Dental implants combined with sinus augmentation: What is the merit of bone grafting? A systematic review.
OBJECTIVE
The aim of the present study was to systematically assess the current evidence on the effect of nongrafted compared to graft-assisted maxillary sinus floor elevation on implant survival/failure, endosinus bone gain, crestal bone loss, and bone density around dental implants.


METHODS
MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE databases were searched up to November 2015 for randomized controlled trials (RCTs) and controlled clinical trials-(CCTs), evaluating dental implants placed in combination with maxillary sinus elevation without and with bone grafting. Implant survival/failure served as the primary outcome, whereas endosinus bone gain, crestal bone loss, and bone density around dental implants were secondary outcomes. To assess possible bias, the Cochrane risk of bias tool was used. Data were extracted and a meta-analysis performed where appropriate.


RESULTS
Independent screening of 3180 papers resulted in six eligible experiments. Heterogeneity was observed among experiments. One experiment showed low, three unclear, and two a high risk of bias. The assessed outcomes showed no significant long-term differences between groups.


CONCLUSIONS
Within the limit of the current systematic review, nongrafted maxillary sinus floor elevation seems to be characterized by new bone formation and high implant survival rate comparable to bone-graft-assisted maxillary sinus floor augmentation. Further long-term studies are needed before definitive conclusions can be made.
Oral Medicine and Periodontology Department, Fayoum University, Fayoum, Egypt.
Shaimaa
S
Nasr
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
Dagmar E
DE
Slot
Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine Cairo University, Cairo, Egypt.
Samah
S
Bahaa
Clinic for Conservative Dentistry and Periodontology(Head: Prof. Dr. C.E. Dörfer), School of Dental Medicine, Christian Albrechts University of Kiel, Germany.
Christof E
CE
Dörfer
Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine Cairo University, Cairo, Egypt; Clinic for Conservative Dentistry and Periodontology(Head: Prof. Dr. C.E. Dörfer), School of Dental Medicine, Christian Albrechts University of Kiel, Germany. Electronic address: karim.fawzy@gmail.com.
Karim M
KM
Fawzy El-Sayed
D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D019232:Dental Restoration Failure; D006801:Humans; D059546:Sinus Floor Augmentation / Q000379:methods; D016896:Treatment Outcome
Bone grafting; Dental implant; Meta-analysis; Sinus floor augmentation; Systematic review