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From: mnansari on 21 Nov 2005 04:48
I have met with an OMFS, and he said that removal of the loose
fragments would require removal of the schneidarian membrane. I asked
him if he would put another membrane instead, he said not to worry the
membrane would regrow by itself. He said that the graft infection
compromised the membrane, and that is why it should be removed.

Is this the procedure? It seems a bit drastic. Is this part of cleaning
out the sinus?

From: Dave King on 21 Nov 2005 10:51
On 21 Nov 2005 01:48:58 -0800, "mnansari" <maenansari(a)hotmail.com>
wrote:

>I have met with an OMFS, and he said that removal of the loose
>fragments would require removal of the schneidarian membrane. I asked
>him if he would put another membrane instead, he said not to worry the
>membrane would regrow by itself. He said that the graft infection
>compromised the membrane, and that is why it should be removed.
>
>Is this the procedure? It seems a bit drastic. Is this part of cleaning
>out the sinus?

The entire sinus membrane isnt removed, unless all of it is in bad
shape. This should be alot faster than the initial sinus lift so
hopefully you will not be in alot of discomfort.
From: mnansari on 21 Nov 2005 13:19
This particular OMFS said he would remove the whole membrane (he had'nt
even seen the extent of the infection) with local anesthetic which was
appealing to me. He said the procedure will take about 2 hours and cost
about $5000. The initial sinus lift was about $1700.

I have since gotten another opinion from another OMFS (Board
Certified). He said that it would be under full sedation (not so
appealing) and would require 1 to 2 days in hospital. He also told me
that he has treated cases similar to mine (infection wise), but with
molars going deep into sinuses with severe infection. I think my
infection is not that bad since I have taken many courses of
antibiotics since problems appeared. I think I will go with this OMFS.
I just hope he's not too aggressive.

I think the reason for the tear in the sinus membrane (which was
probably the cause of the infection as mentioned by Dr. King) was that
during the opening of the "window" to reach the membrane the
periodontist punched the bone with a hammer about 4 powerful hits (it
was like getting punched in the face 4 times - I was seeing stars - it
really worried me). Is that a correct procedure Dr. King? I read
somewhere from other periodontists on the internet that this could be
the cause of major tears of the membrane (the bones sharp edges cutting
into the membrane from the force of the blows). I should have looked
for a more experienced surgeon I guess. Anyway it's done. This time
I've done my research.

Dr. King, I want to thank you again, without your insite I would be
completely lost.

From: Dave King on 21 Nov 2005 14:24
On 21 Nov 2005 10:19:15 -0800, "mnansari" <maenansari(a)hotmail.com>
wrote:

>This particular OMFS said he would remove the whole membrane (he had'nt
>even seen the extent of the infection) with local anesthetic which was
>appealing to me. He said the procedure will take about 2 hours and cost
>about $5000. The initial sinus lift was about $1700.
>
>I have since gotten another opinion from another OMFS (Board
>Certified). He said that it would be under full sedation (not so
>appealing) and would require 1 to 2 days in hospital. He also told me
>that he has treated cases similar to mine (infection wise), but with
>molars going deep into sinuses with severe infection. I think my
>infection is not that bad since I have taken many courses of
>antibiotics since problems appeared. I think I will go with this OMFS.
>I just hope he's not too aggressive.
>
>I think the reason for the tear in the sinus membrane (which was
>probably the cause of the infection as mentioned by Dr. King) was that
>during the opening of the "window" to reach the membrane the
>periodontist punched the bone with a hammer about 4 powerful hits (it
>was like getting punched in the face 4 times - I was seeing stars - it
>really worried me). Is that a correct procedure Dr. King? I read
>somewhere from other periodontists on the internet that this could be
>the cause of major tears of the membrane (the bones sharp edges cutting
>into the membrane from the force of the blows). I should have looked
>for a more experienced surgeon I guess. Anyway it's done. This time
>I've done my research.
>
>Dr. King, I want to thank you again, without your insite I would be
>completely lost.

your welcome.

FYI, the type of sinus lift (Summers procedure) performed shouldnt
feel like you were punched in the face. A succesion of gentle taps is
all that is necessary to upfracture the sinus floor.
From: mnansari on 21 Nov 2005 16:03
The procedure I had was not the Summers procedure - or crestal
approach. It was the more invasive method with the "window" in the
buccal bone. Is it called lateral sinus lift? Maybe I made a mistake in
describing the procedure I had. The perio who did the operation told me
that I had about 2mm of bone, and that was why he chose this approach.
When I went to the other perio, I asked him how much bone I had, he
actually went to the panoramic x-ray and measured it and said I had 4.5
to 5.5mm.

Would the Summers procedure have been the correct one to do with this
amount of bone - how much is enough bone to do the Summers procedure?
Is the Summers procedure less expensive? I have read it is much less
invasive with higher success rate. This information could be helpful
for any person reading this link and thinking of doing the sinus lift
surgery.

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