Sinus floor elevation using osteotomes: a systematic review and meta-analysis.
BACKGROUND
Various techniques of sinus floor elevation (SFE) are described. The elevation with osteotomes (OSFE) from a crestal approach is a relatively new technique. The aim of this systematic review and meta-analysis was to evaluate the clinical outcome of implants placed into the maxillary sinus augmented with an OSFE technique.


METHODS
A systematic online and manual review of the literature identified articles dealing with OSFE. Applying rigid inclusion criteria, screening and data abstraction were performed independently by two reviewers. The follow-up of loaded implants was a minimum of 6 months. The identified articles were analyzed regarding implant outcome and defined surgical aspects. Survival and success rates were estimated by Kaplan-Meier curves.


RESULTS
Eight out of 44 articles dealing with osteotome sinus floor elevation met the inclusion criteria. Five of the studies met established success criteria. The survival and success rates were 95.7% and 96.0% after 24 months and 36 months, respectively. The median and mean follow-up periods were 24 and 18.73 months for the survival rate and 24 and 19.7 months for the success rate. Regarding different surgical elements, i.e., osteotome techniques, implant types, and augmentation materials, the database was multivariate. Thus, no statistical analysis could be performed on these parameters.


CONCLUSIONS
Short-term clinical success/survival (<or years) of implants placed with an osteotome sinus floor elevation technique seems to be similar to that of implants conventionally placed in the partially edentulous maxilla. Controlled prospective clinical studies are needed to evaluate the long-term outcome and various surgical modifications of OSFE.
Emmerich
Dominik
D
Department of Oral and Maxillofacial Surgery, Albert-Ludwigs-University, Freiburg, Germany. emmerich@zmk2.ukl.uni-freiburg.de
Att
Wael
W
Stappert
Christian
C
D003758:Dental Implantation, Endosseous / Q000379:methods; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D006801:Humans; D008443:Maxillary Sinus / Q000601:surgery*; D013516:Oral Surgical Procedures, Preprosthetic / Q000295:instrumentation*; D010027:Osteotomy / Q000295:instrumentation; D017063:Outcome Assessment, Health Care; D016019:Survival Analysis