The sinus bone graft: Report of the first audit at a teaching institution

Objectives: To check if the current crestal and lateral approaches for sinus lift have acceptable success
Methods: A retrospective audit was performed on 42 consecutive sinus lift procedures in 34 patients treated for sinus bone augmentation in posterior maxilla over the last 4 years (2010-2014), using particulate allogeneic bone graft material and absorbable gelatin sponge. The clinical notes were used to collect information on the following: age, sex, type of sinus lift procedure (lateral/crestal), simultaneous implant placement with sinus lift, recorded postoperative complication like 'perforation of sinus membrane', postoperative sinusitis within one year, no bone formation at postoperative intervals, and osseointegration of the immediate/delayed implant placement.

Results: The mean age of patients undergoing this procedure was 52.93 years. 20 patients were females and 14 were males.There were 23 crestal and 19 lateral sinus lift procedures performed. The frequency of overall sinus membrane perforation recorded was 14.4 %, with 7.2 % perforated less than 5 mm, 4.8 % perforated more than 5 mm, and 2.4% perforated more than 5 mm but primarily repaired. No bone formation or graft loss after 6 months was found in 2.4 %, while implant failures in augmented sinus was 7.1 %.
Conclusions: The incidence of complications from sinus lift procedures is comparable to, if not less than, what has been reported in previous studies. Hence, there is evidence of a reasonably high standard of care taken to minimize the complications, and no changes in the way the procedure is carried out is indicated at present. However, this clinical audit did highlight the lack of documentation and standardization of postoperative assessment for wound infection, wound dehiscence and transient sinusitis after procedure. A need is felt for introduction of a proforma assessment system at the department for sinus lift procedures.