Membrane perforation rate in lateral maxillary sinus floor augmentation using conventional rotating instruments and piezoelectric device—a meta-analysis

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Abstract

Objectives

Maxillary sinus augmentation (MSA) is a successful and predictable intervention with low complication rates. Perforations of the Schneiderian membrane may occur impairing the general success. The aim of this study was to compare the incidence of membrane perforations between conventional rotating instruments and piezoelectric devices in a meta-analysis.

Material and methods

An electronic research on MEDLINE and PubMed database was performed evaluating the literature from 1980 till 2016. Meta-analysis was performed with the studies matching the inclusion criteria. The incidence of perforations between conventional and piezo during the lateral maxillary sinus floor elevation was determined, and forest plots and a t test for significance analysis were performed.

Results

The search provided 377 articles of which 69 could be included. Selected non-randomised and non-controlled prospective and retrospective studies were incorporated. Conventional rotary instruments were associated with a perforation rate of 24%, the piezoelectric devices with 8% with statistically significant difference between both modalities ( p < 0.05).

Conclusion

Membrane perforations in MSA may be significantly reduced applying piezoelectrical devices for MSA.

Related collections

Most cited references 65

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P J Boyne, R James (1980)

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Maxillary and sinus implant reconstructions.

H. Tatum (1986)

The root and sinus series of the Omnii system have been used extensively since 1981. They are very versatile in their ability to be used within edentulous areas of the maxilla. Their design attempts to maximize the use of the available bone, and placement techniques allow the manipulation of bone to form sockets in otherwise deficient areas of bone. The root implants can be used as free-standing implants or as multiple abutments. The sinus implant is always used as an abutment. It may be used in conjunction with other implants or with natural abutments. Maxillary implants are not loaded until a 6-month healing time has elapsed following placement. An understanding of the different qualities of bone found in the maxilla is important to achieving the successful loading of these implants. Different times are required to allow physiologic loading in different qualities of maxillary bone. Restorative treatment is normally done with fixed bridge work, and the use of any type of stress breaker attachments is not recommended.

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The prevalence of surgical complications of the sinus graft procedure and their impact on implant survival.

Devorah Schwartz-Arad, Ran Herzberg, Eran Dolev (2004)

Grafting of the maxillary sinus floor has been performed successfully over the last decade. The ultimate goal of this procedure is to allow surviving implants to support a functional prosthesis. Surgical complications of the procedure are rarely reported and their impact on implant survival has been investigated even to a lesser extent. The purpose of this study was to evaluate the prevalence of surgical complications of the sinus graft procedure and their impact on implant survival. The study consisted of 70 patients who underwent 81 sinus graft procedures using the lateral wall approach from 1995 to 2000. A total of 212 screw-shaped implants were placed in the grafted sinuses and were restored by fixed prosthesis. Mean follow-up period for the implants was 43.6 months. Intra- and postoperative complications were thoroughly documented regarding clinical signs, times of occurrence, and treatment regimens. Perforation of the Schneiderian membrane was the major intraoperative complication, observed in 36 of the 81 sinuses (44%). Of the 70 patients, seven (10%) suffered from postoperative complications, specifically related to the sinus graft procedure, which included an uncommon cyst formation and an infection. Membrane perforations were strongly associated with the appearance of postoperative complications (specific and non-specific to the procedure) (P < 0.001). However, no association was found between membrane perforations or postoperative complications and implant survival. Intraoperative complications may lead to postoperative complications. Surgical complications did not significantly influence implant survival.

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Author and article information

Contributors

Corinne Jordi:

ORCID: http://orcid.org/0000-0001-5672-6394

Corinne.Gfeller@unibas.ch

Journal

Journal ID (nlm-ta): Int J Implant Dent

Journal ID (iso-abbrev): Int J Implant Dent

Title: International Journal of Implant Dentistry

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Electronic): 2198-4034

Publication date (Electronic): 29 January 2018

Publication date PMC-release: 29 January 2018

Publication date Collection: December 2018

Volume: 4

Electronic Location Identifier: 3

Affiliations

ISNI 0000 0004 1937 0642, GRID grid.6612.3, Department of Oral Surgery, Oral Radiology and Oral Medicine, University Center for Dental Medicine, , University of Basel, ; Basel, Switzerland

Author information

Corinne Jordi http://orcid.org/0000-0001-5672-6394

Article

Publisher ID: 114

DOI: 10.1186/s40729-017-0114-2

PMC ID: 5787532

PubMed ID: 29376211

SO-VID: 158df0e8-0409-4cd4-86f4-0695264a7cf1

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 28 September 2017

Date accepted : 20 December 2017

Custom metadata

Keywords: sinus lift,conventional,piezosurgery,schneiderian membrane,perforation,ultrasound

Data availability:

Keywords: sinus lift, conventional, piezosurgery, schneiderian membrane, perforation, ultrasound