Schneiderian Membrane Perforation Rate and Increase in Bone Temperature During Maxillary Sinus Floor Elevation by Means of Er:YAG LaserAn Animal Study in Pigs

Purpose:To assess the time of preparation, bone temperature increase, and the Schneiderian membrane perforation rate during maxillary sinus floor elevation.Materials and Methods:The research included 30 maxillary sinuses (n = 30) of a pig, divided into 2 groups (n = 15). The lateral bony windows were created using Er:YAG laser (200 mJ, 15 Hz, energy density: 25.48 J/cm(2)) and a diamond bur (control). The membrane was elevated using laser (50 mJ, 50 Hz) and hand instruments. The bone temperature was measured by K-type thermocouple.Results:Significantly lower rates of the Schneiderian membrane perforation were found in the laser group (6.67%) compared with the bur (33%) (P < 0.05). The significant higher increase in temperature (mean 7.6 degrees C) was found in the experimental group as compared with the control group (mean 2 degrees C) (P = 0.0000033). The average time necessary for the laser bony window osteotomy was 10 minutes and 37 seconds, whereas using the bur required middling 5 minutes and 50 seconds (P = 0.000283).Conclusion:The application of Er:YAG laser may significantly reduce the risk of iatrogenic perforation of the Schneiderian membrane and does not cause an irreversible thermal damage in a pig model.