Maxillary Sinus Membrane Repair With Amnion-Chorion Barriers: A Retrospective Case Series

Abstract

Introduction: Schneiderian membrane perforation is the most common complication of maxillary sinus augmentation procedures and has been associated with a variety of post-surgical problems. Multiple techniques to repair perforated Schneiderian membranes have been reported in dental literature with materials such as connective tissue, buccal fat pads, and resorbable collagen membranes. While these reparative options have proven successful, they are technique sensitive and time consuming. The aim of this case series is to present a simplified method of Schneiderian membrane perforation repair with amnionchorion membranes and results obtained from nine cases utilizing this technique.Case Series: A consecutive retrospective record review was performed of all maxillary sinus augmentation cases performed during the past five years by a board certified private practicing periodontist. Seventy seven cases were identified with a total of 104 sinus augmentations, of which nine perforations were noted. None of the perforation cases were aborted mid-procedure and all perforations were repaired with amnion-chorion membranes. All cases were augmented with a combination of allograft and xenograft particulate bone. After an average healing time of 4.9 months, dental implants were placed in the grafted sinuses.Conclusion: This retrospective case series showed nine perforations during 104 lateral window maxillary sinus augmentation procedures. A total of 23 dental implants were placed in the augmented sinuses with perforated Schneiderian membranes and a one failure was noted according the Albrektsson success criteria. A total of 158 dental implants were placed in non-perforated augmented sinuses with a total of three failures noted.

Assessment of the effectiveness of platelet rich fibrin in the treatment of Schneiderian membrane perforation

“…Perforations of Schneiderian membranes were repaired by many researchers. In many studies, commonly used collagen membranes for treatment of membrane perforation . Although several techniques have been suggested, no proven method has been proposed for repairing sinus membrane perforations .…”

“…In many studies, commonly used collagen membranes for treatment of membrane perforation. [14][15][16] Although several techniques have been suggested, no proven method has been proposed for repairing sinus membrane perforations. 17 The classification of membrane perforations was previously described by size and degree of separation of the soft and hard tissues.…”

Chorion and amnion/chorion membranes in oral and periodontal surgery: A systematic review

“…In 11 studies, patients had a CM allograft 3,[52][53][54][55][56]58,[60][61][62]66 whereas in the other 10 studies an ACM allograft was performed. 37,57,59,[63][64][65][67][68][69][70] Membranes were freeze-dried in seven studies, 3,52,56,58,[60][61][62] decellularized then freeze-dried in one study, 70 de-epithelialized and dehydrated by the Purion process in nine studies, 37,57,59,[63][64][65][67][68][69] and just dehydrated in two studies. 53,55 In two publications, the preservation methods were not mentioned.…”

“…The membranes supplied by the Tata Memorial Hospital tissue bank were irradiated with γ radiation, 3,[52][53][54][55][56]58,[60][61][62]66 Kakabadze et al used γ rays at a dose of 15 kGy, 70 and the BioXclude membranes were sterilized by γ rays or irradiated by electron beams at a dose of approximately 17.5 kGy. 37,57,59,[63][64][65][67][68][69] The membranes were used in monolayer in all studies, but some authors specified that if the membrane folds on itself together, it was not unfolded. 37 None of the selected articles mentioned which side of the membrane was applied in contact with the defect.…”

“…This selection was separated accordingly into three main areas: periodontal surgery, 3,37,[52][53][54][55][56][57][58][59][60][61][62][63][64] implant and preimplant surgery [65][66][67][68][69] and bone reconstruction following tumor resection. 70…”