Background: Until now, sinus floor elevation represents the gold standard procedure in the atrophic maxilla in\norder to facilitate dental implant insertion. Although the procedure remains highly predictive, the perforation of the\nSchneiderian membrane might compromise the stability of the augmented bone and implant success due to\nchronic sinus infection. The aim of this retrospective cohort study was to show that a membrane tear, if detected\nand surgically properly addressed, has no influence on the survival of dental implants and bone resorption in the\naugmented area.\nMethods: Thirty-one patients with 39 perforations could be included in this evaluation, and a control group of 32\npatients with 40 sinus lift procedures without complications were compared regarding the radiographically\ndetermined development of bone level, peri-implant infection, and implant loss.\nResults: Implant survival was 98.9% in the perforation group over an observation period of 2.7 (�± 2.03) years\ncompared to 100% in the control group after 1.8 (�± 1.57) years. The residual bone level was significantly lower in\nthe perforation group (p = 0.05) but showed no difference direct postoperatively (p = 0.7851) or in the follow-up\nassessment (p = 0.2338). Bone resorption remained not different between both groups (p = 0.945). A two-stage\nprocedure was more frequent in the perforation group (p = 0.0003) as well as peri-implantitis (p = 0.0004).\nConclusions: Within the limits of our study, the perforation of the Schneiderian membrane did not have a negative\nimpact on long-term graft stability or the overall implant survival.
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