Surgical management after perforation of Schneider's membrane during sinus lift: case report

Authors

DOI:

https://doi.org/10.33448/rsd-v9i10.9425

Keywords:

Sinus floor augmentation; Dental implants; Maxillofacial surgery; Intraoperative complications.

Abstract

Treatment with dental implants has been used to rehabilitate toothless patients through the fixed prosthesis on implants. In the maxilla, the alveolar bone may be compromised by bone resorption and pneumatization of the maxillary sinus, resulting in insufficient bone height for the implant installation. Thus, the lifting of the maxillary sinus (sinus lift) is a technique that allows the gain of bone volume in the posterior region of the maxilla, enabling rehabilitation with implants. This study aims to highlight a case where Schneider's membrane was perforated during a sinus lift and resolved during the operation. A 63-year-old male patient sought dental care complaining about his removable dental prostheses and longing to replace them with fixed prostheses on implants. On clinical and imaging examination, pneumatization of the maxillary sinus and insufficient bone height were found to install implants in the posterior region of the maxilla. The patient underwent a right maxillary sinus lift and during the procedure there was a 6mm perforation of the Schneidarian Membrane. This complication was solved by suturing the membrane to a perforation in the lateral bone wall of the maxillary sinus, which allowed the procedure to continue and be successful. It is concluded that the perforation of the Schneider membrane during the sinus lift procedure is a common trans-surgical complication and depending on the size of the perforation, there is a more appropriate approach to be performed. The technique chosen by the professional should be based on his clinical experience and scientific evidence.

References

Barone, A., Santini, S., Sbordone, L., Crespi, R., & Covani, U. (2006). A clinical study of the outcomes and complications associated with maxillary sinus augmentation. International Journal of Oral and Maxillofacial Implants, 21(1), 81-85.

Herzberg, R., Dolev, E., & Schwartz-Arad, D. (2006). Implant Marginal Bone Loss in Maxillary Sinus Grafts. International Journal of Oral & Maxillofacial Implants, 21(1), 103-110.

Krennmair, G., Krainhöfner, M., Schmid-Schwap, M., & Piehslinger, E. (2007). Maxillary sinus lift for single implant-supported restorations: a clinical study. The International journal of oral & maxillofacial implants, 22(3), 351–358.

Lee, J. E., Jin, S. H., Ko, Y., & Park, J. B. (2014). Evaluation of anatomical considerations in the posterior maxillae for sinus augmentation. World journal of clinical cases, 2(11), 683–688. https://doi.org/10.12998/wjcc.v2.i11.663

López, C. S., Saka, C. H., Rada, G., & Valenzuela, D. D. (2016). Impact of fixed implant supported prostheses in edentulous patients: protocol for a systematic review. BMJ open, 6(2), e009288. https://doi.org/10.1136/bmjopen-2015-009288

Medeiros, M. S. ., Marcelino, K. P. ., Oliveira Júnior, J. C. de ., Moreira Junior, L. C., Freire, J. C. P. ., Dantas, E. M. ., Barbosa, G. A. S. ., Gondim, A. L. M. F. ., Dias-Ribeiro, E., & Almeida Neto, L. F. de . (2020). Instalação de implantes dentários simultâneo a realização de Sinus Lift: Relato de Caso. Research, Society and Development, 9(10), e2869108462. https://doi.org/10.33448/rsd-v9i10.8462

Misch, C. E. (1999). The maxillary sinus lift and sinus graft surgery. Contemporary Implant Dentistry. Chicago, IL: Mosby, 469-495.

Mohan, N., Wolf, J., & Dym, H. (2015). Maxillary sinus augmentation. Dental Clinics, 59(2), 375-388.https://doi.org/10.1016/j.cden.2014.10.001

Peñarrocha-Diago, M. A., Maestre-Ferrín, L., Demarchi, C. L., Peñarrocha-Oltra, D., & Peñarrocha-Diago, M. (2011). Immediate versus nonimmediate placement of implants for full-arch fixed restorations: a preliminary study. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 69(1), 154–159. https://doi.org/10.1016/j.joms.2010.07.083

Probst, L. F., Vanni, T., Cavalcante, D., Silva, E., Cavalcanti, Y. W., Passeri, L. A., & Pereira, A. C. (2019). Cost-effectiveness of implant-supported dental prosthesis compared to conventional dental prosthesis. Revista de saude publica, 53, s1518-8787.2019053001066. https://doi.org/10.11606/s1518-8787.2019053001066

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

Raja, S. V. (2009). Management of the posterior maxilla with sinus lift: review of techniques. Journal of Oral and Maxillofacial Surgery, 67(8), 1730-1734.

Schwartz‐Arad, D., Herzberg, R., & Dolev, E. (2004). The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. Journal of periodontology, 75(4), 511-516.

Scott, R. A. (2012). ITI treatment guide, volume 5: sinus floor elevation procedures. British Dental Journal, 212(10), 512-512.

Summers R. B. (1994). The osteotome technique: Part 2--The ridge expansion osteotomy (REO) procedure. Compendium (Newtown, Pa.), 15(4), 422–436

Tatum H., Jr (1986). Maxillary and sinus implant reconstructions. Dental clinics of North America, 30(2), 207–229.

Vazquez, J. C. M., de Rivera, A. S. G., Gil, H. S., & Mifsut, R. S. (2014). Complication rate in 200 consecutive sinus lift procedures: guidelines for prevention and treatment. Journal of Oral and Maxillofacial Surgery, 72(5), 892-901.

Published

30/10/2020

How to Cite

MARCELINO, K. P.; SOUZA, J. A. N. de; RIBEIRO, D. T.; DANTAS, E. M.; BARBOSA, G. A. S.; GONDIM, A. L. M. F.; ALMEIDA NETO, L. F. de. Surgical management after perforation of Schneider’s membrane during sinus lift: case report. Research, Society and Development, [S. l.], v. 9, n. 10, p. e9959109425, 2020. DOI: 10.33448/rsd-v9i10.9425. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/9425. Acesso em: 26 apr. 2024.

Issue

Section

Health Sciences