OBJECTIVES: Perforation of the Schneiderian membrane (SM) is a common intraoperative complication of sinus augmentation. This study aimed to evaluate risk factors for SM perforation, and to compare clinical outcomes between patients with SM perforation repaired using crosslinked collagen membranes (CLM) compared to those with an intact SM. METHODS: A retrospective cohort study was conducted at a single tertiary medical center. Data was collected on patients requiring sinus augmentation via lateral approach prior to implant placement. The collected data included demographics, surgical details, implant outcomes, radiographic analysis, and presence of SM perforation. In cases of perforation a CLM was used to repair the SM. Statistical analysis was performed to evaluate risk factors for perforation and whether SM perforation repair using CLM influenced early implant failure (EIF). A p-value <
0.05 was considered significant. RESULTS: Data on 194 individuals who underwent 278 lateral approach sinus augmentation procedures was collected. SM perforation occurred in 66 (23.74%) sinuses. Treatment of SM perforation using CLM yielded similar results to sinuses without perforations: EIF and the augmented gained bone did not correlate with SM perforation. Younger patients, and thick SMs (>
3 mm) had significantly lower risk of perforation. CONCLUSIONS: Older age and thinner SMs are risk factors for sinus membrane perforations. No significant differences in bone gain and EIF were found between perforated and intact membranes. CLINICAL RELEVANCE: Schneiderian membrane perforation repair using crosslinked collagen membrane provides comparable results to sinus augmentations without perforations, demonstrating its effectiveness in preventing complications.