Complications During Maxillary Sinus Augmentation Associated with Interfering Septa: A New Classification of Septa
Tassos Irinakis1, Valentin Dabuleanu2, Salwa Aldahlawi1, 3, *
Identifiers and Pagination:Year: 2017
First Page: 140
Last Page: 150
Publisher ID: TODENTJ-11-140
Article History:Received Date: 25/10/2016
Revision Received Date: 06/01/2017
Acceptance Date: 13/02/2017
Electronic publication date: 22/03/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A new classification of maxillary sinus interfering septa based on its orientation is presented along with its relationship to the prevalence and severity of sinus membrane perforations. Additionally, the impact of membrane perforation on post-operative complications and marginal bone loss during the first year of loading is evaluated.
Materials & Methods:
Retrospective chart review of 79 consecutive sinus lift procedures with lateral window technique and 107 implants. Preoperative Cone Beam Computed Tomography (CBCT) images were evaluated for the incidence and the direction of maxillary septa. Chart notes were examined for the incidence of membrane perforation and postoperative complications. Measurements of mesial and distal marginal bone levels and average bone resorption adjacent to each implant were calculated in intraoral radiographs taken at implant placement and during follow up appointments.
Interfering septa were identified in 48.1 percent of sinuses. 71.1 percent of them had the septum oriented in a buccal-lingual direction (Class I). The overall incidence of membrane perforation was 22.8 percent, and the presence of an interfering septum on CBCT scan was found to be significantly associated with the occurrence of a sinus membrane perforation (P<0.001). The mean implant marginal bone loss for sinuses, which did not experience a membrane perforation, was 0.6±0.8mm, compared with 0.9 ± 0.9 mm for the sinuses that did experience a perforation (P = 0.325).
Septa should be identified, classified and managed with a meticulous attention to technical details. A classification based on the septal orientation is proposed since the orientation of the septa can complicate the surgical procedure and requires modification of the surgical technique.