Effectiveness of Collagen Membrane in the Treatment of Schneiderian Membrane Perforation

Abstract

Schneiderian membrane perforation (SMP) is the most common complication encountered during sinus lift procedures. SMPs should be managed to prevent loss of the valuable bone graft and bone substitute materials. A fast-resorbing collagen membrane (CM) is a soft, white, pliable, and nonfriable sponge used in dental surgery. The purpose of this study was to evaluate the clinical outcomes of SMP repair using CMs when an SMP had occurred during a sinus lifting procedure. The patients were divided into three groups according to the size of the SMPs during the sinus lift procedure. (A) Group 1: there was no perforation of the Schneiderian membrane but the membrane was weakened (or thinned) and repaired using CMs. (B) Group 2: the SMP was small to medium in size (< 10 mm) and repaired using CMs and fibrin adhesive (FA). (C) Group 3: the SMP was large in size (> 10 mm) and repaired using a collagen plug. The negative control group consisted of patients who did not have any SMP (Control) and these patients were randomly selected. Orthopantomographic X-rays taken before surgery, 2–3 days following surgery, and over 6 months after surgery (follow-up) were used to evaluate the acquired bone height according to groups. Bone heights were measured from the crestal bone at the planned implant placement sites. Clinical outcomes, including implant success and complications according to repair method, were also investigated. There was no significant difference in bone heights between the groups with the exception of group 3. The overall implant survival rate was 100% for implants placed in sinuses with frank SMPs or weakened sinus membranes. The CM is applicable for small-to-moderate perforations or sinus membranes which have been weakened or thinned during sinus lift procedures.