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

Area of Science:

• Dental Implantology
• Oral and Maxillofacial Surgery
• Regenerative Dentistry

Background:

• Maxillary sinus augmentation is often required for dental implant placement.
• Graft-free maxillary sinus floor elevation (GFSFE) offers a less invasive alternative.
• Simultaneous implant placement with GFSFE is a technique with growing interest.

Purpose of the Study:

• To systematically review and meta-analyze survival rates of dental implants placed simultaneously with GFSFE.
• To evaluate factors influencing vertical bone gain (VBG), protruded implant length in the sinus at follow-up (PILf), and marginal bone loss (MBL).

Main Methods:

• Systematic review and meta-analysis of human clinical studies (1976-2016).
• Searches conducted using electronic and manual methods, including English language publications.
• Random-effects model and mixed-effect meta-regression used for data analysis.

Main Results:

• 22 studies including 864 implants were analyzed, with a mean residual bone height of 5.7 mm.
• Mean implant survival rate (ISR) was 97.9%.
• Mean VBG was 3.8 mm, influenced by surgical approach, implant length, and immediate protruded implant length (PILi). Mean MBL was 0.91 mm.

Conclusions:

• GFSFE with simultaneous implant placement demonstrates a satisfactory mean ISR of 97.9%.
• The procedure yields predictable vertical bone gain and acceptable marginal bone loss.
• This technique is a reliable option for achieving dental implants in the atrophic maxilla.