Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (34): 5570-5576.doi: 10.12307/2021.256

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Transalveolar sinus floor elevation with or without grafting materials: a meta-analysis

Shi Qianhui, Wu Chao, Zhou Qian, Qi Yuhan, Huo Hua, Liao Jian   

  1. School/Hospital of Stomatology of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
  • Received:2020-08-07 Revised:2020-08-11 Accepted:2020-09-19 Online:2021-12-08 Published:2021-07-28
  • Contact: Liao Jian, MD, Master’s supervisor, Associate professor, Associate chief physician, School/Hospital of Stomatology of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
  • About author:Shi Qianhui, Master candidate, School/Hospital of Stomatology of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
  • Supported by:
    Guizhou Provincial Natural Science Foundation, No. LH [2016]7257 (to LJ)

Abstract: OBJECTIVE: At present, there is no consensus on whether to use bone grafts while lifting the macillary sinus, and there are still controversies. This article compared and analyzed the clinical outcome after transalveolar sinus floor elevation with or without grafting materials.
METHODS:  A computer search was conducted to search all clinical studies on transalveolar sinus floor elevation with and without grafting materials published in CNKI, Wanfang, VIP, CBM, Embase, PubMed, Web of Science and Cochrane. Finally, two reviewers independently extracted study data and conducted quality assessments according to the Cochrane manual and NOS scale, and then used RevMan 5.3 software and Stata 15.1 software to analyze the research data which finally met the inclusion criteria for meta-analysis. 
RESULTS: (1) A total of eleven articles were included, six were randomized controlled trials and five were prospective cohort studies, including 994 implants, with 399 implants in the graft group and 595 implants in the non-graft group. (2) The results of meta-analysis showed that there was no significant difference in implant failure rate (RR=0.57, 95%CI:0.28-1.18, P=0.13), and marginal bone loss (SMD=0.03, 95%CI:-0.23-0.29, P=0.80) between implants with and without graft materials after transalveolar sinus floor elevation. The risk of membrane perforation in the non-graft group was lower than that in the graft group (RR=0.33, 95%CI:0.12-0.96, P=0.04), but the amount of endo-sinus bone gain in the non-graft group was significantly lower than that in the graft group (SMD=-0.89, 95%CI:-1.08 to -0.70, P < 0.05).
CONCLUSION: Transalveolar sinus floor elevation simultaneously implanted with grafting and without grafting can achieve predictable results. There were no statistically significant difference between two groups in implant failure rate and marginal bone loss. There may be a trend toward more endo-sinus bone gain with grafting. However, the sinus membrane perforation rate in the graft group was higher than that in the non-graft group. Therefore, choosing transalveolar sinus floor elevation without grafting during clinical practice has more advantages than that with grafting and the security is high. However, due to the limitation of the quality and many shortcomings of the included literatures, the above conclusions need to be validated by high-quality, multi-center and large-sample randomized controlled trials.

Key words: bone, maxillary sinus, bone augmentation, bone graft material, maxillary sinus elevation, oral implants, meta-analysis

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