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ePaper created 2015-11-17, 15:11:47 | version 1.38.0
26 Volume 1 | Issue 1/2015 Journal of Oral Science & Rehabilitation Complications of postoperative swelling of the maxillary sinus membrane after sinus floor augmentation Abstract Ob jec tive Theaimofthisarticlewastoinvestigatepostoperative swelling of the maxillary sinus membrane that oc- curredoneweekaftersinusflooraugmentation. Materia ls a n d m eth od s Maxillarysinusflooraugmentationswereperformedby the lateral window technique in 132 sites using beta- tricalcium phosphate (β-TCP) granules. Cone beam computedtomography(CBCT)scansweretakenbefore surgery,thedayofsurgery,andoneweek,threemonths andoneyearaftersurgery.Theproportionoftheareaof thepostoperativeswellingofthesinusmembraneinre- lationtotheremainingsinuscavitywasdeterminedand classified into three types: Type 1, less than one-third; Type 2, one-third to two-thirds; and Type 3, more than two-thirdsoftheremainingsinuscavity.Thesiteswere divided into two groups based on the extent of lateral windowcoverage:Group1,notcompletelycovered;and Group2,completelycovered.Thedegreeofmigrationof the β-TCP granules was evaluated and classified into threetypes:TypeA, limitedtothe lateralwindow;Type B, limited to the adjacent tooth; and Type C, extending beyondtheadjacenttooth. Res ults One week after surgery, swelling ofthe maxillary sinus membraneoccurredinall132sites(100%).Thepropor- tion of postoperative swelling was Type 1 at 24 sites (18.2%),Type2at65sites(49.2%)andType3at43sites (32.6%). In Group 1,the extent ofmigrationwasTypeA atsevensites(38.9%),TypeBateightsites(44.4%)and TypeCatthreesites(16.7%).InGroup2,theextentofmi- gration was Type A at 110 sites (96.5%), Type B at one site(0.9%)andTypeCatthreesites(2.6%). Co nclu si o n A complication ofthis temporary swelling ofthe sinus membrane was the migration of β-TCP granules to- ward the buccal side through the lateral window. It is recommended that the lateral window be covered tightlytoavoidthemigrationofbonesubstitutemate- rialsinthelateralwindowtechnique. Ke y wo rds Sinus floor augmentation, cone beam computed to- mography, swelling of the sinus membrane, biologi- cal reaction, complication. C om plic a tion s a fter s i nu s f lo o r au gme ntati o n Introduction Conventional postoperative evaluation using panoramic radiographs provides only 2-D infor- mation and maynot be good enough to evaluate the outcomes of sinus floor augmentation pre- cisely. Recently, cone beam computedtomogra- phy (CBCT) was developed, and it offers the ad- vantageofclearimagequalityatverylowpatient radiation doses. CBCT has made it possible to evaluate biological reactions of the augmented area longitudinally using images taken in the same direction. However, there remains consid- erable disagreement about how to reduce the patient radiation dose from CBCT. The radiation dose depends on the CBCT unit, exposure volt- age, exposure current and imaging volume. Okano et al. reported that the effective dose of the 3D Accuitomo (J. Morita, Kyoto, Japan) ranged from 18 to 66 μSv.1 According to data