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. 2012:2012:261905.
doi: 10.1155/2012/261905. Epub 2012 Jul 17.

Schneider membrane elevation in presence of sinus septa: anatomic features and surgical management

Mario Beretta  1 , Marco Cicciù, Ennio Bramanti, Carlo Maiorana
Affiliations

Schneider membrane elevation in presence of sinus septa: anatomic features and surgical management

Mario Beretta et al. Int J Dent. 2012.

Abstract

Maxillary sinus floor elevation via a lateral approach is a predictable technique to increase bone volume of the edentulous posterior maxilla and consequently for dental implants placement. The sinus floor is elevated and it can be augmented with either autologous or xenogeneic bone grafts following an opening bone window created on the facial buccal wall. Maxillary septa are walls of cortical bone within the maxillary sinus. The septa shape has been described as an inverted gothic arch arising from the inferior or lateral walls of the sinus and may even divide the sinus into two or more cavities. Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in nonatrophic ones. Radiographic identification of these structures is important in order to perform the right design of the lateral window during sinus lift. Aim of this investigation is to highlight the correct steps for doing sinus lift surgery in presence of those anatomic variations. Clinicians should always perform clinical and radiographic diagnosis in order to avoid complications related to the sinus lift surgery.

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Figures

Figure 1
Figure 1
Panoramic rx shows the presence of possible septa in the left maxilla.
Figure 2
Figure 2
CT dental scan confirmed the presence of bone septa in the left maxilla.
Figure 3
Figure 3
Axial view of the CT dental scan confirmed a deep septa in the left maxillary sinus.
Figure 4
Figure 4
A mucoperiostal flap is elevated. The buccal wall shows residual ridge with a perforation of the Schneider membrane related to previous tooth infection and fistula.
Figure 5
Figure 5
The buccal osteotomy is performed according to Boyne and James technique.
Figure 6
Figure 6
The presence of septa is well underlined after the sinus lift procedure performed. Two separate bone windows have been done.
Figure 7
Figure 7
Deproteinized bovine bone has been used for covering the bone defect and for increasing the bone volume of the maxilla after the sinus lift.
Figure 8
Figure 8
Panoramic rx control at 6 months after the surgery confirmed the newly bone formation.
Figure 9
Figure 9
The new opened mucoperiostal flap clearly shows a good amount of bone formation.
Figure 10
Figure 10
Four dental implants have been placed in order to perform prosthetic restoration of the previous edentulous area.
See this image and copyright information in PMC

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