Treatment of sinus membrane perforations during sinus lift surgeries using leukocyte and platelet-rich fibrin: A report of three cases

² Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health, Farmington, Connecticut 06030, United States

³ Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid 28933, Spain

⁴ Department of Stomatology, Faculty of Dentistry, University of Seville, Seville 41009, Spain

JCTR 2022, 8(5), 360–368; https://doi.org/10.18053/jctres.08.202205.006

Submitted: 16 May 2022 | Revised: 12 July 2022 | Accepted: 27 July 2022 | Published: 7 September 2022

© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Background and aim: Schneiderian membrane (SM) perforation is the most frequent intraoperative complication during sinus lifts, which can lead to implant failure or delayed implant treatment. This article aims to show the results of using leukocyte and platelet-rich fibrin (L-PRF) in the treatment of perforations occurring during sinus lifts with a lateral window approach.

Results: Three patients (n = 5 implants) with a mean ± SD age of 57.67 ± 12.12 years were included, in whom perforations of the SM of 3–5 mm and > 5 mm occurred. The mean ± SD preoperative bone height was 4.42 ± 2.96 and, at 6 months it was 9.58 ± 2.41 (p < 0.05). All implants had a 100% survival rate at 6–24 months. At the split-mouth, the mean ± SD baseline height was 5.05 ± 2.99 mm in repaired SM vs. 2.92 ± 1.01 in those without any complications (p > 0.05). At 6 months, mean ± SD gains were 10.09 ± 2.44 mm vs. 7.73 ± 0.90 mm, respectively (p > 0.05).

Conclusion: L-PRF simplifies SM repair, reducing the need for high surgical experience and/or skills. Although there are no significant differences between repaired and intact SM, at the radiological level, greater bone compactness and maturation were observed in the latter, which may be associated with the presence of air bubbles caused by anaerobic bacterial activity in repaired SM.

Relevance for Patients: The use of L-PRF greatly simplifies the resolution of SM perforations during sinus lift surgeries, reducing treatment times and providing predictable results. Being of autologous origin, it accelerates and enhances healing, eliminating the possibility of autoimmune rejection reactions.

Keywords

platelet-rich fibrin

Schneider membrane perforation

sinus floor augmentation

dental implant complications

case report

Conflict of interest

The authors declare that they have no conflict of interest in relation to this article.

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