Introduction: Crestal sinus membrane elevation technique is a surgical procedure that helps gain vertical bone volume when there is a pneumatization of the maxillary sinus. Due to some visual limitations inherent to the procedure, the potential for maxillary sinus membrane perforations and subsequent complications exists. A crestal sinus lift using osseodensification drills has been used lately but there are not many studies to support the protocol. The primary aim of the study is to evaluate the incidence of sinus membrane perforation during Osseodensification compared to the incidence of bone added crestal sinus elevation using osteotomes (BAOSFE). The secondary aim is to observe when the perforation occurs, during instrumentation, bone placement or implant placement.

Methods: A total of 20 sinuses of 10 fresh human cadaver heads were used in a split mouth design. One side received BAOSFE (control group), and the other side received Osseodensification lift (test group). Presurgical cone beam computed tomography (CBCT) scans were taken to evaluate the available subantral bone height and to provide a reference point to standardize the amount of elevation. All sinuses were planned for 5 mm sinus lift with simultaneous implant placement. The perforation of the membrane was recorded using a direct camera video recording on skull-less human cadaver heads. The integrity or the disruption of the maxillary sinus membrane assessed and recorded as the membrane perforation for statistical comparisons. McNemar’s test was used for statistical analysis.

Results: The rate of sinus membrane perforation in the BAOSFE was 40% and the rate for osseodensification group was 50%. There was no statistical difference between both groups (p=0.564). When evaluating the timing of the perforation, most of the perforations happened at the time of implant placement, 20% in the control group and 40% in the test groups (p=0.480). Meanwhile, 10 % of the sinuses perforated at the time of drilling in the test site compared to 20% in the control group with no significant difference (p= 0.317). No perforation was noted at the time of bone graft placement. Conclusion: No significant difference was found between both groups in the incidence of membrane perforation.

LLU Discipline





School of Dentistry

First Advisor

Yoon Kim

Second Advisor

Abdulkareem Alhumaidan

Third Advisor

Jaime Lozada

Degree Name

Doctor of Science (DSc)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Maxillary Sinus / injuries*; Osteotomy / methods*; Sinus Floor Augmentation; Osseointegration*



Page Count

xi, 18 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives