Starch-Jensen Thomas, Østergaard Kimie Bols, Bruun Niels Henrik, Shino Inleel Lundgaard, Hallund Malene Halskov
Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark.
Department of Clinical Medicine, Aalborg University, AalborgDenmark.
J Oral Maxillofac Res. 2025 Jun 30;16(2):e1. doi: 10.5037/jomr.2025.16201. eCollection 2025 Apr-Jun.
The objective of the present systematic review was to test the hypothesis of no difference in implant outcome following transcrestal maxillary sinus membrane elevation using osseodensification compared with osteotome-mediated sinus floor elevation or maxillary sinus floor augmentation applying the lateral window technique.
MEDLINE (PubMed), Embase, and Cochrane Library search combined with hand-search of relevant journals were conducted through March 19, 2025. Randomised controlled trials with an observation period of at least six months were included. Survival of suprastructures and implants were primary outcome, while duration of surgery, implant stability quotient (ISQ), peri-implant marginal bone loss, complications, endo-sinus bone gain, bone density, and patient-reported outcome were secondary outcome, as evaluated by descriptive statistics and meta-analysis including 95% CI.
Six short-term randomised controlled trials characterised by high risk of bias and low GRADE fulfilled inclusion criteria. Comparable high implant survival was revealed. Transcrestal maxillary sinus membrane elevation using osseodensification (TSMEOD) disclosed statistically significant higher ISQ, at implant placement and abutment connection compared with osteotome-mediated sinus floor elevation (OMSFE) and maxillary sinus floor augmentation (MSFA). Duration of surgery, complications, and days using analgesics were diminished following TSMEOD. Endo-sinus bone gain was statistically significant reduced following TSMEOD compared with MSFA, while no statistically significant difference was revealed between TSMEOD and OMSFE.
Transcrestal maxillary sinus membrane elevation using osseodensification is associated with equivalent implant survival compared with osteotome-mediated sinus floor elevation and maxillary sinus floor augmentation, in short-term studies. Long-term randomized controlled trials are, therefore, needed before one treatment may be considered superior to another.
本系统评价的目的是检验以下假设：与使用骨凿介导的上颌窦底提升术或采用外侧开窗技术的上颌窦底增高术相比，采用骨致密化技术经牙槽嵴上颌窦膜提升术后种植体的预后无差异。
截至2025年3月19日，对MEDLINE（PubMed）、Embase和Cochrane图书馆进行检索，并结合对相关期刊的手工检索。纳入观察期至少为6个月的随机对照试验。上部结构和种植体的存留率为主要结局，而手术时间、种植体稳定性商数（ISQ）、种植体周围边缘骨丢失、并发症、窦内骨增量、骨密度和患者报告结局为次要结局，通过描述性统计和包括95%置信区间的荟萃分析进行评估。
六项短期随机对照试验符合纳入标准，这些试验存在高偏倚风险且GRADE较低。结果显示种植体存留率相当高。与骨凿介导的上颌窦底提升术（OMSFE）和上颌窦底增高术（MSFA）相比，采用骨致密化技术经牙槽嵴上颌窦膜提升术（TSMEOD）在种植体植入和基台连接时的ISQ在统计学上显著更高。TSMEOD术后手术时间、并发症和使用镇痛药的天数减少。与MSFA相比，TSMEOD术后窦内骨增量在统计学上显著减少，而TSMEOD与OMSFE之间未显示出统计学上的显著差异。
在短期研究中，与骨凿介导的上颌窦底提升术和上颌窦底增高术相比，采用骨致密化技术经牙槽嵴上颌窦膜提升术的种植体存留率相当。因此，在认为一种治疗优于另一种治疗之前，需要进行长期随机对照试验。
