Survey of Sinus Floor Augmentation Among Oral and Maxillofacial Surgeons

Abstract

Purpose: This study aimed to investigate the clinical preferences of experienced Korean oral and maxillofacial surgeons (OMFS) regarding lateral sinus augmentation. Materials and Methods: A structured 12-item multiple-choice questionnaire was distributed to 42 OMFS in Korea, aged 36‒57 years, all with >10 years of clinical experience and working in university hospitals. The survey assessed key aspects of lateral sinus augmentation, including annual case volume, residual bone height (RBH) thresholds, instrument preferences, implant timing in low-bone conditions, graft material selection, use of growth factors, healing periods, membrane perforation management, preferred implant types, and attitudes toward smoking and alcohol use. Results: Among 42 respondents, 28 (66.7%) reported performing 1‒50 sinus grafts per year. For lateral sinus approach initiation, the most common threshold was 4 mm RBH (17/42, 40.5%), followed by 3 mm (12/42, 28.6%). The most preferred instrument for lateral wall osteotomy was the low-speed carbide or diamond bur (29/42, 69.0%), with piezoelectric devices being the second most common choice. Regarding simultaneous implant placement when RBH <3 mm, 25 respondents (59.5%) reported proceeding with placement, whereas 17 (40.5%) preferred staged procedures. Xenografts were the most frequently used graft material (17/42, 40.5%), often in combination with others. Only six clinicians (14.3%) reported using BMP-2 or similar biologics. The most preferred healing period was 6 months (14/42, 33.3%), followed by 5 (5/42, 11.9%) and 3 (5/42, 11.9%) months. For large sinus membrane perforation (>1 cm), 24 respondents (57.1%) repaired and proceeded, whereas 15 (35.7%) decided based on the case. The most common membrane repair method was the use of absorbable membranes (32/42, 76.2%). Internal connection implants were the most widely adopted system (35/42, 83.3%). For smoking patients, 14 respondents (33.3%) performed surgery regardless of cessation, whereas a similar number recommended cessation prior to surgery. Regarding alcohol intake, 18 respondents (42.9%) recommended temporary abstinence, whereas 17 (40.5%) did not consider it a considerable factor. Conclusion: Korean OMFS tend to prefer simultaneous implant placement, even with RBH <3 mm, particularly when using xenografts, to minimize surgical stages. Smoking cessation is commonly emphasized, whereas attitudes toward alcohol are more lenient. These findings reflect evolving practices within existing protocols and underscore the need for broader, multidisciplinary research to establish a more comprehensive clinical consensus on sinus augmentation.