Abstract：
This systematic review and meta-analysis assesses the clinical outcomes of implants inserted during or following transcrestal sinus lifts. The study protocol was prospectively registered on PROSPERO (CRD42024504513). PubMed, Web of Science, Embase, and Scopus databases were searched up to 21 February 2024, and randomised clinical trials utilising transcrestal sinus lifts were included. Qualitative and quantitative syntheses were conducted. A random effects model was used to pool the survival rate of implants placed with transcrestal sinus lifts using hand osteotomes without grafting, along with meta-regression and subgroup analyses. Funnel plots and Egger\'s linear regression were used to explore possible publication bias. Probabilities of less than 0.05 were considered significant. A total of 1807 records were identified after the initial search. Seventeen studies were included with 10 of them considered for meta-analysis. Studies used hand osteotomes, a combination of piezoelectric and hand osteotomes, drills, and smart lifts for sinus elevation. Only studies that used hand osteotomes reported subsequent vertigo and dizziness in patients. The meta-analysis showed a 100% (95% CI: 99% to 100%) survival rate for both grafted and non-grafted transcrestal sinus lifts using hand osteotomes. Meta-regression showed that follow-up time did not significantly affect the implants\' survival. Subgroup analyses showed no significant difference between bone-level and tissue-level implants and one-stage or two-stage implants. On considering the limitations of this study it can be concluded that closed maxillary sinus elevation can be considered a relatively safe technique that is associated with a high survival rate. However, caution should be taken when using hand osteotomes because of a higher rate of sinus lining perforation and reported patient vertigo.
摘要：
这项系统评价和荟萃分析评估了在经胰窦抬起过程中或之后插入植入物的临床结果。研究方案在PROSPERO（CRD42024504513）上前瞻性注册。PubMed,WebofScience,Embase,和Scopus数据库在2024年2月21日之前进行了检索,并纳入了使用经颌窦解除的随机临床试验.进行了定性和定量综合。使用随机效应模型来汇集使用手骨器而不进行移植的经骨窦提升器放置的植入物的存活率，以及荟萃回归和亚组分析。漏斗图和Egger线性回归用于探索可能的发表偏倚。小于0.05的概率被认为是显著的。最初搜索后，总共确定了1807条记录。纳入了17项研究，其中10项考虑进行荟萃分析。研究使用手骨器，压电和手骨器的组合，钻头,和鼻窦抬高的智能升降机。只有使用手骨器的研究报告了患者随后的眩晕和头晕。荟萃分析显示，使用手骨切开术进行移植和非移植的经颌骨窦提升均具有100％（95％CI：99％至100％）的存活率。Meta回归显示，随访时间对植入物的生存率没有显著影响。亚组分析显示，骨水平和组织水平植入物与一阶段或两阶段植入物之间没有显着差异。考虑到这项研究的局限性，可以得出结论，闭合性上颌窦抬高可以被认为是一种相对安全的技术，具有较高的生存率。然而,由于窦壁穿孔和报告患者眩晕的发生率较高，因此使用手骨凿时应谨慎。
