Lateral Window Osteotomy in Maxillary Sinus Augmentation: Does a Combination of Two Surgical Protocols Offer Any Advantage? A Retrospective Analysis of Clinical Outcome.

Purpose: Maxillary sinus augmentation using the lateral bone window approach has been well documented and studied, with the advent of many newer techniques and instruments. It is prudent that operators make a choice based on scientific evidence and feasibility guided by each case. The purpose of this study is to analyze whether a combination of more than one method could prove beneficial when compared to any one method alone.

Materials and Methods: Radiographic and clinical data from 48 augmented maxillary sinuses in 42 male and female patients was collected and the clinical outcome analyzed based on different clinical parameters. Data collected from 48 augmented maxillary sinuses was divided into 4 groups based on the osteotomy method used. A comparison was made between rotary diamond bur (Group 1), the piezosurgical device (Group 2), a hand-held bone scraper (Group 3) and a combination of method 1 and 3 (Group 4). Mean wall thickness for the maxillary Bucco-facial wall was measured for all cases. Clinical parameters measured included time taken to complete the osteotomy, membrane perforation, operator fatigue, anastomotic vessel damage and autogenous bone collected.

Results: Mean time taken for Group 1 was 17.33 min, Group 2 was 34.83 min, Group 3 was 38 min, Group 4 19.5 min. Membrane perforations were highest in Group 1 & 2 at 16.66%. Groups 2 and 4 showed the least chances of damage to the vessel at 16.66%. Significance of operator fatigue was highest at 16.66% in Group 4.

Conclusions: It was concluded that there may be an advantage in selecting a combination of surgical protocols in accordance with the lateral wall thickness. The advantages may extrapolate to safety, simplicity and ergonomics of surgical approach compared to any one technique alone.