The Effects of Sinus Membrane Pathology on Bone Augmentation and Procedural Outcome Using Minimal Invasive Antral Membrane Balloon Elevation
Membrane pathology tends to complicate the postprocedural course of open sinus lift by ostio-meatal complex (OMC) obstruction and consequent acute sinusitis. The objective of this study was to evaluate the outcome of subjects with considerable sinus membrane pathology undergoing maxillary sinus floor augmentation and simultaneous implant placement using the minimal invasive antral membrane balloon elevation (MIAMBE) method. This study was a retrospective chart review of MIAMBE procedures performed in the presence of significant sinus membrane pathology. Sixteen patients with maxillary sinus membrane thickening in well-ventilated OMC as determined by dental computerized tomography underwent sinus augmentation and simultaneous implant placement using the MIAMBE technique. All 16 procedures were successfully concluded without significant procedural or postprocedural complications or implant failure. Post MIAMBE membrane pathology regressed or disappeared in 8 patients (50%) or remained unchanged in 6 patients (37.5%), while in 2 patients the sinus membrane pathology was limited to evaluation by periapical X rays. Sinus augmentation using the MIAMBE technique can be performed safely in asymptomatic patients in the presence of sinus membrane pathology if the OMC is not obstructed. In a significant proportion of these cases, complete resolution of the membrane pathology after MIAMBE is observed. When compared to open sinus lift, OMC obstruction is less likely to occur when employing the MIAMBE method.
Figure 1. Panoramic radiograph demonstrating membrane pathology (P) of the right maxillary sinus. Figure 2. Sagittal (a) and coronal (b) view of the right maxillary sinus. Figure 3. Coronal view demonstrating bone height and width measurements and dimension of the membrane pathology.
Figure 4. The minimal invasive antral membrane balloon elevation balloon (B) inflation above the sinus floor (SF). Figure 5. Sinus floor augmentation by bone graft (BG) material. Figure 6. Implant placement.
Figure 7. Sagittal (a), coronal (b), and axial (c) views. Seven months post minimal invasive antral membrane balloon elevation, the sinus membrane pathology has disappeared at site number 4. Figure 8. (a) Preprocedure. (b) Eight months postprocedure after prosthetic rehabilitation.
Figure 9. Panoramic view showing dome (D) shape membrane pathology of left sinus membrane. Figure 10. Membrane pathology demonstrated in coronal view.
Figure 11. Membrane pathology (P) demonstrated in axial views. Figure 12. Membrane pathology (P) demonstrated in sagittal view and sinus septum (S). Figure 13. The minimal invasive antral membrane balloon elevation balloon (B) inflation. Note medial wall (MW) and floor (F) of the maxillary sinus. Figure 14. Sinus floor augmentation anterior compartment. Note bone graft (BG) material, sinus floor (F), medial wall (MW), and septum (S). Figure 15. Balloon inflation at the corner of the septum in the anterior compartment. Note bone grafting (BG) in the anterior compartment, sinus floor (F), medial wall (MW), and septum (S). Figure 16. Sinus augmentation followed by implant placement at site number 15 (27).
Coronal view and panoramic radiogram before and 4.5 months post minimal invasive antral membrane balloon elevation.
Implant placement 5 months post minimal invasive antral membrane balloon elevation at site number 14 (26).
Contributor Notes
†Disclosure: All authors except Dr Avramovitz have conflict of interest related to MIAMBE (major).