Patients and methods : Crestal endoscopic approach for evaluating sinus membrane elevation technique [2]
After completing the elevation of the Schneiderian membrane, the endoscope (70° lens) was removed from the lateral wall of the maxillary sinus and re-inserted (with 0°) from the crestal osteotomy site of the implant (Fig. 4) to check the integrity of the Schneiderian membrane, as well as to ensure the absence of any undetected minor perforation (Fig. 5). The implant was finally inserted in the osteotomy site to gradually lift the membrane under total endoscopic guidance from the same lateral sinus trephined hole to ensure again unperforated sinus lining from the lifting procedure during implant insertion. Afterwards, the endoscope was removed from the lateral sinus hole, and the small trephined part of bone was placed back to its original place in the buccal wall and soft tissue closed with interrupted sutures.
The sinus membrane patterns were classified into three types: flat, irregular and polyp. The membrane thickness was measured preoperatively using CBCT. The mean thickness was measured at the proposed implant osteotomy site. Patients were divided into two groups according to membrane thickness (Table 1):
Group A (4 cases): includes membrane thickness less than 2 mm
Group B (8 cases): includes membrane thickness more than 2 mm
Mucosal thickening was classified according to the criteria adopted from Soikkonen and Ainamo as follows [11]:
Flat: shallow thickening without well-defined outlines.
Semi-aspherical: thickening with well-defined outlines rising in angle of > 30° from the floor or the walls of the sinus.
Mucocele-like: complete opacification of the sinus.
Other mucosal thickening types or pathological findings.
Perforation occurrence was clinically monitored and recorded using the endoscopic evaluation through crestal osteotomy site. As it is a new method, we confirmed the evaluation endoscopically through a small trephined hole in the lateral sinus wall. Perforation occurrence was statistically compared to membrane thickness and type using pair-wise test, whereas Mann-Whitney U test was used for comparison between membrane thickness of different morphologies (Figs. 6 and 7). Chi-square was also used to show perforation rate among different groups and different morphologies.
Serial posts:
- Introduction : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Patients and methods : Crestal endoscopic approach for evaluating sinus membrane elevation technique [1]
- Patients and methods : Crestal endoscopic approach for evaluating sinus membrane elevation technique [2]
- Results : Crestal endoscopic approach for evaluating sinus membrane elevation technique [1]
- Results : Crestal endoscopic approach for evaluating sinus membrane elevation technique [2]
- Discussion : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- References : Crestal endoscopic approach for evaluating sinus membrane elevation technique [1]
- References : Crestal endoscopic approach for evaluating sinus membrane elevation technique [2]
- Acknowledgements : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Author information : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Ethics declarations : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Rights and permissions : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- About this article : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Table 1 Descriptive statistics of membrane thickness and perforation rate : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Table 2 Chi square test showing perforation rate among different groups : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Table 3 Descriptive statistics, results of Kruskal-Wallis and Mann-Whitney U tests for comparison between membrane thicknesses of different morphologies : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Table 4 Chi square test showing perforation rate by different morphologies : Crestal endoscopic approach for evaluating sinus membrane elevation technique
- Fig. 1. A trephined hole (4 mm bone) in the lateral wall of the maxillary sinus to allow entrance of the endoscope : Crestal endoscopic approach for evaluating sinus m
- Fig. 2. Malleting instruments supplied from InnoBioSurg (IBS) Company, Korea. a magic sinus splitter: used to widen and split the crest. b magic sinus lifter: used to lift the available bone with its attached membrane : Crestal endoscopic approach for evaluating sinus m
- Fig. 3. Endoscopic view from the lateral sinus wall showing the dome-shape elevation of sinus lining : Crestal endoscopic approach for evaluating sinus m
- Fig. 4. Schematic drawing showing entrance of the endoscope from the crestal osteotomy site after sinus membrane elevation to assess the integrity of the membrane : Crestal endoscopic approach for evaluating sinus m
- Fig. 5. Endoscopic view from the crestal osteotomy site showing perforation of the sinus lining under the power of magnification and illumination of the endoscope : Crestal endoscopic approach for evaluating sinus m
- Fig. 6. Box plot representing mean values of membrane thicknesses for the investigated groups : Crestal endoscopic approach for evaluating sinus m
- Fig. 7. Box and Whisker plot representing median and range values of membrane thicknesses with different morphologies : Crestal endoscopic approach for evaluating sinus m