Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures
Identifieur interne : 006496 ( Ncbi/Merge ); précédent : 006495; suivant : 006497Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures
Auteurs : Andreas Sakkas [Allemagne] ; Ioannis Konstantinidis [Allemagne] ; Karsten Winter [Allemagne] ; Alexander Schramm [Allemagne] ; Frank Wilde [Allemagne]Source :
- GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW [ 2193-8091 ] ; 2016.
Abstract
Url:
DOI: 10.3205/iprs000090
PubMed: 26955510
PubMed Central: 4776049
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures</title><author><name sortKey="Sakkas, Andreas" sort="Sakkas, Andreas" uniqKey="Sakkas A" first="Andreas" last="Sakkas">Andreas Sakkas</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author><author><name sortKey="Konstantinidis, Ioannis" sort="Konstantinidis, Ioannis" uniqKey="Konstantinidis I" first="Ioannis" last="Konstantinidis">Ioannis Konstantinidis</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Prosthodontics, University of Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthodontics, University of Dresden</wicri:regionArea><wicri:noRegion>University of Dresden</wicri:noRegion><wicri:noRegion>University of Dresden</wicri:noRegion><wicri:noRegion>University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Winter, Karsten" sort="Winter, Karsten" uniqKey="Winter K" first="Karsten" last="Winter">Karsten Winter</name><affiliation wicri:level="1"><nlm:aff id="A3">Institute of Anatomy, Medical Faculty, University of Leipzig, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Anatomy, Medical Faculty, University of Leipzig</wicri:regionArea><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Schramm, Alexander" sort="Schramm, Alexander" uniqKey="Schramm A" first="Alexander" last="Schramm">Alexander Schramm</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author><author><name sortKey="Wilde, Frank" sort="Wilde, Frank" uniqKey="Wilde F" first="Frank" last="Wilde">Frank Wilde</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26955510</idno><idno type="pmc">4776049</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776049</idno><idno type="RBID">PMC:4776049</idno><idno type="doi">10.3205/iprs000090</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">002C60</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002C60</idno><idno type="wicri:Area/Pmc/Curation">002C60</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002C60</idno><idno type="wicri:Area/Pmc/Checkpoint">000741</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000741</idno><idno type="wicri:Area/Ncbi/Merge">006496</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures</title><author><name sortKey="Sakkas, Andreas" sort="Sakkas, Andreas" uniqKey="Sakkas A" first="Andreas" last="Sakkas">Andreas Sakkas</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author><author><name sortKey="Konstantinidis, Ioannis" sort="Konstantinidis, Ioannis" uniqKey="Konstantinidis I" first="Ioannis" last="Konstantinidis">Ioannis Konstantinidis</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Prosthodontics, University of Dresden, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Prosthodontics, University of Dresden</wicri:regionArea><wicri:noRegion>University of Dresden</wicri:noRegion><wicri:noRegion>University of Dresden</wicri:noRegion><wicri:noRegion>University of Dresden</wicri:noRegion></affiliation></author><author><name sortKey="Winter, Karsten" sort="Winter, Karsten" uniqKey="Winter K" first="Karsten" last="Winter">Karsten Winter</name><affiliation wicri:level="1"><nlm:aff id="A3">Institute of Anatomy, Medical Faculty, University of Leipzig, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Institute of Anatomy, Medical Faculty, University of Leipzig</wicri:regionArea><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion><wicri:noRegion>University of Leipzig</wicri:noRegion></affiliation></author><author><name sortKey="Schramm, Alexander" sort="Schramm, Alexander" uniqKey="Schramm A" first="Alexander" last="Schramm">Alexander Schramm</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author><author><name sortKey="Wilde, Frank" sort="Wilde, Frank" uniqKey="Wilde F" first="Frank" last="Wilde">Frank Wilde</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm</wicri:regionArea><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion><wicri:noRegion>Military Hospital Ulm and Academic Hospital University Ulm</wicri:noRegion></affiliation></author></analytic><series><title level="j">GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW</title><idno type="eISSN">2193-8091</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background:</bold> Sinuslift is meanwhile an established method of bone augmentation in the posterior maxilla. Aim of the study was to evaluate the significance of intraoperative Schneiderian membrane perforations during maxillary sinus floor elevation surgery using autogenous bone harvested from two different donor sites using a Safescraper device on the success rate, graft survival and implant integration.</p><p><bold>Methods:</bold> The investigators conducted a retrospective cohort study at the Department of Oral and Maxillofacial Surgery of Military Hospital Ulm composed of patients with severe maxillary atrophy who underwent sinus augmentation from January 2011 until December 2011. Ninety-nine consecutive patients (89 men, 10 women) with a mean age of 43.1 years underwent sinus graft procedures in a 2-stage procedure using the lateral wall approach, as described by Tatum (1986). Data on patient age, smoking status, donor site and surgical complications were recorded and the relationship between Schneiderian membrane perforation and complication rate was evaluated. Dental implants were inserted 4 months after grafting.</p><p><bold>Results:</bold> A total of 105 sinus lift procedures were performed in 99 patients. Sixty-one patients (61.6%) underwent sinus elevation with autogenous bone from the buccal sinus wall, while 38 patients (38.4%) bone harvesting from the iliac crest. Intraoperative perforation of the Schneiderian membrane was observed in 11 of the 105 sinuses (10.4%). These perforations resulted in 4 (36.3%) of the cases in major postoperative complications accompanied by swelling and wound infection. Membrane perforations were slightly associated with the appearance of postoperative complications (p=0.0762). In 2.4% of all cases, regarding 2 patients the final rehabilitation with dental implants was not possible because of extensive bone resorption. </p><p><bold>Conclusion:</bold> Intraoperative complications performing sinus augmentation may lead to postoperative complications. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">GMS Interdiscip Plast Reconstr Surg DGPW</journal-id><journal-id journal-id-type="iso-abbrev">GMS Interdiscip Plast Reconstr Surg DGPW</journal-id><journal-id journal-id-type="publisher-id">GMS Interdiscip Plast Reconstr Surg DGPW</journal-id><journal-title-group><journal-title>GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW</journal-title></journal-title-group><issn pub-type="epub">2193-8091</issn><publisher><publisher-name>German Medical Science GMS Publishing House</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26955510</article-id><article-id pub-id-type="pmc">4776049</article-id><article-id pub-id-type="publisher-id">iprs000090</article-id><article-id pub-id-type="doi">10.3205/iprs000090</article-id><article-id pub-id-type="publisher-id">Doc11</article-id><article-id pub-id-type="other">urn:nbn:de:0183-iprs0000903</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Effect of Schneiderian membrane perforation on sinus lift graft outcome using two different donor sites: a retrospective study of 105 maxillary sinus elevation procedures</article-title><trans-title-group xml:lang="de"><trans-title>Einfluss von Perforationen der Schneider’schen Membran auf die Erfolgsrate nach Sinusbodenelevation mit autologen Knochentransplantaten von zwei unterschiedlichen Spenderregionen: eine retrospektive Analyse von 105 Fällen</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sakkas</surname><given-names>Andreas</given-names></name><xref ref-type="corresp" rid="COR1">*</xref><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Konstantinidis</surname><given-names>Ioannis</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Winter</surname><given-names>Karsten</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Schramm</surname><given-names>Alexander</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Wilde</surname><given-names>Frank</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Germany</aff><aff id="A2"><label>2</label>Department of Prosthodontics, University of Dresden, Germany</aff><aff id="A3"><label>3</label>Institute of Anatomy, Medical Faculty, University of Leipzig, Germany</aff><author-notes><corresp id="COR1">*To whom correspondence should be addressed: Andreas Sakkas, Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Military Hospital Ulm and Academic Hospital University Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany, Phone: +49-731-1710-1701, Fax: +49-731-1710-1008, E-mail: <email>ansakkas@yahoo.com</email></corresp></author-notes><pub-date pub-type="epub"><day>02</day><month>3</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>5</volume><elocation-id>Doc11</elocation-id><permissions><copyright-statement>Copyright © 2016 Sakkas et al.</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:type="simple" xlink:href="http://www.egms.de/en/journals/iprs/2016-5/iprs000090.shtml">This article is available from http://www.egms.de/en/journals/iprs/2016-5/iprs000090.shtml</self-uri><abstract><p><bold>Background:</bold> Sinuslift is meanwhile an established method of bone augmentation in the posterior maxilla. Aim of the study was to evaluate the significance of intraoperative Schneiderian membrane perforations during maxillary sinus floor elevation surgery using autogenous bone harvested from two different donor sites using a Safescraper device on the success rate, graft survival and implant integration.</p><p><bold>Methods:</bold> The investigators conducted a retrospective cohort study at the Department of Oral and Maxillofacial Surgery of Military Hospital Ulm composed of patients with severe maxillary atrophy who underwent sinus augmentation from January 2011 until December 2011. Ninety-nine consecutive patients (89 men, 10 women) with a mean age of 43.1 years underwent sinus graft procedures in a 2-stage procedure using the lateral wall approach, as described by Tatum (1986). Data on patient age, smoking status, donor site and surgical complications were recorded and the relationship between Schneiderian membrane perforation and complication rate was evaluated. Dental implants were inserted 4 months after grafting.</p><p><bold>Results:</bold> A total of 105 sinus lift procedures were performed in 99 patients. Sixty-one patients (61.6%) underwent sinus elevation with autogenous bone from the buccal sinus wall, while 38 patients (38.4%) bone harvesting from the iliac crest. Intraoperative perforation of the Schneiderian membrane was observed in 11 of the 105 sinuses (10.4%). These perforations resulted in 4 (36.3%) of the cases in major postoperative complications accompanied by swelling and wound infection. Membrane perforations were slightly associated with the appearance of postoperative complications (p=0.0762). In 2.4% of all cases, regarding 2 patients the final rehabilitation with dental implants was not possible because of extensive bone resorption. </p><p><bold>Conclusion:</bold> Intraoperative complications performing sinus augmentation may lead to postoperative complications. With careful clinical and radiographic evaluation and appropriate treatment, the complications and risk for graft material displacement and implant loss can be eliminated. </p></abstract><trans-abstract xml:lang="de"><title>Zusammenfassung</title><p><bold>Hintergrund:</bold> Die Sinusbodenelevation ist mittlerweile eine etablierte Methode zur Knochenaugmentation im seitlichen Oberkiefer. Ziel der Arbeit war die Evaluation der Auswirkungen von intraoperativ aufgetretenen Perforationen der Schneider’schen Membran bei Sinusbodenelevationen mit autogenen Knochentransplantaten, gewonnen mit Safescraper von zwei verschiedenen Donorseiten, auf den klinischen Erfolg, die Transplantats-Überlebensrate und die Implantatosseointegration. </p><p><bold>Methoden:</bold> In einer retrospektiven Kohortenstudie an der Abteilung für Mund-, Kiefer- und Gesichtschirurgie des Bundeswehrkrankenhauses Ulm wurden die Daten von Patienten mit ausgeprägter Oberkiefer-Atrophie untersucht, bei denen zwischen Januar 2011 und Dezember 2011 Sinusbodenelevationen durchgeführt wurden. Bei 99 Patienten (89 Männer, 10 Frauen) mit einem mittleren Alter von 43,1 Jahren wurden 105 Sinusbodenelevationen in einem zweizeitigen Vorgehen mit der Technik des lateralen Zugangs nach Tatum (1986) unternommen. Patientenparameter wie Alter, Rauchen, Spenderegion und chirurgische Komplikationen wurden erhoben und die Korrelation zwischen Sinusmembranenperforation und postoperativer Komplikationsrate wurde ausgewertet. Die Implantation erfolgte 4 Monate nach Sinusaugmentation.</p><p><bold>Ergebnisse:</bold> Es wurden insgesamt 105 Sinusbodenelevationen bei 99 Patienten durchgeführt. Bei 61 Patienten (61,6%) wurde eine Augmentation mit autologen Knochenspänen von der lateralen Sinuswand und bei 38 Patienten (38,4%) von dem anterioren Beckenkammrand durchgeführt. Eine intraoperative Perforation der Schneider’schen Membran trat bei 11 der Fälle (10,4%) auf. Davon haben sich bei 4 (36,3%) der Fälle postoperativ schwerere Komplikationen wie Wundinfektionen und Abszesse entwickelt. Es wurde eine leichte signifikante Korrelation zwischen intraoperativer Membranperforation und Auftreten von postoperativen Komplikationen festgestellt (p=0,0762). Bei 2 Patienten (2,4%) war aufgrund der ausgeprägten Transplantatresorption keine Implantatversorgung im Verlauf möglich. </p><p><bold>Schlussfolgerung:</bold> Intraoperativ aufgetretene Perforationen der Sinusmembran können zu postoperativen Komplikationen führen. Eine sorgfältige präoperative klinische und radiologische Diagnostik ist notwendig, um postoperative Komplikationen und Risiken für Transplantat-Dislokation und Implantatverlust zu minimieren.</p></trans-abstract><kwd-group><kwd>sinus lift</kwd><kwd>membrane perforation</kwd><kwd>autogenous bone</kwd><kwd>maxillary atrophy</kwd><kwd>maxillary sinus grafts</kwd></kwd-group></article-meta></front><floats-group><fig id="T1" position="float"><label>Table 1</label><caption><title>Membrane integrity at augmentation procedures with postoperative complications</title></caption><graphic xlink:href="IPRS-05-11-t-001"></graphic></fig><fig id="T2" position="float"><label>Table 2</label><caption><title>Membrane integrity at augmentation procedures of failed grafts</title></caption><graphic xlink:href="IPRS-05-11-t-002"></graphic></fig><fig id="T3" position="float"><label>Table 3</label><caption><title>Membrane integrity at augmentation procedures with postoperative complications according to patient’s age</title></caption><graphic xlink:href="IPRS-05-11-t-003"></graphic></fig></floats-group></pmc><affiliations><list><country><li>Allemagne</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Sakkas, Andreas" sort="Sakkas, Andreas" uniqKey="Sakkas A" first="Andreas" last="Sakkas">Andreas Sakkas</name></noRegion><name sortKey="Konstantinidis, Ioannis" sort="Konstantinidis, Ioannis" uniqKey="Konstantinidis I" first="Ioannis" last="Konstantinidis">Ioannis Konstantinidis</name><name sortKey="Schramm, Alexander" sort="Schramm, Alexander" uniqKey="Schramm A" first="Alexander" last="Schramm">Alexander Schramm</name><name sortKey="Wilde, Frank" sort="Wilde, Frank" uniqKey="Wilde F" first="Frank" last="Wilde">Frank Wilde</name><name sortKey="Winter, Karsten" sort="Winter, Karsten" uniqKey="Winter K" first="Karsten" last="Winter">Karsten Winter</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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