Radiographic comparison of osseous healing after maxillary sinusotomy performed with and without a periosteal pedicle

To assess the postoperative fate of bone trapdoors in patients with a trapdoor in the facial wall of the maxillary sinus that was replaced after removal of sinus disease. Twenty patients were studied. In 10 patients (group A) the trapdoor was made as a free bone graft; in the other 10 patients (group B), an osteoperiosteal trapdoor was made. The postoperative fate of bone trapdoors was studied by means of computed tomography. In group A there was poor bony consolidation at the trapdoors' junction with the surrounding bone and a significantly reduced density of the osteotomized bone. In two of the group A patients there was a partial loss of the trapdoor. In group B, however, bony consolidation took place in that all the trapdoors were completely connected again to the surrounding bone and there was no reduction of the bone density. The results indicate that a trapdoor with a periosteal pedicle appears to be more reliable than one without a periosteal pedicle.