Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study

Abstract

Objective Clinical indications for maxillary sinus floor elevation with transcrestal techniques have increased in recent years even in sites with minimal residual bone height (RBH). Nevertheless, limited information is currently available on incidence of intraoperative complications and early implant failure in these cases. Material and Methods This retrospective multicenter study was performed on anonymized clinical and radiographic records of patients who underwent transcrestal sinus floor elevation in seven clinical centers. Influence of different factors related to patient, and sinus anatomy and surgical technique on the incidence of intraoperative complications and early implant failure rate after transcrestal sinus lift were investigated. Results A total of 430 patients treated with transcrestal sinus floor elevation for single‐implant insertion in sites with RBH ≤5 mm were included in the final analysis. After 1 year of loading, 418 implants of 430 were satisfactorily in function. Early implant failure was recorded in 12 cases (2.8%); results were significantly associated with the presence of large sinus cavities and with the occurrence of membrane perforation. The following adverse events were recorded: membrane perforation (7.2%), acute sinusitis (0.9%), implant displacement into the sinus cavity (0.7%), oro‐antral fistula (0.2%), and benign paroxysmal positional vertigo (0.5% of osteotome cases). A strong direct correlation between sinus membrane perforation and bucco‐palatal sinus width (p = .000) was demonstrated. Conclusions Early implant failure after transcrestal sinus elevation showed significant direct correlation with bucco‐palatal maxillary sinus width and the presence of membrane perforation. Sinus membrane perforation was strongly associated with bucco‐palatal sinus width (extremely low perforation rate in narrow and much higher incidence in wide sinuses).

Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study

“…A previous systematic review including 7358 implants indicated that membrane perforation in the sinus augmented procedure could increase the risk of implant failure [ 39 ]. Additionally, a recent multicenter study of 430 implants, also confirmed that the sinus membrane perforation [OR 4.21; 95% CI (1.10–16.05); P = 0.035] had a statistically significant effect on early implant failure [ 40 ]. This could be explained as follows: the membrane perforation may result in local inflammation, influence the remolding of grafting material, reduce bone formation and ultimate implant loss.…”

“…The intro-sinus bone formation has been verified to be more in narrow sinuses than in wider sinuses [52,53]. Meanwhile, based on the logistic regression analysis, a significant correlation was found between larger sinus cavities [OR 8.50; 95 CI (1.02-70.42); P = 0.047] and early implant failure [40].…”

“…The intro-sinus bone formation has been verified to be more in narrow sinuses than in wider sinuses [ 52 , 53 ]. Meanwhile, based on the logistic regression analysis, a significant correlation was found between larger sinus cavities [OR 8.50; 95 CI (1.02–70.42); P = 0.047] and early implant failure [ 40 ]. However, this study did not find any association between sinus width and VBG, which could be partly explained by methodological discrepancies among studies.…”

“…4 The ROC curve of MBL was established. ROC curve receiver operating characteristic curve, MBL marginal bone loss significant effect on early implant failure [40]. This could be explained as follows: the membrane perforation may result in local inflammation, influence the remolding of grafting material, reduce bone formation and ultimate implant loss.…”

Association between smoking and Schneiderian membrane perforation during maxillary sinus floor augmentation: A systematic review and meta‐analysis

“…It was supposed that Schneiderian membrane perforation increased the risk of postoperative sinusitis, and implant failure. 49,50 Non-repair of the Schneiderian membrane perforation had higher intraoperative and postoperative complications. 5 It has been found that the new bone formation was adversely affected by the membrane perforation in a rabbit model.…”