Videoscope-assisted lateral maxillary sinus floor elevation: evaluation of the Schneiderian membrane for micro-perforations

Abstract

Introduction: Sinus floor elevation procedures are of a moderate to high complexity, entailing a significant risk of complications. The most frequent and common intra-operative complication is perforation of the sinus membrane. For the lateral window technique, perforation rates of 10% to 20% have been documented. Several studies have reported a correlation between perforation of the membrane and failure of the graft, as well as post-operative infection. In order to help identify perforations early, the authors evaluated the Schneiderian membrane for micro-perforations. The purpose of this case series was to identify the incidence of micro- perforations during lateral maxillary sinus elevation surgery. Case Series: Lateral maxillary sinus floor elevation was performed on 8 patients. A surfactant solution was applied topically to the exposed Schneiderian membrane. The presence of micro- perforations was assessed by observing for a bubbling effect after slight positive pressure. Evaluations were recorded using a videoscope, which provided magnification and additional lighting at the surgical site. Data was collected after evaluation of the membrane intra- operatively; post-operatively, the recordings of the procedure were randomised and evaluated by three periodontists. Conclusion: Use of a surfactant solution and videoscope evaluation did not reveal any incidence of micro-perforations on the Schneiderian membrane during lateral sinus lift.