Abstract: Objective To investigate the clinical effect of fiber-optic endoscope-assisted transalveolar technique for sinus floor elevation with simultaneous implant placement. Methods 35 patients who visited the Affiliated Stomatology Hospital of Guangzhou Medical University from September 2017 to December 2018 were selected as research subjects. A total of 51 transalveolar sinus floor elevations with simultaneous implant placements were performed. The integrity of the sinus floor mucoperiosteum was examined intraoperatively using a fiber-optic endoscope with direct visualization compared with the Valsalva test. The relationship between maxillary sinus mucoperiosteal perforation and the following factors: alveolar bone quality (Lekholm and Zarb classification), sinus floor bone cortical bone thickness, sinus floor mucoperiosteal thickness, and sinus floor elevation height was also explored. The effect of perforation of the mucoperiosteum on the implant ISQ at 6 months postoperatively was also investigated. Results Among the 51 cases of transalveolar sinus floor elevation, only 2 cases of mucoperiosteal perforation were detected by the Valsalva test, while 10 cases of perforation were detected by the endoscope, and the results showed a significant difference (P=0.013). There was no significant correlation between sinus mucoperiosteal perforation and alveolar bone quality classification, sinus floor mucoperiosteal thickness (<3 mm), or sinus floor elevation height, while there was a significant correlation with sinus floor cortical bone thickness (P=0.001). Maxillary sinus mucoperiosteal perforations with a diameter of >2 mm required a longer healing time to obtain the ideal implant ISQ. Conclusion The fiber-optic endoscope can significantly improve the detection rate of sinus mucoperiosteal perforation in transalveolar sinus floor elevation, which is helpful for the operator to judge the condition of the sinus floor mucoperiosteum and to choose a more appropriate timing for restoration.

Key words: Endoscope, Transalveolar technique for sinus floor elevation, Simultaneous implant placement, Maxillary sinus, Maxillary sinus mucoperiosteum