{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:55:17Z","timestamp":1791251717548,"version":"4.1.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Shandong Provincial Natural Science Foundation","doi-asserted-by":"crossref","award":["ZR2021MH195"],"award-info":[{"award-number":["ZR2021MH195"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Sinus membrane perforation is a common complication of sinus lift surgery. This review aimed to examine if anatomical factors such as the presence of septa and lateral wall thickness influence the risk of membrane perforation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study was registered on PROSPERO (CRD42023488259). PubMed, Embase, and Web of Science were searched for relevant studies published up to 26th June 2024. The outcome of interest was the risk of perforation based on presence of septa and lateral wall thickness. Random-effects meta-analysis was conducted with dichotomous data to obtain the odds ratio (OR) of perforation using Review Manager.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Ten studies with 1865 patients undergoing 2168 \u201clateral\u201d sinus lift procedures were included. The total incidence of Schneiderian membrane perforations was 19% (405 cases). Schneiderian membrane perforation was present in 169\/425 cases (39.76%) with sinus septa and 184\/1492 cases (12.33%) without septa. Meta-analysis showed that septa were significantly associated with an increased risk of perforation (OR: 4.03 95% CI: 1.77, 9.19) with high heterogeneity (I<jats:sup>2<\/jats:sup> = 87%). The certainty of the evidence was very low. Data on lateral wall thickness and risk of perforation was too heterogeneous for a meta-analysis. Studies reported mixed results on the risk of perforation based on lateral wall thickness.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our results show, with very low-quality evidence, that the presence of septa significantly increases the risk of perforations during maxillary sinus lift surgery. Evidence on the association between lateral wall thickness and a risk of perforations during sinus lift surgery is conflicting, and no clear conclusions can be derived at this stage.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0308166","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T17:23:40Z","timestamp":1723137820000},"page":"e0308166","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Association between sinus septa and lateral wall thickness with risk of perforation during maxillary sinus lift surgery: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"given":"Baohua","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiantian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhen","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7631-6592","authenticated-orcid":true,"given":"Xingguang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"key":"pone.0308166.ref001","first-page":"e168","article-title":"Short implants (<8mm) versus longer implants (\u22658mm) with lateral sinus floor augmentation in posterior atrophic maxilla: A meta-analysis of RCT`s in humans","volume":"25","author":"N Lozano-Carrascal","year":"2020","journal-title":"Med Oral Patol Oral y Cir Bucal"},{"key":"pone.0308166.ref002","doi-asserted-by":"crossref","first-page":"681","DOI":"10.11607\/jomi.10048","article-title":"The Impact of Sinus Floor Elevation Techniques on Sinus Membrane Perforation: A Systematic Review and Network Meta-analysis","volume":"38","author":"C-T Lee","year":"2023","journal-title":"Int J Oral Maxillofac Implants"},{"key":"pone.0308166.ref003","first-page":"e752","article-title":"Simultaneous and delayed direct sinus lift versus conventional implants: Retrospective study with 5-years minimum follow-up","volume":"23","author":"J Romero-Mill\u00e1n","year":"2018","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"pone.0308166.ref004","doi-asserted-by":"crossref","first-page":"773","DOI":"10.11607\/prd.1288","article-title":"Long-term implant survival in the grafted maxillary sinus: a systematic review","volume":"33","author":"M Del Fabbro","year":"2013","journal-title":"Int J Periodontics Restorative Dent"},{"issue":"Suppl 21","key":"pone.0308166.ref005","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/jcpe.13055","article-title":"Long-term effectiveness of maxillary sinus floor augmentation: A systematic review and meta-analysis","volume":"46","author":"GM Raghoebar","year":"2019","journal-title":"J Clin Periodontol"},{"key":"pone.0308166.ref006","article-title":"Perforating dental implants and maxillary sinus pathology","author":"T Brandstaetter","year":"2023","journal-title":"Oral Maxillofac Surg"},{"key":"pone.0308166.ref007","first-page":"e49553","article-title":"Maxillary Sinus Lift Procedures: An Overview of Current Techniques, Presurgical Evaluation, and Complications","volume":"15","author":"AM Alshamrani","year":"2023","journal-title":"Cureus"},{"key":"pone.0308166.ref008","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.11607\/jomi.10145","article-title":"How to Prevent and Manage Postoperative Complications in Maxillary Sinus Augmentation Using the Lateral Approach: A Review","volume":"38","author":"P. 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A systematic review","volume":"22","author":"J Ata-Ali","year":"2017","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"pone.0308166.ref010","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1902\/jop.2016.160041","article-title":"Schneiderian Membrane Thickness and Clinical Implications for Sinus Augmentation: A Systematic Review and Meta-Regression Analyses","volume":"87","author":"A Monje","year":"2016","journal-title":"J Periodontol"},{"key":"pone.0308166.ref011","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1563\/aaid-joi-D-20-00145","article-title":"Does the Presence of Pathological Change in the Schneiderian Membrane Increase the Risk of Membrane Perforation During Sinus Floor Elevation? A Systemic Review","volume":"48","author":"Y Fang","year":"2022","journal-title":"J Oral Implantol"},{"key":"pone.0308166.ref012","doi-asserted-by":"crossref","first-page":"105906","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"88","author":"MJ Page","year":"2021","journal-title":"Int J Surg"},{"key":"pone.0308166.ref013","author":"G Wells","year":"2020","journal-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses"},{"key":"pone.0308166.ref014","doi-asserted-by":"crossref","first-page":"1402328","DOI":"10.3389\/fnut.2024.1402328","article-title":"The controlling nutritional status score as a predictor of survival in hematological malignancies: a systematic review and meta-analysis","volume":"11","author":"G Lu","year":"2024","journal-title":"Front Nutr"},{"key":"pone.0308166.ref015","first-page":"77","article-title":"Association between lateral wall thickness and sinus membrane perforation during lateral sinus elevation: A retrospective study","volume":"14","author":"H Basma","year":"2021","journal-title":"Int J oral Implantol (Berlin, Ger"},{"key":"pone.0308166.ref016","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/clr.13698","article-title":"The impact of anatomic, patient and surgical factors on membrane perforation during lateral wall sinus floor elevation","volume":"32","author":"A Pizzini","year":"2021","journal-title":"Clin Oral Implants Res"},{"key":"pone.0308166.ref017","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1002\/JPER.22-0424","article-title":"Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years","volume":"94","author":"S Prajapati","year":"2023","journal-title":"J Periodontol"},{"key":"pone.0308166.ref018","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1111\/cid.13016","article-title":"Prevalence, risk factors, and repair mechanism of different forms of sinus membrane perforations in lateral window sinus lift procedure: A retrospective cohort study","volume":"23","author":"S Krennmair","year":"2021","journal-title":"Clin Implant Dent Relat Res"},{"key":"pone.0308166.ref019","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.ijom.2018.03.027","article-title":"Risk factors and clinical outcomes of sinus membrane perforation during lateral window sinus lifting: analysis of 120 patients","volume":"47","author":"HC T\u00fckel","year":"2018","journal-title":"Int J Oral Maxillofac Surg"},{"key":"pone.0308166.ref020","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.joms.2015.01.039","article-title":"Risk Factors of Membrane Perforation and Postoperative Complications in Sinus Floor Elevation Surgery: Review of 407 Augmentation Procedures","volume":"73","author":"L Schwarz","year":"2015","journal-title":"J Oral Maxillofac Surg"},{"key":"pone.0308166.ref021","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/cid.13052","article-title":"Risk factors for sinus membrane perforation during lateral window maxillary sinus floor elevation surgery: A retrospective study","volume":"23","author":"Q Shao","year":"2021","journal-title":"Clin Implant Dent Relat Res"},{"key":"pone.0308166.ref022","doi-asserted-by":"crossref","first-page":"718","DOI":"10.11607\/jomi.3657","article-title":"Perforation of the sinus membrane during sinus floor elevation: a retrospective study of frequency and possible risk factors","volume":"29","author":"T von Arx","year":"2014","journal-title":"Int J Oral Maxillofac Implants"},{"key":"pone.0308166.ref023","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/cid.12699","article-title":"Potential risk factors for maxillary sinus membrane perforation and treatment outcome analysis","volume":"21","author":"S Marin","year":"2019","journal-title":"Clin Implant Dent Relat Res"},{"key":"pone.0308166.ref024","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.jcms.2023.06.010","article-title":"Which factors affect the risk of membrane perforation in lateral window maxillary sinus elevation? 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