Abstract
We performed a meta-analysis aimed to assess the clinical results after transalveolar sinus floor lift without bone grafting in the atrophic maxilla. A systematic electronic literature search was conducted in PubMed, Embase and The Cochrane Library, followed by a manual search. Two reviewers independently extracted study data and conducted quality assessments. Ten non-controlled studies including 1484 implants and eight controlled studies (5 RCTs and 3 prospective studies) including 817 implants (451 implants in the non-graft group) were enrolled in this study. The survival rate of implants via the graft-free method was 98% (95%CI 96% to 100%). There was no significant difference in the survival rate between the non-graft group and the graft group (RR: 1.02; p = 0.18). No statistically significant difference in marginal bone loss was detected between the groups at 12 months (0.57, p = 0.07) or 36 months (0.05, p = 0.61). The endo-sinus bone gain in the non-graft group was significantly lower than in the graft group at 12 months (−1.10, p = 0.0001) and 36 months (−0.74, p = 0.02). Hence, the available evidence suggests that predictable results could be acquired through transalveolar sinus floor lift without bone grafting, while there may be a trend toward more endo-sinus bone gain with bone grafts.
Highlights
Endosseous dental implants have frequently been used to replace missing teeth and are considered a promising method for functional reconstruction in partially edentulous patients[1]
Si MS et al.[22] found a survival rate that was slightly higher in the graft group than in the non-graft group
The results of our meta-analysis indicate that a graft-free sinus floor lift had a positive effect with a survival rate of 98% (95%confidence intervals (CIs) 96–100%)
Summary
Among the fifteen included studies, there were 10 non-controlled studies assessing graft-free methods involving 1484 implants. The pooled analysis showed that the survival rate of the graft-free method was 98% (95% confidence interval 96–100%) (Fig. 3a). There was no statistically significant difference between the two groups (P = 0.18), and no heterogeneity among the studies was detected (I2 = 0%, p = 0.55) (Fig. 3b). Six of the ten non-controlled studies reported the RBH when the survival rates of the implants were available. No statistically significant difference was detected between groups at 36 months (0.05, 95%CI −0.16 to 0.27, p = 0.61), and no evidence of heterogeneity was found (I2 = 0.0%, p = 0.89) (Fig. 4a).
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