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Journal of Oral & Maxillofacial Research 2020The objective of present systematic review was to test the hypothesis of no difference in histomorphometric outcome after maxillary sinus floor augmentation with... (Review)
Review
Maxillary Sinus Floor Augmentation with Autogenous Bone Graft Alone Compared with Alternate Grafting Materials: a Systematic Review and Meta-Analysis Focusing on Histomorphometric Outcome.
OBJECTIVES
The objective of present systematic review was to test the hypothesis of no difference in histomorphometric outcome after maxillary sinus floor augmentation with autogenous bone graft alone compared with alternate grafting materials applying the lateral window technique.
MATERIAL AND METHODS
MEDLINE (PubMed), Embase and Cochrane library search in combination with hand-search of relevant journals were conducted. Human studies published in English until the 25 of March, 2020 were included. Histomorphometric outcomes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI).
RESULTS
Electronic search and hand-searching resulted in 1902 entries. Sixteen randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. Descriptive statistics showed comparable or improved histomorphometric outcomes with autogenous bone graft. Meta-analysis revealed a mean difference of -7.1% (CI = -11.0 to -3.2) indicating a significant higher amount of bone after maxillary sinus floor augmentation with autogenous bone graft compared with alternate grafting materials. Subgroup analysis demonstrated a non-significantly differences of -3.7% (CI = -10.9 to 3.4), -11.5% (CI = -25.9 to 2.8), 2.2% (CI = -16.9 to 21.3), and -4.6% (CI = -14.4 to 5.2), when autogenous bone graft was compared with allogeneic bone graft, xenograft, composite grafting materials involving xenograft or synthetic biomaterial mixed with autogenous bone graft, respectively.
CONCLUSIONS
Maxillary sinus floor augmentation with autogenous bone graft seems to facilitate improved histomorphometric outcomes compared with alternate grafting materials. However, the included studies were characterised by an unclear risk of bias and various methodological confounding factors. Hence, the conclusions drawn from the results of present study should be interpreted with caution.
PubMed: 33262881
DOI: 10.5037/jomr.2020.11302 -
Dentistry Journal Mar 2022Sinus surgery procedures such as sinus lifting with bone grafting or maxillary functional endoscopy surgery (FESS) can present different complications. The aims of this... (Review)
Review
Temporal and Permanent Changes Induced by Maxillary Sinus Lifting with Bone Grafts and Maxillary Functional Endoscopic Sinus Surgery in the Voice Characteristics-Systematic Review.
Sinus surgery procedures such as sinus lifting with bone grafting or maxillary functional endoscopy surgery (FESS) can present different complications. The aims of this systematic review are to compile the post-operatory complications of sinus elevation with bone grafting and FESS including voice changes, and to elucidate if those changes are either permanent or temporary. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used, and the literature was exhaustively searched without time restrictions for randomized and non-randomized clinical studies, cohort studies (prospective and retrospective), and clinical case reports with ≥4 cases focused on sinus lift procedures with bone grafts and functional endoscopic maxillary sinus surgery. A total of 435 manuscripts were identified. After reading the abstracts, 101 articles were selected to be read in full. Twenty articles that fulfilled the inclusion criteria were included for analysis. Within the limitations of this systematic review, complications are frequent after sinus lifting with bone grafts and after FEES. Voice parameters are scarcely evaluated after sinus lifting with bone grafts and no voice changes are reported. The voice changes that occur after FESS include a decreased fundamental frequency, increased nasality, and nasalance, all of which are transitory.
PubMed: 35323249
DOI: 10.3390/dj10030047 -
Clinical Oral Implants Research Nov 2016To study the effect of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on sinus volumetric and histometric changes after sinus floor augmentation compared... (Meta-Analysis)
Meta-Analysis Review
AIMS
To study the effect of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on sinus volumetric and histometric changes after sinus floor augmentation compared to a conventional approach of non-biologic bone grafting materials.
MATERIALS AND METHODS
An electronic search of 4 databases (January 1990-February 2015), including PubMed/MEDLINE, EMBASE, Web of Science and Cochrane Central, and a hand search of peer-reviewed journals for relevant articles were performed. Human clinical trials with data on comparison of sinus volumetric and/or histometric outcomes with and without the use of rhBMP-2 in sinus grafting procedures, with ≥10 augmentation sites in each study group, and with a follow-up period of at least 6 months, were included. Random-effects meta-analyses were performed to analyze weighted mean difference (WMD) and confidence interval (CI) for the recorded variables according to PRISMA guidelines.
RESULTS
Six randomized controlled trials (RCTs) were included. The results of the meta-analyses showed that the WMD of vertical bone height gain was -0.14 mm (95% CI = -1.91 to 1.62 mm, P = 0.87), the WMD of bone density was -142.42 mg/cm (95% CI = -310.62-25.78 mg/cm , P = 0.10), the WMD of the percentage of vital bone was -4.59% (95% CI = -11.73-2.56%, P = 0.21), and the WMD of the percentage of residual bone grafting materials was -9.90% (95% CI = -26.38-6.58%, P = 0.21). The comparison of implant survival rate presented an overall risk ratio of 1.00 (95% CI = 0.94-1.07). The two approaches (conventional bone grafting compared to BMPs) demonstrated comparable effectiveness for both clinical and histomorphometric measures.
CONCLUSIONS
This systematic review revealed that the use of rhBMP-2 in maxillary sinus floor augmentation achieved similar clinical and histometric outcomes when compared to conventional sinus grafting procedures after a healing period of 6-9 months. However, previous studies showed the morbidity and other patient-reported outcomes were improved in rhBMP-2 approaches as compared to bone autograft procedures (both intraoral and extraoral bone harvesting because no donor site is required). Long-term studies are required to determine the cost-benefit of sinus floor augmentation procedures for patients requiring implant reconstruction.
Topics: Bone Morphogenetic Protein 2; Humans; Recombinant Proteins; Sinus Floor Augmentation; Transforming Growth Factor beta
PubMed: 26620161
DOI: 10.1111/clr.12737 -
Archives of Medical Science : AMS 2024Our goal was to systematically review the current evidence comparing the relative effectiveness of two maxillary sinus floor elevation (MSFE) approaches (internal and... (Review)
Review
Clinical evaluation of maxillary sinus floor elevation with or without bone grafts: a systematic review and meta-analysis of randomised controlled trials with trial sequential analysis.
INTRODUCTION
Our goal was to systematically review the current evidence comparing the relative effectiveness of two maxillary sinus floor elevation (MSFE) approaches (internal and external) without bone grafts with that of conventional/grafted MSFE in patients undergoing implantation in the posterior maxilla.
MATERIAL AND METHODS
Medical databases (PubMed/Medline, Embase, Web of Science, and Cochrane Library) were searched for randomised controlled trials published between January 1980 and May 2023. A manual search of implant-related journals was also performed. Studies published in English that reported the clinical outcomes of MSFE with or without bone material were included. The risk of bias was assessed using the Cochrane Handbook Risk Assessment Tool. Meta-analyses and trial sequence analyses were performed on the included trials. Meta-regression analysis was performed using pre-selected covariates to account for substantial heterogeneity. The certainty of evidence for clinical outcomes was assessed using GRADEpro GDT online (Guideline Development Tool).
RESULTS
Seventeen studies, including 547 sinuses and 696 implants, were pooled for the meta-analysis. The meta-analysis showed no statistically significant difference between MSFE without bone grafts and conventional MSFE in terms of the implant survival rate in the short term ( = 11, = 0%, risk difference (RD): 0.03, 95% confidence intervals (CI): -0.01-0.07, = 0.17, required information size (RIS) = 307). Although conventional MSFE had a higher endo-sinus bone gain ( = 13, = 89%, weighted mean difference (WMD): -1.24, 95% CI: -1.91- -0.57, = 0.0003, RIS = 461), this was not a determining factor in implant survival. No difference in perforation ( = 13, = 0%, RD = 0.03, 95% CI: -0.02-0.09, = 0.99, RIS = 223) and marginal bone loss ( = 4, = 0%, WMD = 0.05, 95% CI: -0.14-0.23, = 0.62, no RIS) was detected between the two groups using meta-analysis. The pooled results of the implant stability quotient between the two groups were not robust on sensitivity analysis. Because of the limited studies reporting on the visual analogue scale, surgical time, treatment costs, and bone density, qualitative analysis was conducted for these outcomes.
CONCLUSIONS
This systematic review revealed that both non-graft and grafted MSFE had high implant survival rates. Owing to the moderate strength of the evidence and short-term follow-up, the results should be interpreted with caution.
PubMed: 38757030
DOI: 10.5114/aoms/174648 -
Journal of Clinical and Experimental... Apr 2015A systematic literature review and a meta-analysis of indirect sinus lift without the use of bone graft material was performed. A PubMed search was made from January... (Review)
Review
A systematic literature review and a meta-analysis of indirect sinus lift without the use of bone graft material was performed. A PubMed search was made from January 2005 to January 2012 with keywords: "sinus lift", "osteotome", "graft" and "maxillary sinus elevation". The inclusion criteria were: maxillary sinus lift technique with osteotomes with a minimum follow-up period of 5 months after surgery without bone graft material. 11 articles were included. The mean gain in residual crestal bone height after maxillary sinus lift without bone graft material was 3,43 mm ± 0,09 (2,5 mm - 4,4 mm). The survival rate ranged from 94% to 100%. Placement of implants with sinus lift without bone graft material, is a valid surgical technique to gain residual crestal height and placed implants in an atrophic posterior maxillary with a crestal height from 5 to 9 mm. Key words:Sinus lift, osteotome, graft, maxillary sinus elevation.
PubMed: 26155353
DOI: 10.4317/jced.51716 -
Journal of Oral & Maxillofacial Research 2021Test the hypothesis of no difference in the volumetric stability of the grafting material following maxillary sinus floor augmentation with autogenous bone graft... (Review)
Review
Maxillary Sinus Floor Augmentation with Autogenous Bone Graft Compared with a Composite Grafting Material or Bone Substitute Alone: a Systematic Review and Meta-Analysis Assessing Volumetric Stability of the Grafting Material.
OBJECTIVES
Test the hypothesis of no difference in the volumetric stability of the grafting material following maxillary sinus floor augmentation with autogenous bone graft compared with composite grafting material or bone substitute alone applying the lateral window technique.
MATERIAL AND METHODS
MEDLINE (PubMed), Embase, Cochrane library and hand-search of relevant journals were conducted. Human studies published in English until the 9 of October 2020 were included. Outcome measures included three-dimensional volumetric changes of the grafting material and potential predictive parameters. Volumetric changes were evaluated by descriptive statistics and meta-analysis including 95% confidence interval.
RESULTS
Electronic search and hand-searching resulted in 102 entries. Four randomized controlled trials with unclear risk of bias fulfilled the inclusion criteria. The volumetric stability of the grafting material was significantly improved by mixing autogenous bone graft with a non-resorbable xenograft compared with autogenous bone graft. Meta-analyses assessing absolute and relative volumetric changes demonstrated no significant differences between autogenous bone graft compared with allogeneic bone graft, synthetic biomaterials combined with autogenous bone graft or used alone. Association between volumetric changes of the grafting material and potential predictive parameters were not assessed in the included studies.
CONCLUSIONS
Volumetric reduction of the augmented area seems inevitable following maxillary sinus floor augmentation regardless of the grafting material. The volumetric stability of autogenous bone graft is improved with addition of xenograft compared with autogenous bone graft. However, conclusions drawn from this systematic review should be interpreted with caution since only four studies using three-dimensional radiographic measurements were included.
PubMed: 33959236
DOI: 10.5037/jomr.2021.12101 -
The Journal of Forensic... Apr 2021Sex estimation is an important part of forensic human identification, and when primary methods cannot be applied, forensic anthropology becomes an important auxiliary...
Sex estimation is an important part of forensic human identification, and when primary methods cannot be applied, forensic anthropology becomes an important auxiliary method of identification. The maxillary sinus may remain intact even if the skull is severely damaged and could thus be used in forensic investigations. The objective of this study was to verify the effectiveness of the evaluation of the maxillary sinus as a technique for sex estimation. Articles published in the past 10 years were searched using PubMed, Web of Science, Scopus, and Cochrane databases, including those that used computed tomography to perform maxillary sinus measurements with the purpose of sex estimation. Studies that used radiographs to perform the measurements were excluded because they do not allow for a three-dimensional analysis. Studies that did not provide information regarding the origin of the analyzed population were also excluded. The selected articles were evaluated for methodological quality according to the indication of the objective, studied population, inclusion and exclusion criteria, parameters for obtaining the computed tomography image, measurements evaluated, bias discussion, and ethical authorization. From the 52 articles found, 18 were included. The populations studied included Indians, Iraqis, Iranians, Egyptians, Brazilians, French, Dutch, and Turkish. Height, width, length, and volume of the maxillary sinus were measured. The maxillary sinus can act as an auxiliary tool for sex estimation in forensic investigations.
Topics: Brazil; Cone-Beam Computed Tomography; Egypt; Humans; Iran; Maxillary Sinus
PubMed: 34057156
DOI: No ID Found -
The Angle Orthodontist Nov 2018To investigate the accuracy of panoramic radiography (PR) in diagnosing maxillary sinus-root relationships (SRRs). (Meta-Analysis)
Meta-Analysis
OBJECTIVE:
To investigate the accuracy of panoramic radiography (PR) in diagnosing maxillary sinus-root relationships (SRRs).
MATERIALS AND METHODS:
PubMed, EMBASE, CENTRAL, Web of Science, ScienceDirect, CBM, Baidu Scholar, and SIGLE were searched. The studies comparing the diagnostic accuracy of PR and computed tomography/cone-beam computed tomography (CT/CBCT) for SRR were included.
RESULTS:
Eleven studies were included. Meta-analyses showed that, for type I SRR, PR had the highest specificity, positive likelihood ratio (+LR), diagnostic odds ratio (DOR), and area under the curve (AUC), with a high sensitivity and a low negative LR (-LR). For type IV, PR had a high DOR and AUC, with the highest sensitivity but a low +LR, the lowest -LR, and the lowest specificity. For type II, PR had the lowest AUC, with a low sensitivity, +LR, and DOR and a high -LR. For type III, PR had the lowest sensitivity, +LR, and DOR and the highest -LR. The distance from root tips to the maxillary sinus floor on PR was significantly longer (mean difference: -1.88 mm; 95% confidence interval: -2.19 to -1.57; P < .0001) than that on CT/CBCT.
CONCLUSIONS:
Currently available evidence suggests PR could be reliable for detecting type I SRR. PR has a good ability to confirm true type IV SRR but a poor ability to rule out false type IV SRR. For type II and III SRR, PR shows poor accuracy and tends to overestimate the extent of protrusion of the roots into the maxillary sinus. When PRs display type II, III, or IV SRR and related treatment is needed, CBCT should be used for further examinations.
Topics: Cone-Beam Computed Tomography; Humans; Maxillary Sinus; Radiography, Dental; Radiography, Panoramic; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed; Tooth Root
PubMed: 30179053
DOI: 10.2319/022018-135.1 -
Medicina Oral, Patologia Oral Y Cirugia... May 2021Mucous retention cysts and pseudocysts of the maxillary sinus are benign lesions present in up to 13% of adult patients. Different surgical approaches for sinus lift and...
BACKGROUND
Mucous retention cysts and pseudocysts of the maxillary sinus are benign lesions present in up to 13% of adult patients. Different surgical approaches for sinus lift and dental implant placement in the presence of these lesions have been proposed.
MATERIAL AND METHODS
A systematic review was performed following the PRISMA statement recommendations to answer the PICO question: Does the aspiration or removal of mucous retention cysts/pseudocysts before or during sinus lifting and dental implant placing, affect the survival of the implants? The study was pre-registered in PROSPERO (CRD42020185528). Included articles quality was assessed using the "NIH quality assessment tool" and "The Newcastle-Ottawa scale".
RESULTS
Previous literature in this field is scarce and with a low level of evidence. There are no randomized prospective studies. Only 19 studies were identified, being composed of 2 cohort studies and 17 case series/reports. These studies involved 182 patients with a previous history of mucous retention cyst or pseudocyst in 195 maxillary sinuses where 233 implants were placed. The mean age of the patients was 45.5 (range: 12-80 years); 122 (67%) were male patients and 60 (33%) were female patients. The mean follow-up of the patients was 17.6 (range: 4-90 months). Only two fail was reported. No differences were identified in relation to the surgical approach or in relation to the removal/aspiration of the sinus lesion (prior to or simultaneous to sinus grafting) or not.
CONCLUSIONS
The level of evidence was grade 4 according to the CEBM and further studies are needed to confirm this observations, but with the available data, dental implants placement after sinus lift procedure in patients with mucous retention cysts and pseudocysts seems to be safe and present high survival regardless on the removal of the lesion or not.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Dental Implantation, Endosseous; Dental Implants; Female; Humans; Male; Maxillary Sinus; Middle Aged; Prospective Studies; Risk Factors; Young Adult
PubMed: 33247569
DOI: 10.4317/medoral.24155 -
International Journal of Implant... Aug 2022This systematic review aimed at assessing the effect of the repositioned bone lid on bone augmentation in lateral sinus lift in pre-clinical in vivo and clinical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review aimed at assessing the effect of the repositioned bone lid on bone augmentation in lateral sinus lift in pre-clinical in vivo and clinical studies. Secondary aims were to report on the healing of the bone window and to assess the implant survival rate.
MATERIAL AND METHODS
Animal and human studies comparing lateral maxillary sinus floor elevation in combination or not with the repositioned bone lid were retrieved from MEDLINE (PubMed), Web of Science and Cochrane online library. Studies published in English up to April 2022 and reporting on histological and/or radiographic outcomes were considered. Case reports, case series and reviews were excluded. A hand search was also conducted. Risk of bias was assessed and meta-analysis performed to investigate the effect of the bone lid on new bone formation.
RESULTS
After screening, 5 animal studies (4 in rabbits, 1 in sheep) and 2 clinical studies (1 RCT, 1 case-control) were included. Meta-analysis confirmed a higher new bone formation in rabbits at 2 and 8 weeks using the bone lid. The two clinical studies investigated lateral sinus lift with concomitant implant placement and reported similar results and high short-term implant success rate in both test and control groups.
CONCLUSIONS
The meta-analysis provided moderate evidence that the repositioned bone lid favored the formation of new bone to a higher extent as compared to resorbable membranes in animal studies. Implant success seems not to be influenced by the technique in the short term.
Topics: Animals; Dental Implantation, Endosseous; Humans; Maxilla; Maxillary Sinus; Rabbits; Sheep; Sinus Floor Augmentation; Transverse Sinuses
PubMed: 36036281
DOI: 10.1186/s40729-022-00433-3