Complications related to maxillary sinus lift procedures: narrative review

Abstract

Aim: This narrative review aims to synthesize the current evidence regarding complications related to maxillary sinus floor elevation procedures, specifically focusing on the lateral and transcrestal approaches. The goal is to categorize the main adverse events, assess their frequency, and analyze their etiopathogenic mechanisms and clinical effects.

Materials and Methods: An extensive electronic search was performed using the MEDLINE database (via NCBI PubMed and PMC). The search strategy included MeSH terms and Boolean operators, such as “maxillary sinus augmentation,” “lateral sinus lift and complications,” and “transcrestal sinus elevation.” Eligible studies comprised randomized controlled trials, observational clinical studies (prospective and retrospective), narrative and systematic reviews, case series, and case reports published in English or Italian. Additionally, a manual screening of references from selected articles and relevant position papers was conducted to ensure a thorough review.

Results: The review identified a spectrum of complications, including Schneiderian membrane perforation, hemorrhage, graft material displacement, chronic rhinosinusitis, obstruction of the ostiomeatal complex, benign paroxysmal positional vertigo, and implant displacement. The occurrence and severity of these events vary depending on the surgical technique, anatomical factors, and biomaterials used. Recent evidence supports the potential benefits of basal bone implant placement in selected cases as an alternative to sinus elevation.

Conclusion: Within the limitations of the current evidence, sinus augmentation procedures, although predictable, are associated with a non-negligible risk of complications. Clinical success depends on accurate case selection, anatomical assessment, and surgical expertise. Further clinical investigations are required to optimize preventive and management strategies.