Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion

OBJECTIVE: The aim of our study was a radiographic, endoscopic, and ultrasound follow-up of the maxillary sinus comparing 2 techniques of sinus floor augmentation. STUDY DESIGN: Sonograms, radiographs (Waters' view) of the sinuses, and endoscopy served before and during surgery to evaluate the maxillary sinus. One week after the operation, ultrasound and radiograph follow-up (Waters' view) were carried out. Six months after the operation, we performed an ultrasound follow-up along with uncovering the implants. If any pathologic condition was found, we took another x-ray film of the sinuses, performed another endoscopic examination, or both. RESULTS: In 23 of 63 patients, healing was uneventful. Waters' view revealed opacification of the maxillary sinus 1 week after surgery in 40 cases when the "window technique" was used. Sinusitis occurred 3 times, as a result of migration of bone chips in 2 patients. We lost 11 of 132 inserted implants during the healing and loading periods. CONCLUSION: Endoscope-controlled sinus floor augmentation may lower the complication rate in a remaining height of the jaws between 4 and 8 mm. In our group of patients, we proved by endoscopic examination that migration of cancellous bone sequestra was the reason for sinusitis. In case of infected bone grafts with antral symptoms, sinoscopy allowed debridement and removal of a sequestrum.