■我们的目标是系统地回顾当前的证据,比较两种没有植骨的上颌窦底抬高(MSFE)方法(内部和外部)与常规/移植MSFE方法在患者中的相对有效性。上颌骨后部。
■医疗数据库(PubMed/Medline,Embase,WebofScience,和CochraneLibrary)搜索了1980年1月至2023年5月之间发表的随机对照试验。还进行了植入物相关期刊的手动搜索。包括以英文发表的研究报告了有或没有骨材料的MSFE的临床结果。使用Cochrane手册风险评估工具评估偏倚风险。对纳入的试验进行Meta分析和试验序列分析。使用预先选择的协变量进行Meta回归分析,以解释实质性异质性。使用GRADeproGDT在线(指南开发工具)评估临床结果的证据确定性。
■17项研究,包括547个鼻窦和696个植入物,进行荟萃分析。荟萃分析显示,没有骨移植的MSFE与常规MSFE在短期植入物存活率方面没有统计学上的显着差异(n=11,I2=0%,风险差异(RD):0.03,95%置信区间(CI):-0.01-0.07,p=0.17,所需信息大小(RIS)=307)。尽管常规MSFE具有较高的窦内骨增益(n=13,I2=89%,加权平均差(WMD):-1.24,95%CI:-1.91-0.57,p=0.0003,RIS=461),这不是植入物存活的决定因素.穿孔无差异(n=13,I2=0%,RD=0.03,95%CI:-0.02-0.09,p=0.99,RIS=223)和边缘骨丢失(n=4,I2=0%,WMD=0.05,95%CI:-0.14-0.23,p=0.62,无RIS)使用荟萃分析在两组之间检测到。在敏感性分析中,两组之间植入物稳定性商的合并结果并不可靠。由于视觉模拟量表报告的研究有限,手术时间,治疗费用,和骨密度,对这些结局进行了定性分析.
■该系统综述显示,非移植和移植的MSFE都具有较高的植入物存活率。由于证据的适度强度和短期随访,结果应谨慎解释.
UNASSIGNED: Our goal was to systematically review the current evidence comparing the relative effectiveness of two maxillary sinus floor elevation (MSFE) approaches (internal and external) without bone grafts with that of conventional/grafted MSFE in patients undergoing implantation in the posterior maxilla.
UNASSIGNED: Medical databases (PubMed/Medline, Embase, Web of Science, and Cochrane Library) were searched for randomised controlled trials published between January 1980 and May 2023. A manual search of implant-related journals was also performed. Studies published in English that reported the clinical outcomes of MSFE with or without bone material were included. The risk of bias was assessed using the Cochrane Handbook Risk Assessment Tool. Meta-analyses and trial sequence analyses were performed on the included trials. Meta-regression analysis was performed using pre-selected covariates to account for substantial heterogeneity. The certainty of evidence for clinical outcomes was assessed using GRADEpro GDT online (Guideline Development Tool).
UNASSIGNED: Seventeen studies, including 547 sinuses and 696 implants, were pooled for the meta-analysis. The meta-analysis showed no statistically significant difference between MSFE without bone grafts and conventional MSFE in terms of the implant survival rate in the short term (n = 11, I2 = 0%, risk difference (RD): 0.03, 95% confidence intervals (CI): -0.01-0.07, p = 0.17, required information size (RIS) = 307). Although conventional MSFE had a higher endo-sinus bone gain (n = 13, I2 = 89%, weighted mean difference (WMD): -1.24, 95% CI: -1.91- -0.57, p = 0.0003, RIS = 461), this was not a determining factor in implant survival. No difference in perforation (n = 13, I2 = 0%, RD = 0.03, 95% CI: -0.02-0.09, p = 0.99, RIS = 223) and marginal bone loss (n = 4, I2 = 0%, WMD = 0.05, 95% CI: -0.14-0.23, p = 0.62, no RIS) was detected between the two groups using meta-analysis. The pooled results of the implant stability quotient between the two groups were not robust on sensitivity analysis. Because of the limited studies reporting on the visual analogue scale, surgical time, treatment costs, and bone density, qualitative analysis was conducted for these outcomes.
UNASSIGNED: This systematic review revealed that both non-graft and grafted MSFE had high implant survival rates. Owing to the moderate strength of the evidence and short-term follow-up, the results should be interpreted with caution.