Piezotome Versus Surgical Bur: Which is More Effective in Reducing the Postoperative Pain and Edema Following Open Sinus Lift Surgery?

OBJECTIVE: The aim of this study was to compare the piezotome versus surgical bur on postoperative edema and pain following open sinus lift surgery. MATERIALS AND METHODS: This was a double-blinded split mouth randomized clinical trial. The subjects who were candidates for bilateral open sinus lifting in the posterior maxilla were included in this experiment. Each maxillary side was assigned randomly to one group, piezosurgery or surgical diamond bur for sinus lifting. Postoperative pain and edema were evaluated on the second and seventh days after the surgery, using the VAS scale. Data were analyzed by SPSS software. RESULTS: In this study, 20 subjects including 10 females (50%) and 10 males (50%) with a mean age of 50.87 ± 9.04 years participated. The mean duration of surgery in piezosurgery (240.13 ± 49.5 s) was significantly higher than the surgical bur technique (135.07 ± 43.53 s) (P < 0.001). Pain and edema were significantly decreased on the seventh day postoperatively compared to the second day in both group (P < 0.05). Pain and edema were similar between the two study groups on the second and seventh days after surgery. CONCLUSION: The results of this study depicted that the piezosurgery clinical outcomes were similar to surgical bur following open sinus lift surgery.

Open Sinus Lift Surgery and the Importance of Preoperative Cone-Beam Computed Tomography Scan: A Review.

Open sinus lift surgery is a form of pre-prosthetic surgery for increasing the quality and quantity of bone in the posterior region of the maxilla. Pre-operative assessment of the maxillary sinus is essential for the success of this surgery. PubMed search was carried out in English language literature for open sinus lift surgery and cone-beam computed tomography (CBCT). The results focused on anatomic variants, vascular anatomy, complications, osteotomy/ostectomy window dimensions and thickness of the Schneiderian Membrane. 59 articles were included in this review. Features other than the height and the width of the residual alveolar ridge that should be evaluated in preoperative CBCT scan include the thickness of the lateral maxillary sinus wall, the presence of the alveolar antral artery and its diameter, the maxillary sinus floor width and angulation, irregularity of sinus floor, intimate relation of Schneiderian membrane with the roots of the adjacent teeth, sinus septum, and the quality of subantral bone. Other conditions that occasionally may be observed in special situations are also explained. More than ten parameters should be checked in evaluating CBCT images of paranasal sinuses other than the width and the length of the residual ridge in the posterior region of the maxilla. Each of them may have a significant impact on the results of the open sinus lift surgery.

Alveolar Antral Artery: Review of Surgical Techniques Involving this Anatomic Structure.

INTRODUCTION: The horizontal bony canal in the lateral maxillary wall is the site of anastomosis between the arterial branches from the posterior superior alveolar artery (PSAa) and the infraorbital artery. This anatomic structure is known as the 'alveolar antral artery'. MATERIALS AND METHODS: We performed a literature review. The anatomic location of the alveolar antral artery in the lateral maxillary sinus wall was researched and its importance in surgical procedures routinely performed on this bony wall discussed. RESULTS: This artery can be accidentally involved during surgical procedures on the lateral maxillary sinus wall, such as open sinus lift surgery, horizontal osteotomy of the maxilla, Le Fort I fracture treatment, and Caldwell-Luc surgeries. CONCLUSION: The alveolar antral artery is an important anatomic structure in the lateral maxillary sinus wall. A preoperative cone beam computed tomography (CBCT) scan can be used as a good diagnostic procedure to reduce surgical complications in suspected cases as well as conditions that may involve this artery.