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Modification of the sinus lift procedure for septa in the maxillary antrum

1994; Elsevier BV; Volume: 52; Issue: 3 Linguagem: Inglês

10.1016/0278-2391(94)90313-1

1531-5053

Norman J. Betts, Michael Miloro,

Cleft Lip and Palate Research

The sinus lift procedure with bone grafting was introduced by Tatum in 1975, ’ who described an alveolar crestal approach. Boyne and James were the first to describe the lateral osteotomy.2 Since this description in 1980 the lateral approach has been modified several times.3‘5 The technique of sinus lift may be difficult if aberrant sinus anatomy, such as a septum of the sinus floor, is encountered during surgical exposure. Radiating septa of varying sizes can form from the sinus floor in the intervals between adjacent teeth.6 These septa divide the sinus into two or more cavities.’ The septa are usually knife-edged and extend from the inner to the outer walls, reinforcing the osseous architecture of the antrum.8 The incidence of antral septa is unknown. Jensen and Greer infrequently encountered “abnormal sinus variations” in 15 patients who had 26 antral grafts.’ However, it is our personal experience that sinus septa are encountered during approximately 20% of sinus elevation procedures. If septa are not identified prior to the initiation of the sinus lift procedure, extreme difficulty may be encountered when attempting to infracture and elevate the bony window. Also, because the sinus membrane is strongly adherent to the septa, elevation without perforation may be difficult. 3,9 In addition, because a septum can divide the sinus into two separate compartments, opening into only one cavity may not allow adequate access for bone grafting. This report describes a modification of the standard sinus lift procedure when sinus septa are encountered.