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Advisory Committee Chair

Ramzi Abou-Arraj

Advisory Committee Members

Hussein Basma

Nicolass Geurs

Maria Geisinger

Amjad Javed

Maninder Kaur

Document Type

Thesis

Date of Award

2020

Degree Name by School

Master of Science (MS) School of Dentistry

Abstract

Although previous studies have attempted to identify risk factors for membrane perforation, limited information with conflicting data exists regarding the significance of the relationship between buccal wall thickness and membrane perforation. Access to the Schneiderian membrane during the sinus augmentation procedure is obtained through the buccal wall, thus the importance of understanding whether its thickness plays a role in membrane perforations. In addition, the anatomy of the sinus cavity plays an important role in rendering the sinus augmentation procedure straightforward or rather complex. It is theorized that the narrower the sinus cavity, the higher the risk of membrane perforation. Residual alveolar bone height seems to also influence the rate of membrane perforation. This study was based upon available periodontal clinical records of treatment of 202 maxillary sinus elevation procedure. The aim of this cone-beam computed tomography (CBCT) scan study was to study the influence of maxillary sinus anatomy on Schneiderian membrane perforation during lateral window sinus augmentation. A sub-analysis of the influence of factors such as surgeons’ level of experience (number of sinus augmentation procedures performed by residents), procedures performed under IV sedation, presence of sinus septa, artery presence and location in the lateral wall and sinus pathology. It can be concluded that membrane perforation risk significantly increases in the following conditions: thicker lateral walls, narrower floor angles (LFM angle), narrower anterior angles (LAM angle), shorter medio-lateral distance at 5 mm from the floor of the sinus, and sinus pathology that affects the consistency of the Schneiderian membrane. Keywords: maxillary sinus, membrane perforation, sinus anatomy, Schneiderian membrane

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