Minimally invasive antral membrane balloon elevation in the presence of antral septa: a report of 26 procedures.

Antral septa of the maxillary sinus occurs in approximately one third of patients undergoing posterior maxillary bone augmentation and is considered a relative contraindication for lateral maxillary window ("hinge osteotomy"). We present the results of 26 consecutive cases of patients with septated maxillary sinus who underwent minimally invasive antral membrane balloon elevation (MIAMBE) followed by bone augmentation and implant fixation. After undergoing preprocedural assessment and signing an informed consent, 57 consecutive patients were referred for posterior maxillary bone augmentation. Alveolar crest exposure (via 3-mm osteotomies), MIAMBE, and bone augmentation were followed by implant placement and primary closure (executed at the same sitting). Implant loading was done 6-9 months later. Twenty-six out of 57 (45.6%) patients had significant septa (detected on computed tomography) in the designated augmentation region. Twenty-four (92%) concluded the initial procedure successfully. Two patients had membrane tear requiring procedure abortion. Mean procedure time was 48 +/- 23 minutes. Incremental bone height consistently exceeded 10 mm, and implant survival of 95.2% was observed at 6-9 months. MIAMBE can be applied to patients in need of posterior maxilla bone augmentation in the presence of septated maxillary sinus with high procedural success, low complication rate, and satisfactory bone augmentation and implant survival. MIAMBE should be an alternative to the currently employed methods of maxillary bone augmentation, especially in the presence of septated maxilla.