Thickening of the Sinus Membrane: What Do You Recommend?

Dr. S. asks:
I have treatment planned a bilateral external sinus lift on a patient. While I was reviewing the CBVT scan I noticed on the lower part of the maxillary sinus an apparent thickening of the sinus membrane of about 5mm. The patient is in good health with no known allergies or acute or chronic sinusitis or other illnesses. Is it safe to perform a sinus lift in this situation? Should I refer the patient to an ENT for an opinion on the thickening of the sinus membrane? Have any of you seen this and what do you recommend?

7 thoughts on “Thickening of the Sinus Membrane: What Do You Recommend?

  1. Gregory J. Gosch DDS,DICOI says:

    Given the fact that the patient, other than a 5 mm thickening of the membrane, has a healthy sinus, I would move forward with the sinus lift. The membrane will actually be easier to elevate with less chance of tearing. The only caveat is to evaluate the degree of lift, i.e. the amount of obliteration of the sinus that will take place with the augmetation and/or implant placement, so that the ostium remains patent.

  2. Peter Fairbairn says:

    Possible Polyp ? go ahead use lateral window easier to see how things are , in fact prefer the lateral window especially with DASK

  3. Dennis Nimchuk says:

    Mucous cysts or diffuse mucosal thickenings are found in roughly 15% of the population but may even be higher. These deviations are most notable on CBVT radiographs and are difficult or impossible to see with periapicals or panoramic views. 5 mm is a modest thickening and should pose no problem to performing a sinus elevation. When there is a mucous retention cyst that occludes 30% or more of the sinus (I have seen 90% occlusion) the prevailing recommendation is surgical removal. Dr. Pikos advocates a pouching membrane and simultaneous grafting. Others recommend stripping out the cyst with schneiderian membrane, waiting for recovery and then grafting several months later.

  4. Roland Balan says:

    For forensic reasons I would consult the ENT. Thickening of the sinus membrane, especially unilateral, may be caused by an obstructed ventilation of that sinus. Especially these sinus tend to have an incresed acidity- by lack of ventilation. (Is there a septum deviation, or polyps) Thickening might be caused by prior infects too or age. But 5mm ?? unilateral ?? Thickened sinus mucosa never diasppears on its own- even if the cause seems to have- residual.
    The most polite procedure- secure free nasal (ENT) ventilation, remove thickend “mucosa” without grafting-wait for histologic result.(If to many septae and the ENT refuses do it by the window procedure- you will be the one to graft lateron anyway)
    The bony reorganization of any graft will develop better if no additional or chronik acidity is provided to the inevitable surgical one.
    Three months later you can do it even microinvasive and sleep well.

  5. Dr K. says:

    what about a patient that came to my office with a unliateral irregular 10mm mucous thickening??Any chance the membrane will tear more easily if i try to lift it/???

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

This entry was posted in Clinical Questions, Sinus Lifts, Surgical and tagged .

Videos to Watch:

Suturing in Guided Bone Regeneration

This video provides clinical tips for suturing techniques in Guided Bone Regeneration. In Guided Bone[...]

Watch Now!
Socket grafting with Collagen Dressing and Bond Apatite

This video demonstrates socket grafting with just bond apatite and a collagen wound dressing.[...]

Watch Now!
Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]

9 Comments

Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!