Maxillary sinus augmentation using sinus membrane elevation without grafts - A Systematic Review

Abstract

Implants have a predictable outcome and are the foremost treatment modality for prosthetic rehabilitation of edentulous patients. Due to loss of bone after extraction and pneumatization of maxillary sinus, there is insufficient bone volume for implant placement. The direct maxillary sinus lift procedure has been performed with different grafting materials (autogenous bone grafts, alloplasts, allografts, and xenografts) and without grafting material, having new bone formation around the implant. There is no evidence to prove the need for grafting material in all direct sinus lift procedures, hence the need for this review. Previous meta-analysis showed that survival rates of implants placed in grafted maxillary sinuses had similar survival rates whether autogenous, allogenous, or alloplastic grafts were used. This paper aims to review scientific data on the direct sinus elevation technique without use of any grafting material, volume of new bone formed, and also mechanism behind this technique. Articles were searched from 1997 to October 2014 in PubMed, Google Scholar, and Cochrane CENTRAL. The study eligibility criteria were (1) direct sinus lift procedure without any graft material during implant placement and (2) human or animal studies with a minimum follow-up of 6 months or more. Two authors independently scrutinized the literature and if any controversy was raised, third author's opinion was sought to arrive at a mutual consensus for including the study in the review. Due to the heterogeneity across all studies in all study designs, the data were not pooled and a meta-analysis was not performed. Taking into consideration all factors reviewed in this regard along with the outcomes, the direct sinus lift technique without grafting can be suggested as a viable treatment option keeping in mind the limitations involved. The average bone gain was seen across all studies ranging from 2.37 to 10 mm and with an implant survival rate ranging from 79.9% to 100% across studies.

Improved guided bone regeneration by combined application of unmodified, fresh autologous adipose derived regenerative cells and plasma rich in growth factors: A first-in-human case report and literature review

“…GBR-MSA has been performed using a number of grafting materials, including autologous bone grafts, allografts, and xenografts[106]. An earlier meta-analysis published in 1998 found that the survival rates of implants placed in grafted maxillary sinuses did not depend on whether autologous, allogeneic, or alloplastic grafts were used[107].…”

Therapeutic outcomes of non-grafted and platelet concentrations-grafted transcrestal maxillary sinus elevation (TSFE): a systematic review and meta-analysis

“…In this study, initially we analyzed the implant survival rate (ISR) within non-grafted TSFE studies among different RBH, and no significant differences were observed on 1-year ISR among groups with different average RBH within non-grafted TSFE group, even cases with limited RBH (<4 mm) obtained favorable 1-year ISR 51,60,61 . This confirmed that limited RBH does not impact the implant survival for non-grafted TSFE surgeries, as long as secured primary stabilities are obtained on implants 51,60,61 . Furthermore, the increase in bone-implant contact area and the compression of bone during TSFE augments the bone density around implant sites.…”

A new approach for better anterior esthetic using platelet-rich fibrin as sole graft material combined with ovate design dental bridge

“…However, this procedure has several disadvantages and limitations such as the success and predictability of this protocol relies on the handling, blood collection time and its transference for the centrifuge, the patient may refuse the puncture required for blood collection, rigidity lack and fast degradation of the PRF, the size of the defect and amount of bone loss. [ 15 16 ]…”