Re-Entry Protocol after Aborted Sinus Elevation Procedure?

wait atleast 4 weeks. why did it tear ?how big? are u new in th buisiness? was the lining diseased? retention cyst phenomena? ?? change ip location if possible protho driven. consider change tx plan. cons refere to specialist, almez

ENT will tell you that after 6 to 8 weeks, the membrane will be back. What thickness? I don't know... so I would wait 4 months before re-entry. If you have a small perforation, you can use any membrane. For a bigger one, there are a few techniques, and the succes rate is similar when it is well done. Look at Testori article in IJPRD 2008-28-p.9-17 or J Oral Maxillofac Surg 64:277-282, 2006 Good luck, JF Brochu

We use 2 months and the Lining can possibly be thicker as a result. Recently we have placed graft material which sets hard directly onto a tear in a few cases with no adverse effects as the linig heals over in a few days. Maybe on your retry just create your osteotomy on the ridge and raise the lining with a ballon but this option varies from case to case.

prognosis depend on many factores such as the dimater of perforation , the health of the mambrane and so on but in normal situation when truma (during the elavation of mambrane ) is the main reason of the perforation it is better to wait as long as possible ( at least 8 weeks) and there is no matter what kind of material used if the operation would have been technicaly perfect . good luck s_yaghobee

Be also careful upon the re-entry of the membraine (Schneiderian) attaching itself to the periosteum. Without repositioning of the bony plate it is a distinct possibility

Hi Just a quick look at the possible reasons for perforation of the Schniedarian membrane during a Sinus Lift - 1) Inadequate access from ill-positioned window 2) Indadequate access from too small a window 3) Blunt instruments 4) Sharp, thin bony walls of the window with a fragile membrane attached rather fastidiuosly 5) Improper technique (I was told, and wisely so, by a mentor during my early tryst with sinus Lifts) .."do not try to push the membrane off the Sinus walls, stay along the bone and attempt to 'slide' on bone without worrying about the membrane, as in a Cyst eneucleation technique".. the membrane by and large peels off cleanly!) 6) Blame it on the membrane.. bad days and bad membranes are reality! So what if it tears? Your best chance to re-enter and not have it perforate yet again in the same location would be if it has scarred sufficiently and is also not going to yield at the same site while attempting a lift again. 6-8 weeks would offer a mature scar, depending upon a host of variables such as the pre-existing status of the Sinus ; general condition of the patient (systemic compromise would delay it further). A mature scar would be most easily visualised and accessed via the same opening that you started with earlier as, it would provide the same orientation to the Sinus as the previous time and so you would know where to expect the tear, and also with a slightly widened window, you could do better this time around. probably! Cheers