Analysis of Forces Applied During Transalveolar Sinus Lift: A Preliminary Clinical Study.

PURPOSE: To introduce a novel modality that enables the measurement of forces applied during a transalveolar sinus floor elevation (tSFE) and to investigate the influence of anatomical and surgical factors on the necessitated force in sinus membrane detachment.

MATERIAL AND

METHODS

A new endosinus probe, innovated with a calibrated load cell, was used to test the forces needed to perforate ten maxillary sinuses in 5 human cadavers. The same probe was also used to detach the Schneiderian membrane from the bony floor of 21 human subjects undergoing tSFE.

RESULTS

The force needed to cause membrane perforation in the cadaver sample was on average 3.46 ± 1.04 N. The maximum force applied in vivo to a sinus membrane without perforation was 2.01 ± 0.67 N on average. Regression analysis showed that smoking (P < 0.001), as well as 3.0 mm osteotomy (P < 0.001), was significantly correlated to increased forces during membrane detachment.

CONCLUSIONS

The maximum force needed to detach the membrane was found to be, on average, lower than the membrane breaking load in cadavers. Furthermore, because of smoking and a 3.0-mm osteotomy diameter demonstrating a high association with increased forces during membrane detachment, they may be considered as risk factors of membrane perforation.