Sure you can. You can expect to find the previous antrostomy under the membrane. Even if it is not strictly needed, If you want to be very cautious you can ask for a new 3D scan to assess sinus health before the re-entry.

The question is not whether the sinus lift can be performed once more

The problem is to know what did not work in the first time

Normally a reintervention is a wee bit difficult than the first, in some parts the plans are not easy to detach, there are adherences and scars,

You have to win the nervousness and hurry, wait for the maturation of tissues, repeat all the diagnostic investigation that can help you not to repeat the mistake

Thank You Dr.Carlo. I agree with your comments. But my questions would be can the sinus lift be repeated or not? Are there available studies about success rate when sinus lift is repeated? are there any clinical tips that can be helpful to maximize the success rate?

perhaps I was not clear due to my poor English, and I apologize

You can repeat the sinus lift. In my daily work I often have to perform sinus lift failed once, sometimes two times . I say yes based on my daily practice

With regard to specific publications on the second or third sinus lift I do not remember

Thank you.

when you repeat the sinus lift due to perforation of the membrane. you will find it healed at the re-entry surgery?

yes

I'll find healed

Yes, the sinus lift can be reattempted. I would wait about 4 months and reattempt. The lateral window will likely be filled with granulation tissue and it will need to be dissected out with elevation of the flap taking care not to reperforate the membrane during this crucial step. I see many people reperforate the Schneiderian membrane when they try to elevate this soft tissue in the old lateral window site. If I have any membrane perfs, I will place a piece of amnion-chorion membrane (BioXclude) directly over the perf. This particular membrane is about the same thickness as the Schneiderian membrane and it self-adheres upon hydration. Very good technique and works well.

There some questions before i can give you a correct answer. How large was the lateral window about? how large was the membrane perforation? Why he used a non resorbable membrane? You must be careful that a non resorbable membrane exposed in the maxillary sinus shuold infect. In this case i think that a ct scan before the second attempt is mandatory.

There are few options: The first would be reentering and doing a new lift- you should be careful in disecting the soft tissue which adheres to the membrane.Second option would be doing a crestal balloon lift avoiding the lateral wall.

yes definitely we can do sinus lift again but precautions should be taken.  first if you have kept a non resorbable membrane, it can be removed at the earliest and allow for secondary healing. perforation will heal by 6 to 10 weeks, it also depends upon the size of the perforation.  Take a CT assess the structure and  while re-entering care should be taken not to perforate the membrane. Either lateral wall or crestal approach can be done even for second attempt. otherwise the amnion-chorion membrane can be used in the perforated area to allow for healing of the perforation. later re-entry can be done in the same site on the lateral wall with extra care not to perforate.

Check cone beam CT before doing again. Possible compartment-dividing septa might cause the membrane perforation and also make elevation difficult. If the surgeon is not well experienced, he or she should use the round bur with the speed of 4000 rpm. The rotation speed at 4000 rpm could make you feel the outer cortex as well inner cortex.  Moreover the level of inferior osteotomy also determines the difficulties of elevation. Orientation is also important during the sinus lift as well...