Dr. Z. asks:
I have a question which may be rather naive for the experienced implant surgeons. What is wrong with perforating the floor of the maxillary sinus with an implant? The implant will engage two cortical plates which should provide greater initial primary stability. This should be especially helpful in Type IV bone. Will bone grow up from the floor of the maxillary sinus to eventually cover the implant? I have attended lectures where plastic surgeons have demonstrated procedures where they perforate the maxillary sinus with screws when doing reconstructions. They do not seem to be as concerned as we are about the problems that perforations might cause. Any comments?