Sling Suture Technique Used to Stabilize the Collagen Membrane on the Lateral Bone Window During Maxillary Sinus Floor Augmentation With a Lateral Approach: A Retrospective Case Series

Purpose: Maxillary sinus floor augmentation is a safe and predictable technique used to increase bone volume under sinus cavity for implant placement in atrophic posterior maxilla before implant placement. Despite conflicting results concerning the new bone formation rates with or without a barrier membrane, the benefits of using a collagen membrane to cover the lateral bone window has been demonstrated, in order to prevent bone substitute particles dislodgement that may occur from the sinus cavity through the sinus antrostomy towards the oral mucosa, and to significantly reduce the postoperative swelling and pain reactions. The purpose of this case series is to present a sling suture technique used to stabilize the collagen membrane against the lateral bone window so as to improve the bone substitute stability inside the sinus cavity. Materials and methods: Maxillary sinus floor augmentation with lateral approach using sling suture technique to maintain the collagen membrane against the lateral bone window was performed in 17 patients (8 women/ 9 men, mean age: 58.2 years). Postoperative cone-beam computed tomography (CBCT) images up to 6-month follow-up were performed to control the bone graft stability at the level of the lateral antrostomy. The clinical postoperative pain and swelling were assessed through a Visual Analogue Scale (VAS) questionnaire from level 1 (low), level 5 (acceptable), to level 10 (high) at one week postoperative. Results: No bone substitute displacement was observed for all clinical cases on the CBCT images at 6-month postoperative. The pain and swelling level observed at one-week post operative were significantly low (respectively 1.6±1.0/2.1± 0.9). Conclusions: Within the limits of this case series, the use of sling suture technique to maintain the barrier membrane at the level of the lateral bone window in case of maxillary sinus floor augmentation with lateral approach surgery revealed to be a predictable protocol to prevent bone substitute displacement outside the sinus cavity.