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Results : Crestal endoscopic approach for evaluating sinus membrane elevation technique [1]

Results : Crestal endoscopic approach for evaluating sinus membrane elevation technique [1]

author: Samy Elian, Khaled Barakat | publisher: drg. Andreas Tjandra, Sp. Perio, FISID

All patients tolerated the procedure without major complications. Minor complications included postoperative swelling, edema, and pain that were managed by antibiotic and anti-inflammatory drugs. All implants were successfully osseo-integrated and loaded after about 6 months.

The floor was lifted without perforation in 83.33% of cases. The lifter was able to raise and stretch the sinus membrane safely. However, it varied according to the thickness of the membrane.

The direct observation of the sinus membrane showed that it is stretchable and can be easily elevated in eight cases where the membrane morphology was classified as thick (group B), whereas in the other four cases (group A), the membrane was thin and hardly accepted the lifting procedure (Tables 1 and 2).

Mann-Whitney U test (Table 3) was used for comparison between membrane thickness and the three different morphologies. It showed a statistically significant difference between the three membrane patterns. The polyp type showed the highest statistically significantly mean membrane thickness when compared to the flat or irregular shapes, whereas the flat and irregular membranes showed no differences between their mean membrane thickness. Chi-square test (Tables 2 and 4) showed that perforation rate in different morphologies was near to significant that could be attributed to the small sample size who accepted to do a window on the lateral sinus wall.

The membrane was successfully raised under direct endoscopic guidance. Regarding the elevation technique, the perforation was monitored in two cases (16.67%) under the extraordinary magnification of the endoscope. One case was early detected from the lateral approach, whereas both cases were detected from the crestal osteotomy site. Both cases were managed using PRF to seal the perforation. The implants were then immediately inserted without further complications.

There was a statistically significant relation between both groups in terms of their perforation liability, where the membrane thickness of less than 2 mm showed the highest rate of perforation (P = 0.008).

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