Mahardawi Basel, Jiaranuchart Sirimanas, Arunjaroensuk Sirida, Dhanesuan Kanit, Mattheos Nikos, Pimkhaokham Atiphan
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 1033, Thailand.
Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Sci Rep. 2025 Jul 2;15(1):23019. doi: 10.1038/s41598-025-06261-w.
This study aimed to collectively synthesize the available evidence on the effect of alveolar ridge preservation at the posterior maxilla in reducing maxillary sinus pneumatization after tooth extraction, and the necessity of sinus floor augmentation during implant placement. Database search, along with additional screening in the grey literature were conducted, to find clinical studies where ridge preservation was performed in the posterior maxilla, and was compared with normal healing. Eleven studies were included, with 185 and 203 sites for the test and control groups, respectively. Ridge preservation significantly decreased sinus pneumatization (SMD = - 0.88, 95% CI - 1.19 to - 0.58, p-value < 0.00001) and reduced the need for additional sinus floor augmentation when placing dental implants (OR = 0.18, 95% CI 0.09 to 0.36, p-value < 0.00001). Moreover, ridge height was significantly greater (SMD = 1.33, 95% CI 0.58 to 2.09, p-value = 0.0005), while ridge width did not show a statistical significance, compared to spontaneous healing (p-value = 0.053). Therefore, alveolar ridge preservation in the posterior maxilla decreases sinus pneumatization, as well as the need for sinus floor augmentation at the time of implant placement, along with its general benefits in preserving bone volume. Nevertheless, future comparisons are still needed, considering the small number of studies available.
本研究旨在综合现有证据，探讨上颌后牙区牙槽嵴保存对减少拔牙后上颌窦气化的影响，以及种植体植入时上颌窦底提升的必要性。通过数据库检索以及对灰色文献的额外筛选，寻找在上颌后牙区进行牙槽嵴保存并与正常愈合进行比较的临床研究。共纳入11项研究，试验组和对照组分别有185个和203个位点。牙槽嵴保存显著减少了上颌窦气化（标准化均数差[SMD]= -0.88，95%可信区间[-1.19至-0.58]，p值<0.00001），并减少了种植体植入时额外上颌窦底提升的需求（比值比[OR]=0.18，95%可信区间[0.09至0.36]，p值<0.00001）。此外，与自然愈合相比，牙槽嵴高度显著更高（SMD=1.33，95%可信区间[0.58至2.09]，p值=0.0005），而牙槽嵴宽度未显示统计学意义（p值=0.053）。因此，上颌后牙区牙槽嵴保存可减少上颌窦气化以及种植体植入时上颌窦底提升的需求，并在保留骨量方面具有总体益处。然而，考虑到现有研究数量较少，仍需要未来进行更多比较。
