In an extraction near the maxillary sinus floor, what socket preservation approach minimizes sinus complications?

• A. Extraction with no graft.
• B. Atraumatic extraction with socket grafting using bone substitute and membrane; consider sinus lift planning if sufficient residual bone height.
• C. Extraction with immediate implant placement without graft.
• D. Extraction with packing material only.

Answer: (B)

The strategy tested is about preserving the socket when an extraction is near the upper jaw sinus floor to prevent sinus problems. The best approach is to perform an atraumatic extraction and fill the socket with a bone substitute graft while placing a membrane. This combination provides an osteoconductive scaffold that supports new bone growth and a barrier that keeps soft tissue from invading the healing space, helping to maintain ridge height and width. By preserving the bony architecture and protecting the sinus membrane, the risk of sinus membrane perforation, sinusitis, or future grafting complications is minimized. If there’s enough remaining bone height, planning for a sinus lift can be considered to ensure adequate vertical support for future implants.

Other approaches either neglect bone preservation, fail to provide a regenerative scaffold, or don’t adequately protect the sinus membrane, increasing the chance of sinus-related complications.