Untreatment With Schneiderian Membrane Perforation In Transcrestal Sinus Floor Elevation

This study aimed to evaluate the outcome of untreated Schneiderian membrane (SM) perforation in transcrestal sinus floor elevation (TSFE) using the reamer-scraping and implant-pushing technique (RSIPT) we invented. This study (Ethics No.20201210002; ChiCTR2400090550) included 202 patients with residual bone height (RBH) between 3-5 mm and 166 patients with RBH between 5-8 mm who had undergone RSIPT with simultaneous implantation, and the SM perforation rates were evaluated. And the early and late implant failure rates, peri-implant bone height (PBH) and endo-sinus bone gain (ESBG), marginal bone loss (MBL) were compared between the perforated and unperforated groups with 3-5 mm RBH. The SM perforation rates of the 3-5 mm and 5-8 mm RBH groups were 11.1% and 2.8%, respectively (P = 0.005). When RBH was 3-5 mm, the perforated group had no significantly higher risk of early and late implant failure (P = 1.000; P = 1.000), and MBL (P = 0.575). And one year after loading, the PBH and ESBG in the perforated group were 7.67 ± 0.37 mm and 4.73 ± 0.56 mm respectively, lower than that in the unperforated group, 8.33 ± 0.34 mm and 5.49 ± 0.90 mm (P = 0.001; P = 0.003). In TSFE using RSIPT with simultaneous implantation, sufficient PBH can be obtained for loading without treatment after SM perforation, but long-term observation is needed.