Nasr Shaimaa, Slot Dagmar E, Bahaa Samah, Dörfer Christof E, Fawzy El-Sayed Karim M
Oral Medicine and Periodontology Department, Fayoum University, Fayoum, Egypt.
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
J Craniomaxillofac Surg. 2016 Oct;44(10):1607-1617. doi: 10.1016/j.jcms.2016.06.022. Epub 2016 Jul 2.
The aim of the present study was to systematically assess the current evidence on the effect of nongrafted compared to graft-assisted maxillary sinus floor elevation on implant survival/failure, endosinus bone gain, crestal bone loss, and bone density around dental implants.
MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE databases were searched up to November 2015 for randomized controlled trials (RCTs) and controlled clinical trials-(CCTs), evaluating dental implants placed in combination with maxillary sinus elevation without and with bone grafting. Implant survival/failure served as the primary outcome, whereas endosinus bone gain, crestal bone loss, and bone density around dental implants were secondary outcomes. To assess possible bias, the Cochrane risk of bias tool was used. Data were extracted and a meta-analysis performed where appropriate.
Independent screening of 3180 papers resulted in six eligible experiments. Heterogeneity was observed among experiments. One experiment showed low, three unclear, and two a high risk of bias. The assessed outcomes showed no significant long-term differences between groups.
Within the limit of the current systematic review, nongrafted maxillary sinus floor elevation seems to be characterized by new bone formation and high implant survival rate comparable to bone-graft-assisted maxillary sinus floor augmentation. Further long-term studies are needed before definitive conclusions can be made.
本研究旨在系统评估与植骨辅助上颌窦底提升术相比，非植骨上颌窦底提升术对种植体存活/失败、窦内骨增量、嵴顶骨吸收以及种植体周围骨密度的影响的现有证据。
检索MEDLINE-PubMed、Cochrane-CENTRAL和EMBASE数据库至2015年11月，查找评估未植骨和植骨上颌窦提升术联合植入牙种植体的随机对照试验（RCT）和对照临床试验（CCT）。种植体存活/失败作为主要结局，而窦内骨增量、嵴顶骨吸收以及种植体周围骨密度为次要结局。为评估可能的偏倚，使用Cochrane偏倚风险工具。提取数据并在适当情况下进行荟萃分析。
独立筛选3180篇论文后得到6项符合条件的实验。实验间存在异质性。1项实验显示低偏倚风险，3项不明确，2项高偏倚风险。评估的结局显示两组间无显著长期差异。
在当前系统评价的范围内，非植骨上颌窦底提升术似乎以新骨形成和高种植体存活率为特征，与植骨辅助上颌窦底增高术相当。在得出明确结论之前，需要进一步的长期研究。
