Assessment of maxillary sinus lifting procedure in the presence of chronic sinusitis, a retrospective comparative study

Abstract

Introduction: Chronic sinusitis can be considered a relative contraindication for sinus lifting procedure. However, its specific effects on bone height, infection and healing have not been as well investigated as its incidence as a post-operative complication.

Methods: A retrospective comparative investigation was executed to evaluate the impact of chronic sinusitis on sinus lifting procedures regarding bone height, infection, and healing scores. Pre-operative and 6-month postoperative records (CBCT or CT and panoramic radiographs) of 40 patients who underwent sinus lifting procedure with graft and implant placement were split into two sets of 20 patients each; Group A is comprised of a patient with healthy sinus, whereas Group B includes patients with chronic sinusitis (identified as the presence of thickening of Schniederian membrane ≥ 2 mm, mucosal cyst, polyp or fluid level). Records of both groups were assessed for the difference in bone height of alveolar ridge between pre-operative radiograph and after six months postoperatively, and clinical notifications at the postoperative follow-up to report the healing and infection scores.

Results: Statistically, there was non-significant difference in mean bone height gain (p-value > 0.05) in comparison to control group mean bone height (8.84 ± 0.93). Also, there was non-significant variation in mean healing and infection scores.

Conclusion: According to the available data, chronic sinusitis presenting as a thickening in the Schneiderian membrane has no significant effect on postoperative bone height, healing, or infection score in patients undergoing sinus augmentation with simultaneous implant placement. Further research is needed to better evaluate the effect of chronic sinusitis and its current status as a relative contraindication for sinus lifting procedure.

Keywords: Bone height; Chronic sinusitis; Healing scores; Infection; Maxillary; Sinus lifting.

Fig. 1

Cross-section on CBCT, (A) Preoperative showing normal sinus with low vertical bone height, (B) 6-month post-operative showing increase in bone height following osseointegrated implant and healing graft, and (C) pre-operative cross-section on CBCT showing chronic sinusitis with low vertical bone height. (D) 6-month post-operative cross-section on CBCT showing increased vertical bone height after osseointegrated implant and healing graft.

Fig. 2

(A) bar chart of the height bone gain, (B) boxplot of the healing scores, and (C) regression trendline between postoperative follow-up time points (on X-axis) and healing scores (on Y-axis) in both chronic sinusitis and control groups.