Videoscope-assisted Lateral Maxillary Sinus Floor Elevation: Evaluation of the Schneiderian Membrane for Micro-tears

This case series will recruit patients who require lateral maxillary sinus floor elevation surgery. This procedure will be carried out as per standard surgical protocol. The periodontal resident performing the surgery will evaluate the Schneiderian membrane at several points during the surgery to determine its integrity (beyond visual inspection). This will be completed by using the videoscope to evaluate the membrane. This evaluation will take place at at least 3 points during the surgery (before membrane elevation, half-way through membrane elevation, and prior to initiating bone grafting procedures). If the resident wishes to evaluate the membrane at other points during the surgery to inspect the integrity of the membrane, this may be accomplished. This evaluation will be recorded for later, further evaluation by experienced periodontists. If no visible perforation is evident, a 1% baby shampoo solution in normal saline (Johnson and Johnson) will be applied topically over the membrane prior to videoscope evaluation. At this point, the patient will lightly blow their nose; if any micro-tears not visible to the naked eye are present, these tears will produce a bubbling effect, which will be recorded by the videoscope. This evaluation will take place with the 1st and 2nd videoscope evaluations (before membrane elevation, and mid-way through elevation).

Patients will be asked to complete a VAS questionnaire at their one-week follow-up appointment in order to determine how post-op healing has been progressing.

After all procedures have been performed, three experienced periodontists will individually evaluate the videos post-surgically. They will evaluate each video and determine if, in their opinion, there is a membrane perforation (yes/no). Each video will be evaluated in a random fashion (each video being evaluated as a separate event, and not by case). The evaluating periodontists will also be masked to the results noted by the surgeon who completed the surgery, and blinded to the patient's information.

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Key information

Conditions

Videoscope Maxillary Sinus Schneiderian Membrane

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

University of Manitoba

Winnipeg, Manitoba, Canada

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients requiring maxillary sinus floor elevation (lateral approach), with current subantral bone height 6 mm or less
Male or female patient, 18 years of age and older
Patients who exhibit adequate ability to comply with postoperative instructions, research protocols and methods
Patients who have read, understand, and have signed the informed consent form
Patients with an adequate level of oral hygiene, defined as Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS) should be <20% (after periodontal therapy, if necessary)

Exclusion criteria

Absolute contraindications:

Patients on IV bisphosphonates
Patients who are undergoing chemotherapy
Patients who have undergone head and neck radiotherapy where the field of irradiation included the maxilla
Patients whose membrane thickness is increased due to an existing sinus pathology (sinusitis or mucosal cysts): These conditions should be treated prior to surgical treatment (S. W. Kim et al. 2019)
Diabetic patients with uncontrolled diabetes and poor glycemic control
Patients who are undergoing long-term immunosuppressive therapy, or have been taking corticosteroids long-term (Bornstein et al. 2009)
Patients with active or untreated periodontitis

Relative contraindications:

Patients who have been receiving long term oral bisphosphonate therapy (3 years duration or more) (Bornstein et al. 2009)
Patients who smoke >10 cigarettes per day
Patients who are alcohol abusers (Li and Wang 2008)
Patients who are on antithrombotic medications should be treated with extra caution during surgery, as well as patients with blood disorders that may affect hemostasis

Treatment and study plan

videoscope

Other

a videoscope will be used to evaluate the integrity of the membrane while doing lateral maxillary sinus elevation surgery

Primary outcomes

incidence of micro-tears present in the Schneiderian membrane

Time frame: first evaluation will be done before the membrane is elevated; second will be part-way through elevation of the membrane; and the third evaluation will be once membrane elevation has been completed

incidence of micro-tears will be evaluated at 3 points during the surgery

Sponsors and collaborators

Lead sponsor

University of Manitoba

Other

Registry information

Important dates

Study start: 2020
Primary completion: 2022
Study completion: 2022
First posted: Aug 12, 2020
Registry last updated: Jan 6, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed