23 May 2021

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What happens if dental implant penetrates the maxillary sinus?

Alessandra Abbà

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Oral rehabilitation with dental implant prosthesis after tooth loss have shown satisfactory masticatory function and good oral specific health-related quality of life. However, placement of dental implant in the posterior maxilla could be difficult -or even impossible- due to atrophy of the alveolar process, poor bone quality and maxillary sinus pneumatization. In order to compensate the lack of bone height, vertical alveolar ridge augmentation procedures are often necessary before or contextually the installation of dental implant.
Various surgical approaches have been proposed and should be selected according to the vertical height of the residual alveolar bone, local intrasinus anatomy and the number of teeth to be replaced. Performing these techniques, the integrity of the Schneiderian membrane is of paramount importance to avoid potential complication.
In this systematic review the Authors analyze the relevance of this phenomenon on survival dental implant and complication.

Material and methods
Two independent reviewers performed an electronic and manual literature searches in several databases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, analyzing articles up to January 2018. Only studies with at least 6 months of follow-up were included.

Results
eight articles fulfilled the inclusion criteria and were selected for the qualitative analysis for a total of 493 implants as global sample with a mean follow-up of 52.7 months.
The weighted mean survival rate results 95.6% (IC 95%).
It was analyzed if there were any differences in survival according to the level of dental implant penetration (≤ 4 mm or > 4 mm) and there were no statistical significant differences in survival (p = 0.403). 

Clinical complication among the different authors range from 0 to 14.3%. 

Conclusions

Regarding radiographic complication, the most common was thickening of the Schneiderian membrane with a weighted complication rate of 14.8% (IC 95%). Penetration level affects the rate without reaching statistical significant difference (p = 0.301).

For additional information: Influence of exposing dental implants into the sinus cavity on survival and complications rate: a systematic review