Postoperative Perforation of the Schneiderian Membrane in Maxillary Sinus Augmentation: A Case Report
Perforation of the Schneiderian membrane constitutes a major intraoperative complication of maxillary sinus floor elevation with graft materials, but postoperative perforation of the sinus membrane is very rare. This case report demonstrates that conservative treatment involving drainage and the administration of systemic antibiotics can be used to successfully treat postoperative sinus membrane perforation with infection of the graft material.
Figure 1 . Pre-operative panoramic radiograph showing no sinus-related pathologic lesions and adequate residual bone height in the right maxillary sinus. Figure 2. Postoperative panoramic radiograph showing that the implants were placed in positions #2–4 simultaneously with sinus augmentation. Figure 3. Panoramic radiograph 2 weeks postoperatively, revealing perforation and thickening of the sinus membrane with separated bone graft materials. Figure 4. Panoramic radiograph 4 weeks postoperatively, showing the tendency of the perforated sinus mucosa and bone graft to return to the original position.
Figure 5 . Computed tomography scans taken 1 year postoperatively. Note the intact sinus mucosa covering the graft material. CT scan showed a radiolucent area in the center of the grafted area, but the loss of the bone-implant contact was restricted to the apical tip area of the implants. Figure 6. Intraoral photograph and panoramic radiograph taken 13 months after implant loading.
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