Clinical Oral Investigations

, Volume 22, Issue 3, pp 1139–1145 | Cite as

Mechanical characteristics of the maxillary sinus Schneiderian membrane ex vivo

  • Angel Insua
  • Florencio Monje-Gil
  • Lucía García-Caballero
  • Jordi Caballé-Serrano
  • Hom-Lay Wang
  • Alberto Monje
Original Article



It has been speculated that certain Schneiderian membrane thickness (SMT) might be more prone to perforation. This investigation was aimed at studying the mechanical characteristics of the Schneiderian membrane under one- and two-dimensional tests and their correlation to the histological SMT in human samples.

Material and methods

Sixteen Schneiderian membranes were collected from 11 cadaver heads treated with Thiel’s embalming method. The samples were processed and analyzed clinically and histologically. One-dimensional maximum elongation until perforation and two-dimensional resistance to ball penetration were performed after the biopsy. Data was analyzed by using the Wilcoxon rank test and the Spearman’s rank correlation.


The histological SMT was 1.36 ± 0.42 mm, whereas the clinical thickness was 0.27 ± 0.21 mm, yielding statistical significance (p = 0.000). The resistance under ball penetration was 0.59 ± 0.43 N and the mean maximum elongation in the one-dimension test 11.19 ± 7.14 mm. Expressed in percentage, the mean stretch was 241.36 ± 227.97% (range 31.5 up to 947%). A weak positive correlation was found between the ball penetration test and the SMT (r = 0.10, p = 0.711), while a weak negative correlation was found between stretching test and the SMT (r = −0.021, p = 0.94).


Mechanical tests seem to indicate that SMT might not significantly predispose to Schneiderian membrane perforation. Hence, other anatomical and operator’s factors should be considered of surpassing importance.

Clinical relevance

Thinner SM might be more prone to perforation when detaching it from the maxillary sinus antrum; however, a thick membrane is not prevented to tear, as their resistance under elastic forces is not higher than thinner ones.


Dental implants Grafting Bone Alveolar ridge augmentation Maxillary sinus floor augmentation 



This article was fully supported by FEDICOM (Fundación para el Estudio y Desarrollo de la Implantologia, Cirugía Oral y Maxilofacial, Badajoz, Spain). We thank Dr. Domingo Macias (Department of Anatomy and Pathology, University of Extremadura, Badajoz, Spain) for his collaboration, support, and acquisition of the specimens. We thank Dr. Tomás García-Caballero (Professor with Chair, Department of Morphological Sciences, University of Santiago de Compostela, Spain) for processing and assessing the histological samples. Furthermore, we thank Christian Caballé for designing the clamping devices used in the study.


This article was fully supported by FEDICOM (Fundación para el Estudio y Desarrollo de la Implantologia, Cirugía Oral y Maxilofacial, Badajoz, Spain).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

As the study involved the biopsy of cadaver samples without personal private information, the approval of the ethical committee was not needed, although it was conducted under the permission and supervision of the Department of Anatomy and Pathology of The University of Extremadura, Badajoz, Spain.

Informed consent

The Department of Anatomy and Pathology of The University of Extremadura kept all the consents for research and educational uses of the bodies.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Angel Insua
    • 1
    • 2
  • Florencio Monje-Gil
    • 3
  • Lucía García-Caballero
    • 4
  • Jordi Caballé-Serrano
    • 5
  • Hom-Lay Wang
    • 1
  • Alberto Monje
    • 1
    • 6
    • 7
  1. 1.Department of Periodontics and Oral Medicine, School of DentistryUniversity of MichiganAnn ArborUSA
  2. 2.Department of Oral Surgery and Oral Medicine, School of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
  3. 3.Department of Oral and Maxillofacial SurgeryHospital Infanta CristinaBadajozSpain
  4. 4.Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS)University of Santiago de CompostelaSantiago de CompostelaSpain
  5. 5.Department of Oral and Maxillofacial SurgeryInternational University of CataloniaBarcelonaSpain
  6. 6.Department of Oral Surgery and Stomatology, ZMK School of DentistryUniversität BernBernSwitzerland
  7. 7.Department of PeriodontologyInternational University of CataloniaBarcelonaSpain

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