a lateral approach and the impact of sinus integrity on incidence of sinusitis and bone graft survival in the maxillary sinus.

PATIENTS AND METHODS:

A total of 359 sinus augmentation procedures (208 patients) were evaluated retrospectively for sinus integrity during augmentation, complications, graft failure, and implant loss.

RESULTS:

The incidence of sinus membrane perforation was 41%. There was an overall sinus graft failure rate of 6.7%; of the failed sinus grafts, 70.8% had a perforated sinus membrane at augmentation. There were 11.3% of sinuses with perforated membranes at graft placement that failed compared with 3.4% of sinuses with intact membranes failing (general linear model [GLM], P = .003). Age, gender, and provider type were not significantly associated with sinus integrity at 1 year. Overall, 11.3% of sinuses with perforated membranes at graft placement required secondary antibiotics for sinusitis and infection compared with 1.4% of sinuses with intact membranes (GLM, P < .0006). Of the sinuses requiring secondary antibiotics, 30% failed compared with 5% of untreated sinuses (GLM, P = .0071). Of the sinuses developing sinusitis or secondary infection requiring antibiotics, 85% had a membrane perforation during augmentation compared with 39.2% of those not requiring antibiotics; gender, age, and provider were not associated with antibiotic use.

CONCLUSIONS:

In the present study, antibiotic use for postoperative sinusitis and infection and graft failure were shown to be statistically higher in sinuses with perforated membranes at augmentation.

PMID:
24071378
DOI:
10.1016/j.joms.2013.07.020
[Indexed for MEDLINE]
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