"Maxillary Sinus-Related Risks and Complications in Dental Implantology: Findings from a Prospective Cohort with Literature Integration"

Background: Implant placement in the posterior maxilla often requires proximity to the maxillary sinus and, at times, sinus floor elevation. Complications include Schneiderian membrane perforation, sinusitis, oroantral communication, and implant migration. The frequency, predictors, and clinical consequences of these events remain variably reported. Objectives: To (1) quantify the incidence and spectrum of sinus-related complications after implant placement in the posterior maxilla and (2) identify patient- and procedure-related risk factors, implant survival, and patient-reported outcomes. Methods: Prospective cohort of 300 adults, stratified by procedure: no sinus lift (A), lateral window lift (B), transcrestal elevation (C). Follow-up: 24 months. Pre-specified outcomes: sinusitis (acute/chronic), membrane perforation, oroantral communication (OAC), implant migration, mucosal thickening, implant survival/success, and symptom scores. Results: Overall sinus-related complications occurred in 9.3%. Perforation: 0% (A), 14% (B), 6% (C). Acute sinusitis: 5.7% overall (highest in B). Implant survival at 24 months: 97% (A), 92% (B), 95% (C). Independent predictors of sinus complications: lateral sinus lift (OR 2.9), membrane thickness >3 mm (OR 2.3), smoking (OR 1.8), residual bone height