This Presentation was Sponsored by New York University Department of Implant Dentistry Alumni Association (NYUDIDAA) and the Office for International Programs  

INTRODUCTION    Insufficient  alveolar  bone  height  and  proximity  to  the  sinus  floor  are  o9en  limita:ons  for  implant  placement  in  the  posterior  maxilla.   Maxillary   sinus   augmenta:on   has   demonstrated   a   high   success   rate   and   is   rou:nely   used   to   enable   implant  placement.  Despite  its  predictability,  the  technique  has  poten:al  to  develop  complica:ons  jeopardizing  the  final  outcomes  .  Perfora:on  of  the  Schneiderian  membrane  is  the  most  frequently  reported  complica:on  with  incidence  rate  ranging  from  10  to  44%.  Several  protocols  have  been  described  to  repair  sinus  membrane  perfora:ons.  However,  these  procedures  are  technique  sensi:ve  and  likely  to  increase  surgical  and  healing  :me.  The  purpose  of  this  case  series  with  histological  reports  is  to  present  a  simple  novel  technique  to  treat  large  perfora:ons  of  the  sinus  membrane  during  lateral  window  sinus  floor  eleva:on  with  a  collagen  sponge,  associate  with  a  re-­‐entry  procedure  3-­‐6  weeks  following  the  repair.  MATERIALS  AND  METHODS  Retrospec:ve   data   on   consecu:ve   pa:ents   who   had   received   sinus   augmenta:on   using   the   lateral   window   approach  technique,   and   in   whom   large   Schneiderian   membrane   perfora:ons   occurred   (>10   mm)   were   included.   A   total   of   15  pa:ents  (15  sinuses,  8  female,  7  males)  were  included,  age  ranged  from  35  to  75  years  (mean:  53.5  years).  

RESULTS  Clinical  assessment  of  the  healed  membranes  revealed  complete  closure  and  significant  membrane  thickening  in  80%  of  the  cases.   Although   the   remaining   20%   showed   small   residual   perfora:ons,   an   increase   in   the   membrane   thickness   was  recorded  in  all  cases.  Histology  finding  showed  connec:ve  :ssue  forma:on  with  li\le  inflammatory  responses.      CONCLUSIONS  Two  years   follow-­‐up  of   15  pa:ents  demonstrated  100%   implant   success   rate.   Thickening  of   the   Schneiderian  membrane  lead  to  an  easier  procedure  and  a  reduc:on  in  the  :me  between  repair  and  re-­‐entry  surgery.  Within  the  limita:ons  of  this  case   series,   the   presented   protocol   appeared   to   be   a   simple   and   reliable   alterna:ve   to   treat   large   sinus   membrane  perfora:ons.  More  cases  and  clinical  comparisons  are  necessary  to  validate  the  result  of  the  study.  

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Wang, Wendy; Shu-Wei Kuo; Amma Boateng; Shalin Vinayak; Paul Yung Cheng Yu

Arthur Ashman Department of Periodontology and Implant Dentistry New York University College of Dentistry