Prevalence, risk factors, and repair mechanism of different forms of sinus membrane perforations in lateral window sinus lift procedure: A retrospective cohort study

• Published in: Clinical implant dentistry and related research Vol. 23; no. 6; pp. 821 - 832
• Main Authors: Krennmair, Stefan, Gugenberger, Alexander, Weinländer, Michael, Krennmair, Gerald, Malek, Michael, Postl, Lukas
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2021; Wiley Subscription Services, Inc
• Subjects: Cohort analysis; Evaluation; Humans; lateral window; Maxillary Sinus; Membranes; Multivariate analysis; Patients; Perforation; Prevalence; repair mechanism; Retrospective Studies; Risk analysis; Risk Factors; Septum; Sinus Floor Augmentation - adverse effects; sinus membrane perforation; Sinuses; Subgroups; sinus membrane perforation; lateral window; repair mechanism
• ISSN: 1523-0899; 1708-8208
• DOI: 10.1111/cid.13016

Objectives To evaluate prevalences, affecting risk factors and efforts for repair mechanism for different forms of sinus membrane perforations (SMP) during sinus floor elevation (SFE) using the lateral window technique (LWT). Material and methods For 334/434 patients, SFE undergoing LWT prevalence of SMP was retrospectively evaluated including a subselection based on membrane perforation size (<10 mm: small–moderate/≥10 mm: large) and biotype (BT; thick BT/thin BT) into four subgroups (SMP1: thick BT/small–moderate; SMP2: thin BT/small–moderate; SMP3: thick BT/large; SMP4: thin BT/large). For the various subgroups, patient‐ and surgery‐related/anatomic risk factors affecting SMP were evaluated and the scope of sinus membrane repair (SSMR) mechanisms rated with 1 (easy) to 5 (complex) was compared. Results For 103/434 SMP (27.6%) in 93/334 patients (30.8%) the prevalence of various forms of SMP differed significantly (p < 0.001) among the four subgroups. SMP4 with a prevalence of 45.6% (n = 47) was the most frequent type, while SMP3 had low prevalence with 4.85% (n = 5). Small/moderate SMPs with thick (SMP1: n = 26) or thin BT (SMP2: n = 23) were seen in 26.2% and 23.3%, respectively. Univariate analysis showed significant differences between subgroups with large perforations (SMP3/SMP4) and those with small/moderate perforations (SMP1/SMP2) regarding anatomic risk factors such as residual ridge height (p = 0.023) and history of previous oral surgical interventions (OSI; p = 0.026). Most evidently, multivariate analysis showed that induction of large SMP with thin biotype (SMP4) was significantly affected by the presence of sinus septa (p < 0.022, OR: 2.415), reduced residual ridge height (p < 0.001, OR: 1.842), and previous OSI (p < 0.001, OR: 4.545). SSMR differed significantly (p < 0.001) between SMP4 (4.62 ± 0.49) and the subgroups SMP1 (1.11 ± 0.32), SMP2 (1.08 ± 028), and SMP3 (2.2 ± 0.55). Conclusion The most frequently found type of SMP had characteristics of thin biotype and large size associated with risk factors such as sinus septa, reduced residual ridge, and previous surgical interventions and required challenging repair mechanisms assessing clinical impact.