J Korean Assoc Oral Maxillofac Surg.  2014 Aug;40(4):188-194. 10.5125/jkaoms.2014.40.4.188.

Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study

• Kim YK
• Yun PY
• Oh JS
• Kim SG

• KMID: 2005444
• DOI: http://doi.org/10.5125/jkaoms.2014.40.4.188

Abstract

For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.

Keyword

Sinus floor augmentation; Maxillary sinus; Adipose tissue

MeSH Terms

Adipose Tissue*
Anti-Bacterial Agents
Collagen*
Drainage
Follow-Up Studies
Humans
Maxillary Sinus
Maxillary Sinusitis
Membranes*
Prognosis*
Sinus Floor Augmentation
Transplants
Anti-Bacterial Agents
Collagen

Figure

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  Fig. 1 A large sinus membrane perforation was covered using a pedicled buccal fat pad.

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  Fig. 2 Measurement of alveolar bone height. (ABH: augmented bone height, RBH: residual bone height)

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  Fig. 3 Change in alveolar bone height (Case 1). A. Preoperative panoramic radiograph. B. Panoramic radiograph 78 months after sinus-bone graft.

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  Fig. 4 Change in alveolar bone height (Case 2). A. Preoperative panoramic radiograph. B. Panoramic radiograph 59 months after sinus-bone graft.

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  Fig. 5 Change in alveolar bone height (Case 3). A. Preoperative panoramic radiograph. B. Panoramic radiograph 53 months after sinus-bone graft: The failed implant was removed and replaced with a wide and long implant.

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  Fig. 6 Change in alveolar bone height (Case 4). A. Preoperative panoramic radiograph. B. Water's view two weeks after bone graft: left maxillary sinusitis developed. C. Panoramic radiograph 53 months after sinus bone graft: the second molar implant was removed and a new implant was placed at a distal area. The first molar implant was also removed.

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