Volume changes of maxillary sinus augmentations over time: a systematic review

Area of Science:

• Dental implantology
• Regenerative medicine
• Biomaterials science

Background:

• Sinus augmentation (SA) is a common procedure to increase bone volume for dental implants.
• Understanding graft volume changes over time is crucial for predictable outcomes.
• Various biomaterials are used, each with potentially different volumetric stability.

Purpose of the Study:

• To systematically review the literature on three-dimensional, time-dependent graft volume changes following sinus augmentation.
• To compare volume changes associated with different biomaterials used in SA.
• To assess the impact of graft volume changes on long-term treatment success.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and CENTRAL databases.
• Inclusion of controlled and uncontrolled studies with >10 SAs and ≥6 months follow-up.
• Assessment of volume changes using computed tomography (CT) or cone beam CT (CBCT).

Main Results:

• Seven controlled and five uncontrolled studies (n=234 SAs) were included, all with a high risk of bias.
• All studies reported augmentation volume reduction (AVR) over time.
• Autogenous bone (AB) showed higher AVR (~45%) compared to bone substitutes (BS) or composite grafts (CG) (~18-22%) within 2 years.

Conclusions:

• Some degree of augmentation volume loss is expected after SA during early healing.
• BS or CG generally exhibit less volume reduction compared to AB.
• Observed augmentation volume loss did not appear to compromise subsequent implant placement or survival.