Surgical Complications Associated to Maxillary Sinus Floor Elevation in Implantology

Authors

  • Deisy E. Quispe Damián DDS, MSc Especialista, Periodoncia e Implantología, Universidad Científica del Sur, Lima, Perú. Author
  • Carmen T. Castro-Ruiz DDS, MSc Profesora, Especialidad de Periodoncia e Implantología, Universidad Científica del Sur, Lima, Perú. Author
  • Gerardo Mendoza Azpur DDS, MSc Coordinador, Especialidad de Periodoncia e Implantología, Universidad Científica del Sur, Lima, Perú. Author

DOI:

https://doi.org/10.15517/ijds.2020.39253

Keywords:

Maxillary Sinus; Sinus Floor; Sinus Floor Augmentation; Membrane; Septum.

Abstract

Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.

Downloads

Download data is not yet available.

References

Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clin N Am. 1986; 30 (2): 207-229. DOI: https://doi.org/10.1016/S0011-8532(22)02107-3

Boyne P. J., James R. A. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980; 38 (8): 613-616.

Summers R. B. The osteotome technique: part 4–future site development. Compend Contin Educ Dent. 1995; 16 (11): 1090, 92 passim; 94-96, 98, quiz 99.

Bornstein M. M., Chappuis V., von Arx T., Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients. Clinical Oral Implants Res 2008; 19: 1034-1043. DOI: https://doi.org/10.1111/j.1600-0501.2008.01573.x

Chan H. L., Monje A., Suarez F., Benavides E., Wang H. L. Palatonasal recess on medial wall of maxillary sinus and clinical implications for sinus augmentation via lateral window approach. J Periodontol 2013; 84: 1087-1093.

Galindo-Moreno P., Padial-Molina M., Avila G., Rios H. F., Hernández-Cortés P., Wang H. L. Complications associated with implant migration into the maxillary sinus cavity. Clin Oral Implants Res. 2012; Oct; 23 (10): 1152-60. DOI: https://doi.org/10.1111/j.1600-0501.2011.02278.x

Von Arx T., Fodich I., Bornstein M. M., Jensen S. S. Perforation of the sinus membrane during sinus floor elevation: a retrospective study of frequency and possible risk factors. Int J Oral Maxillofac Implants. 2014; 29 (3): 718-26. DOI: https://doi.org/10.11607/jomi.3657

Sharan A., Madjar D. Maxillary sinus pneumatization following extractions: A radiographic study. Int J Oral Maxillofac Implants. 2008; 23: 48-56.

Tepper G., Haas R., Schneider B., et al.Effects of sinus lifting on voice quality. Aprospective study and risk assessment. Clin Oral Implants Res. 2003; 14: 767-774. DOI: https://doi.org/10.1046/j.0905-7161.2003.00957.x

Galindo-Moreno P., Moreno-Riestra I., Ávila-Ortiz G., et al. Predictive factors for maxillary sinus augmentation outcomes: A case series analysis. Implant Dent. 2012; 21: 433-440. DOI: https://doi.org/10.1097/ID.0b013e3182691959

Velasco-Torres M., Padial-Molina M., Avila-Ortiz G., et al. Maxillary Sinus Dimensions Decrease as Age and Tooth Loss Increase. Implant Dent 2017; 26: 288-295. DOI: https://doi.org/10.1097/ID.0000000000000551

Velasco-Torres M., Padial-Molina M., Alarcón J. A., et al. Maxillary sinus dimensions with respect to the posterior superior alveolar artery decrease with tooth loss. Implant Dent. 2016; 25: 464-470.

Sharan A., Madjar D. Maxillary sinus pneumatization following extractions: A radiographic study. Int J Oral Maxillofac Implants. 2008; 23: 48-56.

Tolstunov L., Thai D., Arellano L. Implant-guided volumetric analysis of edentulous maxillary bone with cone beam computerized tomography scan maxillary sinus pneumatization classification. J Oral Implantol. 2012; 38: 377-390. DOI: https://doi.org/10.1563/AAID-JOI-D-11-00212

Barak M. M., Lieberman D. E., Hublin J. J. A Wolff in sheep’s clothing: Trabecular bone adaptation in response to changes in joint loading orientation. Bone. 2011; 49: 1141-1151. DOI: https://doi.org/10.1016/j.bone.2011.08.020

Chappard D., Basle M. F., Legrand E., et al. Trabecular bone microarchitecture: A review. Morphologie. 2008; 92: 162-170. DOI: https://doi.org/10.1016/j.morpho.2008.10.003

Al-Moraissi E., Elsharkawy A., Abotaleb B., Alkebsi K., Al-Motwakel H. Does intraoperative perforation of Schneiderian membrane during sinus lift surgery causes an increased the risk of implants failure? A systematic review and meta regression analysis. Clin Implant Dent Relat Res. 2018; 20 (5): 882-889. DOI: https://doi.org/10.1111/cid.12660

Insua A., Monje-Gil F., Garcia-Caballero L., Caballe-Serrano J., Wang H. L., Monje A. Mechanical characteristics of the maxillary sinus Schneiderian membrane ex vivo. Clin Oral Investig. 2018; 22 (3):1139-1145. DOI: https://doi.org/10.1007/s00784-017-2201-4

Schwartz-Arad D., Herzberg R., Dolev E. The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. J Periodontol. 2004; 75 (4): 511-516. DOI: https://doi.org/10.1902/jop.2004.75.4.511

Levin L., Herzberg R., Dolev E., Schwartz-Arad D. Smoking and complications of onlay bone grafts and sinus lift operations. Int J Oral Maxillofac Implants. 2004; 19 (3): 369-373.

Nkenke E., Schlegel A., Schultze-Mosgau S., Neukam F. W., Wiltfang J. The endoscopically controlled osteotome sinus floor elevation: a preliminary prospective study. Int J Oral Maxillofac Implants. 2002; 17 (4): 557-566.

Proussaefs P., Lozada J., Kim J., Rohrer M. D. Repair of the perforated sinus membrane with a resorbable collagen membrane: a human study. Int J Oral Maxillofac Implants. 2004; 19 (3): 413-420.

Ardekian L., Oved-Peleg E., Mactei E. E., Peled M. The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus. J Oral Maxillofac Surg. 2006; 64(2):277-282. DOI: https://doi.org/10.1016/j.joms.2005.10.031

Froum S. J., Khouly I., Favero G., Cho S. C. Effect of maxillary sinus membrane perforation on vital bone formation and implant survival: a retrospective study. J Periodontol. 2013; 84 (8): 1094-1099. DOI: https://doi.org/10.1902/jop.2012.120458

Proussaefs P., Lozada J., Kim J. Effects of sealing the perforated sinus membrane with a resorbable collagen membrane: a pilot study in humans. J Oral Implantol. 2003; 29 (5): 235-241. DOI: https://doi.org/10.1563/1548-1336(2003)029<0235:EOSTPS>2.3.CO;2

Hernandez-Alfaro F., Torradeflot M. M., Marti C. Prevalence and management of Schneiderian membrane perforations during sinus-lift procedures. Clin Oral Implants Res. 2008; 19 (1): 91-98. DOI: https://doi.org/10.1111/j.1600-0501.2007.01372.x

Kim Y. K., Hwang J. Y., Yun P. Y. Relationship between prognosis of dental implants and maxillary sinusitis associated with the sinus elevation procedure. Int J Oral Maxillofac Implants. 2013 ; 28 (1): 178-183. DOI: https://doi.org/10.11607/jomi.2739

Al-Dajani M. Incidence, risk factors, and complications of Schneiderian membrane perforation in sinus lift surgery: a meta-analysis. Implant Dent. 2016; 25 (3): 409-415. DOI: https://doi.org/10.1097/ID.0000000000000411

Chan H. L., Wang H. L. Sinus pathology and anatomy in relation to complications in lateral window sinus augmentation. Implant Dent. 2011; 20: 406-412. DOI: https://doi.org/10.1097/ID.0b013e3182341f79

Elian N., Wallace S., Cho S. C., et al. Distribution of the maxillary artery as it relates to sinus floor augmentation. Int J Oral Maxillofac Implants. 2005; 20: 784-787.

Stern A., Green J. Sinus lift procedures: An overview of current techniques. Dent Clin North Am. 2012; 56: 219-233. DOI: https://doi.org/10.1016/j.cden.2011.09.003

Morant J. J., Salvado M., Hernandez- Giron I., et al. Dosimetry of a cone beam CT device for oral and maxillofacial radiology using Monte Carlo techniques and ICRP adult reference computational phantoms. Dentomaxillofac Radiol. 2013; 42 (3): 92555893. DOI: https://doi.org/10.1259/dmfr/92555893

Naitoh M., Katsumata A., Nohara E., et al. Measurement accuracy of reconstructed 2-D images obtained by multi-slice helical computed tomography. Clin Oral Implants Res. 2004; 15: 570-574. DOI: https://doi.org/10.1111/j.1600-0501.2004.01034.x

Hayek E., Nasseh I., Hadchiti W., et al. Location of posterosuperior alveolar artery and correlation with maxillary sinus anatomy. Int J Periodontics Restorative Dent. 2015; 35: e60-e65. DOI: https://doi.org/10.11607/prd.2172

Velasco-Torres M., Padial-Molina M., A. Alarcón J., O’Valle F., Catena A., Galindo Moreno P. Maxillary sinus dimensions with respect to the posterior superior alveolar artery decrease with tooth loss. Implant Dent. 2016; 25 (4): 464-70. DOI: https://doi.org/10.1097/ID.0000000000000445

Cho S. C., Wallace S. S., Froum S. J., Tarnow D. P. Influence of anatomy on Schneiderian membrane perforations during sinus elevation surgery: three-dimensional analysis. Pract Proced Aesthet Dent. 2001; 13: 160-163.

Chan H. L., Monje A., Suarez F., Benavides E., Wang H. L. Palatonasal recess on medial wall of the maxillary sinus and clinical implications for sinus augmentation via lateral window approach. J Periodontol. 2013; 84 (8): 1087-1093. DOI: https://doi.org/10.1902/jop.2012.120371

Niu L., Wang J., Yu H., Qiu L. New classification of maxillary sinus contours and its relation to sinus floor elevation surgery. Clin Implant Dent Relat Res. 2018; 20 (4): 493-500. DOI: https://doi.org/10.1111/cid.12606

Underwood, A. S. An inquiry into the anatomy and pathology of the maxillary sinus. J. Anat. Physiol. 1910; 44: 354-69.

Malec M., Smektała T., Trybek G., Sporniak-Tutak K. Maxillary sinus septa: prevalence, morphology, diagnostics and implantological implications. Systematic review. Folia Morphol 2014; 73 (3): 259-266. DOI: https://doi.org/10.5603/FM.2014.0041

Maestre-Ferrín L., Galán-Gil S., Rubio-Serrano M., PeñarrochaDiago M., Peñarrocha-Oltra D. Maxillary sinus septa: a systematic review. Med Oral Patol Oral Cir Bucal. 2010; 15 (2): 383-386. DOI: https://doi.org/10.4317/medoral.15.e383

Irinakis T., Dabuleanu V., Aldahlawi S. Complications During Maxillary Sinus Augmentation Associated with Interfering Septa: A New Classification of Septa. The Open Dentistry Journal, 2017; 11, 140-150. DOI: https://doi.org/10.2174/1874210601711010140

Lee W. J., Lee S. J., Kim H. S. Analysis of location and prevalence of maxillary sinus septa. J Periodontal Implant Sci. 2010; 40 (2): 56-60. DOI: https://doi.org/10.5051/jpis.2010.40.2.56

Qian L., Tian X. M., Zeng L., Gong Y., Wei B. Analysis of the morphology of maxillary sinus septa on reconstructed cone-beam computed tomography images. J Oral Maxillofac Surg. 2016; 74: 729-737. DOI: https://doi.org/10.1016/j.joms.2015.11.019

Maestre-Ferrín L., Carrillo-García C., Galán-Gil S., Peñarrocha-Diago M., Peñarrocha-Diago M. Prevalence, location, and size of maxillary sinus septa: panoramic radiograph versus computed tomography scan. J Oral Maxillofac Surg. 201; 69 (2): 507-11. DOI: https://doi.org/10.1016/j.joms.2010.10.033

Monje A., Urban I. A., Miron R. J., Caballe-Serrano J., Buser D., Wang H. L. Morphologic Patterns of the Atrophic Posterior Maxilla and Clinical Implications for Bone Regenerative Therapy.Int J Periodontics Restorative Dent. 2017; 37 (5): e279-e289. DOI: https://doi.org/10.11607/prd.3228

Park S. H., Brooks S. L., Oh T. J., Wang H. L. Effect of ridge morphology on guided bone regeneration outcome: Conventional tomographic study. J Periodontol 2009; 80: 1231-1236. DOI: https://doi.org/10.1902/jop.2009.090090

Garaicoa C., Suarez F., Fu J. H., et al. Using cone beam computed tomography angle for predicting the outcome of horizontal bone augmentation. Clin Implant Dent Relat Res 2015; 17: 717-723. DOI: https://doi.org/10.1111/cid.12174

Monje A., Monje F., González-García R., Suarez F., Galindo-Moreno P., García nogales A., Wang H. L. Influence of atrophic posterior maxilla ridge height on bone density and microarchitecture. Clin Implant Dent Relat Res. 2015; 17 (1): 111-9. DOI: https://doi.org/10.1111/cid.12075

Ulm C., Kneissel M., Schedle A., et al. Characteristic features of trabecular bone in edentulous maxillae. Clin Oral Implants Res 1999; 10: 459-467. DOI: https://doi.org/10.1034/j.1600-0501.1999.100604.x

Trisi P., Rao W. Bone classification: clinical-histomorphometric comparison. Clin Oral Implants Res 1999; 10: 1-7. DOI: https://doi.org/10.1034/j.1600-0501.1999.100101.x

Rios, H.F., Avila, G., Galindo, P., Bratu, E. & Wang,H.-L. (2009) The influence of remaining alveolar bone upon lateral window sinus augmentation implant survival. Implant Dentistry 18: 402-412. DOI: https://doi.org/10.1097/ID.0b013e3181b4af93

Khalighi Sigaroudi A., Dalili Kajan Z., Rastgar S., Neshanqdar Asli H. Frequency of different maxillary sinus septal patterns found on cone-beam computed tomography and predicting the associated risk of sinus membrane perforation during sinus lifting. Imaging Sci Dent. 2017; 47 (4): 261-267. DOI: https://doi.org/10.5624/isd.2017.47.4.261

Van Zyl A. W., Van Heerden W. F. A retrospective analysis of maxillary sinus septa on reformatted computerized tomography scans. Clin Oral Implants Res. 2009; 20 (12): 1398-401. DOI: https://doi.org/10.1111/j.1600-0501.2009.01802.x

Gosau M., Rink D., Driemel O., Draenert F. G. Maxillary sinus anatomy: a cadaveric study with clinical implications. Anat Rec (Hoboken). 2009; 292 (3): 352-4. DOI: https://doi.org/10.1002/ar.20859

Ella B., Noble Rda C., Lauverjat Y., Sédarat C., Zwetyenga N., Siberchicot F., Caix P. Septa within the sinus: effect on elevation of the sinus floor. Br J Oral Maxillofac Surg. 2008; 46 (6): 464-7. DOI: https://doi.org/10.1016/j.bjoms.2008.01.016

Neugebauer J., Ritter L., Mischkowski R. A., Dreiseidler T., Scherer P., Ketterle M., Rothamel D., Zöller J. E. Evaluation of maxillary sinus anatomy by cone-beam CT prior to sinus floor elevation. Int J Oral Maxillofac Implants. 2010; 25 (2): 258-65.

Kim M. J., Jung U. W., Kim C. S., Kim K. D., Choi S. H., Kim C. K., Cho K. S. Maxillary sinus septa: prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol. 2006; 77 (5): 903-8. DOI: https://doi.org/10.1902/jop.2006.050247

Raghoebar G. M., Onclin P., Boven G. C., Vissink A., Meijer H. J. A. Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis. J Clin Periodontol. 2019; 21: 307-318. DOI: https://doi.org/10.1111/jcpe.13055

Takeda D., Hasegawa T., Saito I., Arimoto S., Akashi M., Komori T. A radiologic evaluation of the incidence and morphology of maxillary sinus septa in Japanese dentate maxillae. Oral Maxillofac Surg. 2019; 23 (2): 233-237. DOI: https://doi.org/10.1007/s10006-019-00773-2

Published

2026-06-15