Transnasal endoscopy – Evaluation and treatment method for patients with sinus lift and dental implants indications

Open access


BACKGORUND. Sinus floor elevation, also known as sinus lift, is the surgical procedure meant to elevate the maxillary floor in order to increase the height of the alveolar bone. This will allow the oral surgeon specialist to insert the desired implants, the ground of dental reconstruction. As the procedure involves the maxillary sinus and its Schneiderian membrane the main concern is to have a healthy maxillary sinus prior to implantation and to the maxillary augmentation.

OBJECTIVE. The aim of our study was to identify the patients with abnormal CT scan and refer them to an ENT evaluation, in order to identify and treat any sinusal pathology that can lead to a poor outcome of the sinus-lift intervention.

MATERIAL AND METHODS. Our prospective study included 15 patients selected from a group of 79 adults, candidates for dental implantation with sinus augmentation. These patients had abnormal sinus CT scan in terms of mucosal hypertrophy, cysts or fungal material. Transnasal diameatic sinusoscopy was performed for all the patients, assessing the aspect of the sinus cavity and the mucosa. The following abnormal aspects were found in our group: 5 patients with cysts, 2 patients with fungus ball and 4 with mucosal hypertrophy. 4 patients had normal maxillary mucosa despite the CT scan appearance.

RESULTS. All the patients with abnormal aspects at sinusoscopy (11 patients) were operated on before sinus lift procedure - antrostomy, cyst removal, fungus ball removal. 4 patients showed normal aspect of the sinus mucosa despite the CT scan donations, meaning a 26.66% error rate in appreciating the real changes of the maxillary mucosa on the CT scan.

CONCLUSION. Endoscopic assessment of the maxillary sinus is mandatory in patients with changes of the CT scan. This allows a proper examination of the sinus mucosa and can predict the outcomes of the sinus lift procedures. It is mandatory to cure the inflammation or infection of the maxillary sinus prior to implant procedure in order to be able to increase the success rate, as it can lead to failures of the implant procedure.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. McCaul L.K. Jenkins W.M. Kay E.J. - The reasons for the extraction of various tooth types in Scotland: a 15-year follow up. J Dent. 2001;29:401-407.

  • 2. Thomson W.M. - Monitoring edentulism in older New Zealand adults over two decades: A review and commentary. Int J Dent. 2012;2012. doi:10.1155/2012/375407.

  • 3. Muller F. Naharro M. Carlsson G.E. - What are the prevalence and incidence of tooth loss in the adult and elderly population in Europe? Clin Oral Implants Res. 2007;18 Suppl 3:2-14.

  • 4. Douglass C.W. Shih A. Ostry L. - Will there be a need for complete dentures in the United States in 2020? Journal of Prosthetic Dentistry 2002;87(1):5-8.

  • 5. Carlsson G.E. Bergman B. Hedegard B. - Changes in contour of the maxillary alveolar process under immediate dentures. A longitudinal clinical and x-ray cephalometric study covering 5 years. Acta Odontol Scand. 1967;25:45-75.

  • 6. Pietrokovski J. Massler M. - Alveolar ridge resorption following tooth extraction. J Prosthet Dent. 1967;17:21-27.

  • 7. Kelsey C.C. - Alveolar bone resorption under complete dentures. J Prosthet Dent.1971;25:152-161.

  • 8. Pietrokovski J. Starinsky R. Arensburg B. Kaffe I. - Morphologic characteristics of bony edentulous jaws. J Prosthodont. 2007;16:141-147.

  • 9. Wehrbein H. Diedrich P. - Progressive pneumatization of the basal maxillary sinus after extraction and space closure. Fortschr Kieferorthop 1992;53:77-83.

  • 10. Sharan A. Madjar D. - Maxillary sinus pneumatization following extractions: a radiographic study. Int J Oral Maxillofac Implants 2008;23:48-56.

  • 11. Johanson L.Å. - On minimally invasive approaches to sinus lift procedures. Sweden. 2012. Available from:

  • 12. Beaumont C. Zafiropoulos G.G. Rohmann K. Tatakis D.N. - Prevalence of maxillary sinus disease and abnormalities in patients scheduled for sinus lift procedures. J Periodontol. 2005;76:461-467.

  • 13. Bucur A. - Compendium de chirurgie oro-maxilo-faciala. Volumul I. Editura Q Med Publishing Bucuresti 2009.

  • 14. Manor Y. Mardinger O. Bietlitum I. Nashef A. Nissan J. Chaushu G. - Late signs and symptoms of maxillary sinusitis after sinus augmentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:e1-4.

  • 15. Anavi Y. Allon D.M. Avishai G. Calderon S. - Complications of maxillary sinus augmentations in a selective series of patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:34-38.

  • 16. Timmenga N.M. Raghoebar G.M. Boering G. van Weissenbruch R. - Maxillary sinus function after sinus lifts for the insertion of dental implants. J Oral Maxillofac Surg. 1997;55:936-939;discussion 940.

  • 17. Sarafoleanu C. - Rinologie. Editura Medicala Bucuresti 2003;pp.83-103.

  • 18. Manea C. Iosif C. Sarafoleanu D. - The value of histopathologic score as predictive factor in choosing the optimal surgical treatment for chronic rhinosinusitis. Romanian Journal of Rhinology 2012;2(6):90-95.

  • 19. Sarafoleanu C. - Examenul endoscopic al nasului si sinusurilor paranazale. In: sub red. Sarafoleanu D. - Explorarea paraclinica si functionala in Otorinolaringologie. Vol I. Editura didactica si Pedagogica Bucuresti 1998;pp.26-34.

  • 20. Testori T. del Fabbro M. Weinstein R. Wallace S. - Maxillary sinus surgery and alternatives in treatment. Quintessence Pub Co Ltd. 2009.

  • 21. Chan H.L. Wang H.L. - Sinus pathology and anatomy in relation to complications in lateral window sinus augmentation. Implant Dent. 2011;20:406-412.

  • 22. Brook I. - Sinusitis of odontogenic origin. Otolaryngol Head Neck Surg. 2006;135:349-355.

  • 23. Abrahams J.J. Glassberg R.M. - Dental disease: a frequently unrecognized cause of maxillary sinus abnormalities? AJR Am J Roentgenol. 1996;166:1219-1223.

  • 24. Watzek G. - The Precrestalsunus lift. From illusion to reality. London UK 2012;pp.3-14.

Journal information
Cited By
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 304 95 5
PDF Downloads 112 46 3