To investigate the prevalence of anatomical and surgical findings and complications in maxillary sinus floor elevation
surgery, and to describe the clinical implications.
Patients and Methods
One hundred consecutive patients scheduled
for maxillary sinus floor elevation were included. The patients consisted of 36 men (36%) and 64 women (64%), with a mean
age of 50 years (range, 17 to 73 years). In 18 patients, a bilateral procedure was performed. Patients were treated with a
top hinge door in the lateral maxillary sinus wall, as described by Tatum (Dent Clin North Am 30:207, 1986). In bilateral
cases, only the first site treated was evaluated.
In most cases, an anatomical or surgical finding forced
a deviation from Tatum's standard procedure. A thin or thick lateral maxillary sinus wall was found in 78% and 4% of patients,
respectively. In 6%, a strong convexity of the lateral sinus wall called for an alternative method of releasing the trapdoor.
The same method was used in 4% of cases involving a narrow sinus. The sinus floor elevation procedure was hindered by septa
in 48%. In regard to complications, the most common complication, a perforation of the Schneiderian membrane, occurred in
11% of patients. In 2%, visualization of the trapdoor preparation was compromised because of hemorrhages. The initial incision
design, ie, slightly palatal, was responsible for a local dehiscence in 3%.
To avoid unnecessary surgical
complications, detailed knowledge and timely identification of the anatomic structures inherent to the maxillary sinus are