无移植物上颌窦底提升术：系统评价和荟萃分析。

Graft-Free Maxillary Sinus Floor Elevation: A Systematic Review and Meta-Analysis.

机构信息

Department of General Dentistry, School and Hospital of Stomatology, Peking University, Beijing, People's Republic of China.

Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore.

出版信息

J Periodontol. 2017 Jun;88(6):550-564. doi: 10.1902/jop.2017.160665. Epub 2017 Feb 7.

DOI:10.1902/jop.2017.160665

PMID:28168901

Abstract

BACKGROUND

This systematic review and meta-analysis aims to investigate survival rates of dental implants placed simultaneously with graft-free maxillary sinus floor elevation (GFSFE). Factors influencing amount of vertical bone gain (VBG), protruded implant length (PIL) in sinus at follow-up (PILf), and peri-implant marginal bone loss (MBL) are also evaluated.

METHODS

Electronic and manual searches for human clinical studies on simultaneous implant placement and GFSFE using the lateral window or transcrestal approach, published in the English language from January 1976 to March 2016, were conducted. The random-effects model and mixed-effect meta-regression were used to analyze weighted mean values of clinical parameters and evaluate factors that influenced amount of VBG.

RESULTS

Of 740 studies, 22 clinical studies were included in this systematic review. A total of 864 implants were placed simultaneously with GFSFE at edentulous sites having mean residual bone height of 5.7 ± 1.7 mm. Mean implant survival rate (ISR) was 97.9% ± 0.02% (range: 93.5% to 100%). Weighted mean MBL was 0.91 ± 0.11 mm, and it was significantly associated with the postoperative follow-up period (r = 0.02; R = 43.75%). Weighted mean VBG was 3.8 ± 0.34 mm, and this parameter was affected significantly by surgical approach, implant length, and PIL immediately after surgery (PILi) (r = 2.82, 0.57, 0.80; R = 19.10%, 39.27%, 83.92%, respectively). Weighted mean PILf was 1.26 ± 0.33 mm (range: 0.3 to 2.1 mm).

CONCLUSION

Within limitations of the present systematic review, GFSFE with simultaneous implant placement can achieve satisfactory mean ISR of 97.9% ± 0.02%.

摘要

背景

本系统评价和荟萃分析旨在调查无植骨上颌窦底提升（GFSFE）同期牙种植体的存活率。还评估了影响垂直骨增量（VBG）量、窦内突出种植体长（PILf）和种植体边缘骨吸收（MBL）的因素。

方法

对 1976 年 1 月至 2016 年 3 月期间发表的关于同期使用外侧壁或经牙槽嵴窦底提升法植入 GFSFE 的人类临床研究进行了电子和手动检索。采用随机效应模型和混合效应荟萃回归分析，对临床参数的加权平均值进行分析，并评估影响 VBG 量的因素。

结果

在 740 项研究中，有 22 项临床研究被纳入本系统评价。共有 864 个种植体同期植入无牙区，剩余骨高度平均为 5.7±1.7mm。种植体存活率（ISR）的加权平均值为 97.9%±0.02%（范围：93.5%至 100%）。加权平均 MBL 为 0.91±0.11mm，与术后随访时间显著相关（r=0.02；R=43.75%）。加权平均 VBG 为 3.8±0.34mm，该参数受手术入路、种植体长度和术后即刻 PILi 显著影响（r=2.82、0.57、0.80；R=19.10%、39.27%、83.92%）。加权平均 PILf 为 1.26±0.33mm（范围：0.3 至 2.1mm）。