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Analysis of Forces Applied During Transalveolar Sinus Lift

A Preliminary Clinical Study

Tavelli, Lorenzo, DDS*; Borgonovo, Andrea Enrico, MD, DDS; Ravidà, Andrea, DDS, MS; Saleh, Muhammad H. A., BDS; Zappa, Emanuele, PhD§; Testori, Tiziano, MD, DDS; Wang, Hom-Lay, DDS, MSD, PhD

doi: 10.1097/ID.0000000000000817
Basic and Clinical Research
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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.

*Graduate Resident, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

Associate Professor, Department of Oral Rehabilitation, Istituto Stomatologico Italiano, University of Milan, Milan, Italy; Ludes Foundation, University of Malta, Msida, Malta.

Post-graduate Student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

§Associate Professor, Department of Mechanical Engineering, Politecnico of Milan, Milan, Italy.

Associate Professor, Section of Implant Dentistry and Oral Rehabilitation, Dental Clinic, IRCCS Galeazzi Institute, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.

Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

Reprint requests and correspondence to: Hom-Lay Wang, DDS, MSD, PhD, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI 48109-1078, Phone: 734-764-9148, Fax: 734-936-0374, E-mail: homlay@umich.edu

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