Outcome Measures in Alveolar Ridge Augmentation in the Edentulous Maxilla: A Systematic Review and COSMIN Analysis

This systematic review evaluated the current outcome measures following alveolar ridge augmentation (ARA) in the edentulous maxilla. The secondary objective was to determine the validity of the identified patient-reported outcome measures (PROMs) through standard analysis and methodology.

A systematic review was conducted. Databases including MEDLINE, Embase, Scopus, and Cochrane Central were searched in April 2024, limited to studies published in the last 10 years. Inclusion criteria were prospective clinical studies with at least 10 patients per treatment arm, edentulous maxilla, and ARA procedures. The quality and validity of patient-reported outcomes (PROs) were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, which systematically evaluates their reliability, validity, and responsiveness.

Of 1426 articles, 14 studies were included, with 11 unique study cohorts. Only 45.45% of the studies reported PROMs. The COSMIN analysis indicated that the Dutch version of the Oral Health Impact Profile (OHIP-49NL) and the Denture Satisfaction Questionnaire showed strong psychometric properties. However, the Patient Satisfaction and the Change in Psychology Questionnaire and Patient's Overall Satisfaction with Denture Questionnaire exhibited significant shortcomings.

Future research should focus on improving the validity of PROMs incorporating ARA-specific outcome measures and adopting a dual-phase approach for assessing early healing and long-term PROMs to enhance study consistency and reliability.