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Friday, November 9, 2018

Sinus floor elevation in sites with a perforated schneiderian membrane: What is the effect of placing a collagen membrane in a rabbit model?

Abstract

Objective

To investigate the healing following sinus grafting in sites with a perforated schneiderian membrane repaired using a collagen membrane, compared to control sites without membrane perforation.

Materials & Methods

Following elevation of the sinus membrane in 16 rabbits, each sinus was assigned to one of the following groups: (i) intentional schneiderian membrane perforation, followed by the placement of a collagen membrane and bone grafting (group SMP), (ii) bone grafting without a perforation of the schneiderian membrane and without a collagen membrane placement (control group). At 2 and 4 weeks (n=8 for each time‐point), micro‐computed tomographic (micro‐CT) and histomorphometric analyses were performed.

Results

Overall new bone formation in group SMP was significantly delayed compared to the control group at 2 and 4 weeks (1.58±1.25 vs. 9.23±2.69% at 2 weeks, 10.43±3.55 vs. 17.86±4.11% at 4 weeks, p<0.05). At 2 weeks, new bone formation for the areas close to lateral (1.19±2.02%) and medial sinus bone walls (3.17±1.98%) was markedly delayed in group SMP compared to the control group (13.08±6.13 and 12.75±5.63%, respectively, p<0.05), but there was no statistical difference in those areas at 4 weeks (p>0.05). The augmented volumes at 2 and 4 weeks were not statistically significantly different in both groups.

Conclusion

The perforation of the schneiderian membrane and the repair using a collagen membrane delayed new bone formation in the augmented sinuses. However, the extension of the collagen membrane on the sinus bone walls was also attributable to this delayed bone formation.

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