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DOI

https://doi.org/10.1016/j.jds.2025.10.036

First Page

509

Last Page

514

Abstract

Background/purpose This ex vivo study aimed to evaluate the perforation of Schneiderian membrane upon the advancement of drills incrementally in 1 mm passing through the sinus during the implant site osteotomy with two different drill types and techniques. Materials and methods Fifty goat heads with 50 pairs of sinuses were assigned to two groups: osseodensification drill (OD) and inverse conical shape drill (ICSD) to simulate transcrestal sinus elevation. Osteotomy was performed to pass through the lateral sinus wall, advancing the drills incrementally in 1 mm until perforation occurred. The integrity of the Schneiderian membranes was confirmed under a microscope. Results The OD group caused sinus perforation after drilling 1 mm beyond the sinus wall, with 8 perforations (16 %) out of 50. The ICSD group only showed perforations after 2 mm of drilling, with 3 perforations (6 %) out of 50. Seventy percent of perforations in the OD group occurred within 3 mm, while 44 % of those in the ICSD group did. Most OD perforations occurred between 2 and 3 mm, while in the ICSD group, they occurred between 3 and 4 mm. No perforation was observed in the ICSD group when drilling up to 1 mm beyond the sinus wall. Conclusion Different designs of the drills possessed different tolerance of the advancement of drills exceeding the sinus walls. The ICSD group did not show sinus membrane perforation until the drills extended 2 mm passing through the sinus wall, while the OD group would encounter perforation with less than 1 mm exceeding the sinus walls.

Publication Date

1-1-2026

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