Effect of schneiderian membrane perforation on vertical bone gain in transalveolar sinus lift procedures: a retrospective cohort study

Background: The transalveolar sinus lift technique, when paired with dental implant placement, offers a dependable approach for restoring the posterior maxilla, even in the absence of bone grafts. Schneiderian membrane perforation is the most common complication of these procedures and may lead to undesirable complications. Purpose: This study evaluated the impact of Schneiderian membrane perforation on vertical bone gain in transalveolar sinus lift procedures Methods: This is a retrospective study conducted between 2019 and 2023 on patients visiting the Department of Oral and Maxillofacial Surgery, Latakia University. The sample included all patients who met the inclusion criteria and underwent transalveolar sinus lift combined with dental implant placement without the use of any bone graft material. Radiographic studies were conducted using cone beam computed tomography scans (CBCTs) before surgery and 6 months post-surgery. The difference in vertical bone gain (VBG) based on the modalities of perforation was evaluated using the Mann-Whitney test. The alpha risk level was set at 5% (α = 0.05). Results: The sample consisted of 66 patients, comprising 36 males and 30 females, who underwent a total of 77 dental implants alongside transalveolar sinus lift procedures without the use of bone graft material. The implant survival rate was 100% pre-loading. Among the sample, there were 13 cases of Schneiderian membrane perforations, accounting for 16.8% of cases. The average vertical bone gain in the overall sample was measured at 1.89 ± 0.74. Interestingly, our analysis did not reveal any statistically significant variances in mean bone gain between the two groups. Conclusions: This study found no significant association between Schneiderian membrane perforation and reduced vertical bone gain in transalveolar sinus lifts. However, these results require validation through larger trials with extended follow-up periods, standardized perforation assessment methods, and functional outcome measures to address limitations inherent in our retrospective design. Future research should also explore how perforation size and location interact with long-term implant success.