Packed in More Graft than Needed: What Should I Do?
This is my first case of using a lateral window for a sinus lift. The surgery went very well and I did not notice any perforations of the Schneiderian membrane after I elevated it. I packed 3.5 grams of bone graft material into the sinus. When I viewed the immediate post-op panoramic radiograph, I noticed that I had packed in a bit more graft than I really needed and this appears to have obliterated part of the maxillary sinus cavity. The graft is tent shape with the summit at the first molar area. Could this result in any complications? The patient reported some nose bleeding the day after the surgery and I wonder if this could be an indication of a perforated membrane due to excessive packing of the graft material? Is there anything I can do? Should I just observe at this point?