Clinical Performance of Dental Implants Following ...

Clinical Performance of Dental Implants Following Sinus Floor Augmentation: A Systematic Review and Meta-Analysis of Clinical Trials with at Least 3 Years of Follow-up Georgios N. Antonoglou, DDS, PhD1/Andreas Stavropoulos, DDS, CDT, PhD, Dr Odont2/ Maria D. Samara, DDS, MSc3/Alexis Ioannidis, DMD, Dr Med Dent4/Goran I. Benic, DMD, Dr Med Dent4/ Spyridon N. Papageorgiou, DDS, Dr Med Dent5/George K. Sándor, DDS, MD, PhD6 Purpose: The purpose of this systematic review was to assess the survival of implants placed in augmented sinuses on a medium- to long-term basis, and identify factors affecting implant survival such as surgical technique, bone grafts, and timing of implant placement. Materials and Methods: A literature search up to July 2016 was performed to identify prospective clinical studies on sinus floor augmentation in conjunction with implant placement with a minimum follow-up of 3 years. Meta-analytic methods were implemented to calculate implant survival rates and relative risks (RR) for failure and the effect of surgical technique, use of bone graft, graft type, use of membrane, mean residual bone height, and timing of implant insertion. Results: A total of 17 clinical trials (1 randomized and 16 prospective nonrandomized) were included, which pertained to 637 patients (at least 48% male) and 1,610 implants placed after sinus floor augmentation with the osteotome (transalveolar) or lateral window approach. The pooled implant survival rate at 3 to 6 years of follow-up was 97.7% (17 studies; 95% CI = 94.4% to 99.7%) with high heterogeneity. Smoking was associated with significantly worse implant survival (2 studies; RR = 4.8; 95% CI = 1.2 to 19.4; P < .05). However, evidence of influencing factors varied from very low to moderate after adopting the GRADE approach, due to risk of bias, imprecision, inconsistency, and small-study effects. Conclusion: Current evidence suggests that implants in augmented sinuses have high survival rates, with smoking playing a potentially important negative role in their prognosis. Both indirect and direct maxillary sinus floor augmentation seem to have a low frequency of manageable complications. Int J Oral Maxillofac Implants 2018;33:e45–e65. doi: 10.11607/jomi.6417 Keywords: atrophic maxilla, bone graft, implant success, implant survival, peri-implantitis, sinus elevation

1Research

Associate, Institute of Dentistry, Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland; Postgraduate Student, Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Greece. 2Professor and Chair, Department of Periodontology, Malmö University, Malmö, Sweden. 3Dentist, Private Practice, Manchester, United Kingdom. 4Senior Teaching and Research Assistant, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland. 5Senior Teaching and Research Assistant, Clinic for Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland. 6 Professor, Department of Oral and Maxillofacial Surgery, Oulu University Hospital & Department of Oral and Maxillofacial Surgery, University of Oulu, Oulu, Finland. Correspondence to: Dr Georgios N. Antonoglou, Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece. Email: [email protected] ©2018 by Quintessence Publishing Co Inc.

S

ince the introduction of the maxillary sinus floor augmentation (MSFA) procedure in the 1970s with the direct “lateral window” approach1 and its modification in the 1990s as an indirect transcrestal approach,2 this procedure has been widely implemented—in conjunction with dental implant placement—in the rehabilitation of the posterior atrophic maxilla.3,4 Considerable differences exist between the lateral window and the transcrestal approach for MSFA, with the latter being associated with reduced chair time, invasiveness, and postoperative discomfort.5 Although autogenous grafts are still considered the gold standard as far as quality of the regenerated bone is concerned,6–9 xenogeneic or alloplastic graft alternatives, in spite of their limitations,10–12 have been used increasingly3,13 to eliminate unpredictable autogenous bone graft resorption, the need for a second surgery,14–16 and increased patient morbidity. Empirically, use of a well-developed grafting and surgical protocol is considered to have potentially The International Journal of Oral & Maxillofacial Implants e45

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important implications for decision-making in terms of treatment cost, surgical time, loading protocol, and prosthesis selection.17 However, existing systematic reviews do not seem to support a direct influence of grafting on implant prognosis after MSFA, at least in the short term (up to 2 years).18–20 Additionally, other systematic reviews have assessed the survival of dental implants placed in conjunction with sinus floor augmentation with either the transcrestal or the lateral window approach,21–24 but the conclusions of these reviews could be compromised by the lack of a priori design with registration in PROSPERO,25 inclusion of flawed retrospective studies that are associated with higher bias than prospective ones,26 short-term follow-up of included studies (starting from 1 year postloading), lack of robust quantification of betweenstudy heterogeneity,27 and investigation of heterogeneity sources,28 or outdated literature searches. Therefore, a systematic review with a priori design and methodologically robust procedures of data synthesis based on prospective cohort studies29 was deemed to be needed to reliably assess the treatment effects of implant placement with MSFA. The objective of this study was to assess the medium- (3 to 6 years) and long-term (> 6 years) survival and success of dental implants in combination with MSFA procedures, as well as the possible influence of various patient-/ surgery-/ graft-/ or implant-related characteristics on implant survival.

MATERIALS AND METHODS Protocol and Eligibility Criteria

The protocol for this systematic review was developed a priori based on the corresponding Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) extension30 and registered a priori in PROSPERO (CRD42016041238). This review was conducted and reported per the Cochrane Handbook31 and the PRISMA statement,32 respectively. The eligibility criteria for a study to be included in the present review included: (1) randomized clinical trials (RCTs) and prospective nonrandomized studies (NRSs), (2) at least 10 patients, (3) implant placement after any type of sinus elevation procedure, and (4) a postoperative follow-up period of at least 3 years. Nonclinical studies, case reports, and narrative/systematic reviews were excluded (the latter after scanning their citation and refererence lists). Additionally, studies with hydroxyapatite-coated implants, ceramic implants, monotype implants, and narrow implants (diameter < 3 mm) or studies with removable prosthetic reconstructions on implants were also excluded.

Information Sources and Search

A comprehensive literature search was performed from inception of each database up to July 2016 in seven electronic databases (MEDLINE, Scopus Cochrane CENTRAL, Cochrane DARE, Web of Science, LILACS, BBO, and DECS) without any limitations to publication year, language, type, or status (Appendix 1). In addition, several trial registers (ClinicalTrials.gov, metaRegister of Controlled Trials, International Clinical Trials Registry Platform, EU Clinical Trials Register, Health Services Research Projects in Progress, and ISRCTN) were manually searched for any missed studies.

Study Selection, Data Collection Process, and Data Items

Titles identified from the search were screened by one author (G.N.A.) with a subsequent duplicate independent checking of their abstracts/full texts against the eligibility criteria by a second author (M.D.S.), while conflicts were resolved by a third author (S.N.P.). Characteristics of included studies and numerical data were extracted in duplicate by two authors (G.N.A., M.D.S.) using predetermined and piloted extraction forms including study design, patient characteristics (number, sex, age, residual bone height), surgical characteristics (surgery type, use of any bone grafts or membranes), number of implants (both placed and followed-up), and implants with complications, signs of failure, and loss of function. Missing or unclear information was requested by the studies’ corresponding authors or calculated firsthand, where possible.

Risk of Bias within Individual Studies

The risk of bias of included RCTs was assessed with the Cochrane risk of bias tool based on the Cochrane Handbook.31 The risk of bias of included NRS was assessed with a modified Downs and Black checklist,33 which included 21 individual questions pertaining to study design, study conduct, statistical analysis, and conclusions. Fulfillment of specific key domain questions was used to determine the risk of bias and the subsequent strength of evidence.

Summary Measures and Data Synthesis

Identified studies were a priori judged as eligible for data synthesis based on the fulfillment of the common eligibility criteria. From each study, the cumulative number of failed implants (implants needed to be removed regardless if they had any problems or not; primary outcome) and the number of implants with complications that could be further used (secondary outcome) were extracted at the study’s main follow-up time (of at least 3 years) as binary outcomes (events) and used in the meta-analyses. For ease of interpretation reasons, these were transformed after analysis

e46 Volume 33, Number 3, 2018 © 2018 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.

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and presented as % survival rate (100% - failure rate) and as % success rate (100% - failure or complication rate), respectively. Furthermore, the continuous outcomes of peri-implant marginal crestal bone loss and of implant mobility (determined as implant stability quotient) were extracted from each study and analyzed as further secondary outcomes. After initial meta-analytic pooling of each outcome across studies to calculate their weighted averages, data analysis was performed on two levels: direct analysis of within-study comparisons (ie, comparisons using summaries of different groups within eligible studies pertaining to different patients, techniques, implants, etc) and indirect analysis of across-study comparisons (ie, comparisons using a summary of each study). In the within-studies analysis, relative risks (RRs) of binary outcomes and mean differences (MDs) with their corresponding 95% confidence intervals (CIs) were used as a summary measure. In the case of statistically significant RRs, the Number Needed to Treat (NNT) was used to express these in a clinically intuitive way.34 In the across-studies analysis, the pooled event rate (transformed afterward to % survival or success rate) or the pooled weighted response was used as the summary measure, after pooling multiple trial arms originating from the same trial to circumvent their correlation.31 In the across-studies analysis, the implant failure or complication event rates were calculated with the exact binomial Clopper-Pearson35 procedure after the Freeman-Tukey double arcsine transformation36 to stabilize their variances. The peri-implant bone loss from baseline was either given from the original studies or calculated in two instances with a paired approach37 with conservative 0.75 pre-post correlations. One of the identified studies38 provided raw patient data in its published report, and clustering-adjusted estimates were calculated for this review with multivariable generalized linear models for the binary family. As implant prognosis can be affected by various patient-, implant-, or technique-related characteristics,7,13,39,40 a random-effects model was a priori deemed appropriate based on statistical and clinical reasoning.41 The novel variance estimator proposed by Paule-Mandel was chosen a priori as the primary method to estimate all direct estimates instead of the widely known DerSimonian-Laird estimator, whenever possible, due to its superior performance.42 The absolute extent and relative impact of between-study heterogeneity was assessed by calculating the τ2 and the I2 statistic, respectively. The 95% CIs around I2 were calculated to quantify uncertainty around heterogeneity estimates. In meta-analyses of at least five studies, mixed-effects subgroup analyses and meta-regressions were implemented to investigate the influence of the following patient-, graft-, or

technique-related characteristics: patient age, patient sex, use of membrane, use of bone grafts, type of bone grafts, and implant insertion timing (immediate one-phase or delayed two-phase insertion after sinus floor augmentation). All analyses were performed in Stata version 12 (StataCorp LP) with an open dataset,43 and all P values are two-sided with a level of significance set at 5%, except for the tests of between-studies heterogeneity (at 10%).

Quality of Evidence and Additional Analyses

The overall quality of evidence (confidence in effect estimates) for each of the main outcomes was rated by using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.31Given the fact that indirect (across-study) estimates are more imprecise and more easily heterogenous than direct (within-study) estimates of RRs or MDs, in which comparisons are normalized within each trial’s clinical setting, the more robust within-studies comparisons were used in the GRADE evaluation.31 For this evaluation, large effects were defined as RRs between 2.0 and 5.0 (or between 0.5 and 0.2), and very large effects were defined as RRs greater than 5.0 (or smaller than 0.2). The optimal information size was calculated with α at 5% and β at 80%. Further indications of selective outcome reporting bias were evaluated in meta-analyses of at least 10 studies via contour-enhanced funnel plots, followed by Egger’s test for asymmetry.44 If evidence of reporting bias or small-study effects were identified, sensitivity analyses were performed by subdividing studies into small and large ones (using the arbitrary cut-off of 100 implants per study). Sensitivity analyses by risk of bias or improvement in the GRADE summary scores were planned, but could not be performed.

RESULTS Study Selection

The search yielded a total of 1,610 studies, which were reduced to 747 studies after elimination of duplicates and initial screening of titles/abstracts (Fig 1). A total of 33 potentially eligible papers were left after applying the review’s eligibility criteria.43 From these, no unanimous decision could be reached for 11 of the studies, since they partially collided with the set criteria, and the matter could not be resolved via communication with the authors for raw data.43 Subsequently, 21 papers were finally included in the systematic review. After grouping together multiple publications from the same trial, a total of 17 unique studies were finally included in the qualitative and quantitative synthesis. The International Journal of Oral & Maxillofacial Implants e47


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Identification

Records identified through the electronic databases (n = 1,453)

Additional records identified through other sources (n = 157)

Screening

Records after duplicates removed (n = 1,361)

Records excluded by title/abstract (n = 786)

Records screened (n = 747)

Eligibility

Full-text articles assessed for eligibility (n = 33)

Included

Full-text articles excluded, with reasons (n = 714)

Studies included in the systematic review/meta-analyses (n = 21 papers/n = 17 studies)

Eligibility decision pending; authors contacted (n = 12; 1 responded and subsequently excluded; 11 pending)

Fig 1 PRISMA flow diagram for the identification and selection of eligible studies for this review.

Table 1 Characteristics of Included Studies

No.

Study

Transcrestal technique 1 Calvo-Guirado85 (2010) 2 Crespi86 (2010) 3 Nedir92 (2006) (collated) 4 Nedir89 (2016) (collated) 5 Si93 (2013) Lateral window technique 6 Agliardi73 (2014) 7 Bassi74 (2015) 8 Bornstein75 (2008) 9 10 11 12 13 14 15 16 17

Butz76 (2005) Cha77 (2014) Cricchio78 (2011) Di Stefano79 (2015) Hallman80 (2005) Kahnberg81 (2001) Kahnberg82 (2008) Özkan83 (2011) Valentini84 (2000)

IMPs

Residual bone height (mm)

30 (12/18); 53.6 20 (8/12); 55.2 17 (3/14); 54.2 12 (3/9); 57.6

60 30 25 37

5.0–8.0 < 2.4 5.3 ≤ 4.0

RCT; Uni; CHN

45 (27/18); 48.5

41

4.6

pNRS; Uni; ITA pNRS; Uni; BRA pNRS; Uni; CHE

10 (4/6); 60.4 17 (NR); NR 56 (22/34); 53.9

20 25 111

< 5.0 5.6 < 4.0

pNRS; practice; BEL/ZAF 20 (5/15); 55.5 pNRS; Uni; KOR 161 (96/65); NR pNRS; Uni; SWE 84 (46/38); 54.0 pNRS; Uni; ITA 40 (21/19); 57.0 pNRS; Hosp; SWE 20 (6/14); 56.0 pNRS; Uni; SWE 26 (13/13); 56.0 pNRS; Uni; SWE 36 (13/23); 59.9 pNRS; Uni; TUR 28 (12/16); 49.6 pNRS; practice; FRA 15 (6/9); 57.0

22 462 239 40 108 126 118 84 57

Design; setting; country

Patients (M/F); mean age (y)

pNRS; Uni; ESP pNRS; Uni; ITA pNRS; practice; CHE pNRS; practice; CHE

Graft XEN SYN No XEN/No AUG+XEN/No

AUG No AUG+XEN/ AUF+SYN 4.0 SYN 1.0–8.0 XEN 5.7 No < 2.0 XEN1/XEN2 2.7 AUG+XEN/No < 5.0 AUG 5.0–6.0 AUG/AUG+XEN 4.0–9.0 XEN 1.8 XEN

Follow-up (mos) 36 36 120 60 36 50 51 60 84 57 120 40 36 48a 60 60 49

a Also,

up to 72 months reported; time point of up to 48 months was included, as afterward, half of the study sample dropped out. M = male; F = female; IMPS = implants; pNRS = prospective nonrandomized study; Uni = university; XEN = xenograft; SYN = synthetic alloplastic graft; RCT = randomized controlled trial; AUG = autograft; NR = not reported.


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Table 2 Surgical Staging, Healing Times, and Implant System in Included Studies No.

Study

Surgical stages

Graft healing (wk)

Osseointegration (wk)

Combined healing (wk)

Implant system

Transcrestal technique 1

Calvo-Guirado (2010)

1

18

18

18

Osseotite Certain PREVAIL Biomet 3i Implants Innovations

2

Crespi (2010)

1

12

12

12

Sweden & Martina, Due Carrare, Italy

3

Nedir (2006) (collated)

1

12–16

12–16

12–16

Straumann, SLActive, Straumann

4


1

8

8

8


5

Si (2013)

1

24

24

24


1

24

24

24

NobelSpeedy Groovy Implant, Nobel Biocare Alvim, Neodent

Lateral window technique 6

Agliardi (2014)

7

Bassi (2015)

1

36

36

36

8

Bornstein (2008)

2

12–48

8–14

20–62

–

9

Butz (2005)

1, 2

–

12–36

12–36

Southern Implants

10

Cha (2014)

1

24

23

24

Implantium, Dentium

11

Cricchio (2011)

1

24

24

24

Brånemark System, TiUnite implants, Nobel Biocare

12

Di Stefano (2015)

2

24

12

36

– Brånemark System, Nobel Biocare

13

Hallman (2005)

2

24

24–32

48–56

14

Kahnberg (2001)

1

24

24

24

Brånemark SystemA, Nobel Biocare

15

Kahnberg (2008)

2

16

24

24

Astra Tech

16

Özkan (2011)

1

–

–

–

17

Valentini (2000)

2

24

24

48

ITI Dental implants, Straumann –

wk = week.

Study Characteristics

The characteristics of the 17 included studies can be seen in Tables 1 and 2. In brief, from these 17 (16 prospective NRSs and 1 RCT) included studies, 12 (71%) were conducted in university clinics, 4 (24%) in private practices, and 1 (6%) in a hospital of 11 different countries. These studies included a total of 637 patients (mean: 37.5 patients/trial; range: 10 to 161 patients/trial), with at least 297 male patients (48%) and a mean age of 54.5 years across all studies. Smoking was reported in only 2 out of the 17 included trials, and the percentages of smokers were 14.6%45 and 20.8%,38 respectively. In these 637 patients, a total of 1,605 implants were placed after MSFA (mean of 94.4 implants/trial with range of 20 to 462 implants/trial; mean of 2.5 implants/ patient with range of 1 to 5.4 implants/patient), which were followed a mean duration of 59.7 months (range: 36 to 120 months). The residual maxillary bone height of the patients varied from 1 to 9 mm. Regarding surgical characteristics of the included trials, 5 trials (29%) used the indirect or transcrestal sinus augmentation approach, and 12 trials (71%) used

the direct or lateral window augmentation approach. Eleven trials (65%) used bone grafts to augment residual bone, three trials (18%) did not use a graft, and the remaining three trials (18%) used bone grafts in some of their patients as shown in Table 1. Most studies with grafts used xenografts, autografts, or a combination thereof (Table 1). The various grafts used in the included studies are summarized together with their description in Appendix 2. The majority of xenografts used were Bio-Oss (5/7 studies; 71%) and three different calcium phosphate substitute products. The period of graft healing and implant osseointegration varied from 8 to 62 weeks based on the graft type and surgical protocol (Table 2). Additionally, five trials (29%) used a barrier membrane to cover the lateral window. Finally, in 11 of the included trials (65%), implants were placed simultaneously with a one-stage approach; in five trials (29%), implants were placed after a healing period of the graft (3 to 12 months) with a two-stage approach; and in one trial (6%), implants were placed with either a one-phase or a two-phase approach (Table 2). The International Journal of Oral & Maxillofacial Implants e49


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Randomized studies Si 2013 Random sequence generation (selection bias) Allocation concealment (selection bias) Blinding of participants and personnel (performance bias) Blinding of outcome assessment (detection bias) Incomplete outcome data (attrition bias) Selective reporting (reporting bias) Other bias +

+

? +

+

?

+

Criterion fulfilled Criterion unclear Criterion unfulfilled

Nonrandomized studies Reporting C1 C2 C3 C4 C5 C6 C7 C8 External validity C9 C10 C11 Internal validity: C12 bias C13 C14 C15 C16 Internal validity: C17 confounding C18 C19 C20 Power C21

Fig 2 Summary risk of bias assessment for the included randomized (left) and nonrandomized (right) studies.

Risk of Bias in Individual Studies

The single included RCT was judged to be of low risk of bias per the Cochrane guidelines (Fig 2; Appendix 3). The methodologic quality of included NRSs was moderate, with many domains being problematic, mostly pertaining to the studies’ external validity (questions 10 and 11), risk of confounding (question 19), and statistical power (question 21) (Fig 2; Appendix 4). Out of the 16 included NRSs, 3 (19%) fulfilled less than 9 criteria, 8 (50%) fulfilled 9 to 14 criteria, and 5 (31%) fulfilled 15 or more criteria (mean of 12.4 criteria met) (Appendix 4).

Results of Data Synthesis

The incidence of implant failures leading to implant removal (mainly due to peri-implantitis and lack of osseointegration) or nonterminal complications (such as bone loss, increased mobility, etc) can be seen in Table 3. Additionally, the re-analysis of the provided raw data in an identified study38 can be seen in Appendix 5. The results of the random-effects meta-analysis across studies (Table 4) indicated that the pooled mid-term (3 to 6 years) survival rate of the 1,607 implants placed after sinus augmentation from the 17 included studies was 97.7% (17 studies; 95% CI = 94.4% to 99.7%), and the pooled success rate was 97.0% (17 studies; 95% CI = 93.2% to 99.5%), while the pooled peri-implant marginal bone loss from insertion time was 0.99 mm (10 studies; 95% CI = 0.62 to 1.37 mm). In all instances, very high inconsistency existed among the included studies (I2 > 75%). Finally, the long-term (7 to 10 years) survival or success rate was found to be 99.6% (95% CI = 98.2% to 100.0%), although only limited data existed (3 studies and 320 implants).

Subgroup analyses and meta-regression analyses (Table 5 and Appendix 6) did not find a significant modifying effect on implant survival, success, or peri-implant marginal bone loss from patient age, sex, sinus floor augmentation technique, use of bone graft, type of bone graft, use of membrane, or timing of implant insertion (P > .10 in all instances). The only exception was the use of membranes in the lateral window technique, where studies with a membrane barrier as part of the surgical protocol (2 studies; bone loss = 0.34 mm; 95% CI = 0.29 to 0.39 mm) reported significantly less peri-implant marginal bone loss than studies without membrane (4 studies; bone loss = 1.45 mm; 95% CI = 0.89 to 2.02 mm; P = .052). Finally, random-effects meta-analyses were performed with a direct approach using data from within-study comparisons (Appendix 7; Fig 3). These failed to find that patient age, sex, baseline levels of residual bone height, use of bone grafts, or perforation of the sinus membrane had a significant influence on implant survival. The sole exception was smoking status, where implants placed in the sinuses of smokers were associated with a 382% increase in the risk of failure (2 studies; RR = 4.82; 95% CI = 1.20 to 19.40; P = .027).

Additional Analyses

The “Summary of Findings” table per the GRADE approach can be seen in Appendix 8, indicating that the quality of evidence in all instances was very low. The only exception is the effect of smoking on implant failure, which corresponds to a moderate GRADE score, due to the large effect magnitude. Assessments of reporting biases (including small-study effects and publication bias) could be


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Table 3 Details of Number and Prognosis of Placed Implants Complications (success)

Reason

%

Events

Event timing (mo)

Reason

%

1

Calvo-Guirado (2010)

60

0

60

0

–

–

96.7

2

4.5/4.5

NR; probably mobility

96.7

2

Crespi (2010)

30

0

30

0

–

–

100.0

0

–

–

100.0

3


25

0

25

0

–

–

100.0

0

–

–

100.0

4


37

0

37

0

–

–

91.9

3

31.2

Periimplantitis/ mobility

91.9

5

Si (2013)

41

0

41

0

–

–

95.1

2

12–18

Periimplantitis

95.1

6

Agliardi (2014)

20

0

20

0

–

–

100.0

0

–

–

100.0

7

Bassi (2015)

25

0

25

0

–

–

96.0

1

0–9

NR; probably mobility

96.0

8

Bornstein (2008)

111

11

100

0

–

–

98.0

2

20

Pain

98.0

9

Butz (2005)

56

0

56

0

–

–

100.0

0

–

–

100.0

10

Cha (2014)

462

0

462

11

NR

Bone loss

96.5

5

–

–

98.9

11

Cricchio (2011)

239

0

239

0

–

–

98.7

3

–

–

98.7

12

Di Stefano (2015)

40

0

40

2

36

Bone loss

95.0

0

–

–

100.0

13

Hallman (2005)

108

20

88

0

–

–

83.0

15

NR

NR

83.0

14

Kahnberg (2001)

126

0

126

7

NR

Bone loss

64.3

38

0–12: 31 IMPs 12–24: 4 IMPs 24–36: 2 IMPs 36–48: 1 IMP

NR

69.8

15

Kahnberg (2008)

153

35

118

0

–

–

100.0

0

–

–

100.0

16

Özkan (2011)

84

0

84

0

–

–

100.0

0

–

–

100.0

17

Valentini (2000)

56

0

56

0

–

–

100.0

0

–

–

100.0

Nr

Study

IMPs inserted

Dropouts

IMPs analyzed Events

Event timing (mo)

Failure (survival)

IMP = implant; mo = month; NR = not reported.

Table 4 Pooled Outcome Values from Indirect Meta-analysis Across Studies (Inverse-Variance Random-Effects Estimator) Outcome

n

Estimate

95% CI

𝛕2

I2% (95% CI)

Implant survival rate (%)

17

97.7%

94.4%–99.7%

0.091

89 (84–92)

Implant success rate (%)

17

97.0%

93.2%–99.5%

0.100

90 (86–92)

Bone loss around implant (mm)

10

0.99

0.62–1.37

0.356

99 (98–100)

65.26–97.14

NE

NE

Implant stability quotient

1

66.2

n = number of studies; CI = confidence interval; NE = not estimable.

performed only for the overall pooling of implant failures, complications, and bone loss around implants (Appendices 9 and 10). Visual inspection of funnel plots indicated asymmetry, which was confirmed in all instances by a statistically significant Egger’s test, which was interpreted as small-study effects. Although

a sensitivity analysis indicated that large studies (with at least 100 implants) tended to report lower survival or success rates and higher bone loss than small studies (Appendix 10), this did not reach statistical significance in all instances (P > .10). The same was observed for the sensitivity analysis according to the methodologic The International Journal of Oral & Maxillofacial Implants e51


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Study

Smokers Fail (%)

Nonsmokers Fail (%)

Cha (2014)

7 (14.6%)

9 (2.2%)

6.71 (2.62, 17.20)

57

11 (20.8%)

4 (5.7%)

3.09 (0.74, 12.86)

43

4.82 (1.20, 19.40)

100

Hallman (2005) (adjusted)

RR (95% CI)

Overall (Paule-Mandel random-effects) 0.05 a

Study

Tear Yes Fail (%)

Tear No Fail (%)

Cha (2014)

3 (4.4%)

13 (3.3%)

Cricchio (2011)

1 (4.0%)

2 (0.9%)

0.2 0.5 Fewer failures in smokers

1

2 5 More failures in nonsmokers

Weight

20

RR (95% CI)

Weight

1.34 (0.39, 4.57)

Overall (Paule-Mandel random-effects)

61

4.28 (0.40, 45.53)

39

2.10 (0.26, 16.82)

100

0.056 0.2 0.5 1 2 5 18 Fewer failures with tear More failures with tear of the sinus membrane of the sinus membrane

b Graft Fail (%)

Study Nedir (2016) (collated)

2 (10.0%)

No graft Fail (%)

RR (95% CI)

1 (5.9%)

Weight

1.70 (0.17, 17.16)

24

Si (2013)

1 (4.8%)

1 (5.0%)

0.95 (0.06, 14.22)

19

Hallman (2005) (adjusted)

9 (11.4%)

6 (20.7%)

0.66 (0.47, 0.93)

57

0.89 (0.21, 3.82)

100

Overall (Paule-Mandel random-effects) 0.0625 0.2 0.5 1 2 5 16 Fewer failures with graft More failures with graft

c

Fig 3 Contour-enhanced forest plots with random-effects (Paule-Mandel) meta-analyses of factors affecting implant survival. (a) Implant failure according to patient smoking status. (b) Implant failure according to tear of the sinus membrane. (c) Implant failure according to use of bone graft.

Table 5 Meta-Analyses of Indirect Across-Study Data on Success or Survival Rate of Implants Placed After Sinus Elevation Outcome/Group Implant survival (% rate) Sinus elevation technique Transcrestal Lateral window Use of bone graft Yes No Graft type None AUG XEN SYN Use of membrane Yes No

n

Estimate

95% CI

P SG

𝛕2

I2% (95% CI)

5 12

97.3% 97.8%

93.8%–99.5% 93.4%–100.0%

.685

0.004 0.108

13 (0–68) 92 (89–94)

14a 6a

97.8% 95.9%

93.7%–99.9% 88.7%–99.9%

.444

0.107 0.062

90 (85–93) 70 (0–85)

6a 4a 8a 2a

95.9% 95.8% 98.1% 100.0%

88.7%–99.9% 77.0%–100.0% 95.7%–99.9% 97.9%–100.0%

.220

0.062 0.308 0.036 0

70 (0–85) 97 (95–98) 73 (33–85) 0% (NE)

4 13

99.6% 97.2%

97.3%–100.0% 92.5%–99.8%

.226

0.004 0.111

20 (0–74) 91 (87–93)

n = studies; CI = confidence interval; P SG = P value for differences between subgroups; AUG = autograft; XEN = xenograft; SYN = synthetic alloplastic graft; NE = not estimable. aMultiple experimental groups from included studies analyzed separately.


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Table Meta-Analyses of Indirect Across-Study Data on Success or Survival Rate of Implants Table 5 5 cont. Meta-Analyses of Indirect Across-Study Data on Success or Survival Rate of Implants After Sinus Elevation PlacedPlaced After Sinus Elevation Outcome/Group Mean residual bone height < 5.0 mm ≥ 5.0 mm Implant insertion 1-phase (immediate) 2-phase (delayed) 1- or 2-phase Implant success (% rate) Sinus elevation technique Transcrestal Lateral window Use of bone graft Yes No Graft type None AUG XEN SYN Use of membrane Yes No Mean residual bone height < 5.0 mm ≥ 5.0 mm Implant insertion 1-phase (immediate) 2-phase (delayed) 1- or 2-phase Bone loss (mm) Sinus elevation technique Transcrestal Lateral window Use of bone graft Yes No Graft type None AUG XEN SYN Use of membrane Yes No Mean residual bone height < 5.0 mm ≥ 5.0 mm Implant insertion 1-phase (immediate) 2-phase (delayed)

n

Estimate

95% CI

PSG

𝛕2

I2% (95% CI)

11 4

96.7% 99.1%

90.1%–100.0% 96.8%–100.0%

.280

0.160 0.010

90 (84–93) 47 (0–81)

10 6 1

96.6% 98.6% 86.7%

90.8%–99.8% 93.2%–100.0% 60.6%–100.0%

.268

0.112 0.088 NE

91 (87–94) 86 (69–92) NE

5 12

97.3% 96.8%

93.8%–99.5% 91.8%–99.7%

.999

0.004 0.119

13 (0–68) 93 (90–95)

14a 6a

96.9% 95.9%

92.2%–99.7% 88.7%–99.9%

.641

0.118 0.062

91 (87–93) 70 (0–85)

6a 4a 8a 2a

95.9% 95.1% 96.9% 100.0%

88.7%–99.9% 73.0%–100.0% 93.5%–99.2% 97.9%–100.0%

.153

0.062 0.389 0.026 0

70 (0–85) 97 (96–98) 67 (7–83) 0% (NE)

4 13

98.5% 96.7%

95.0%–100.0% 91.7%–99.7%

.474

0.014 0.120

45 (0–81) 92 (88–94)

11 4

95.9% 99.1%

88.2%–99.9% 96.8%–100%

.197

0.184 0.010

91 (86–94) 47 (0–81)

11 5 1

96.0% 97.8% 86.7%

98.6%–100.0% 91.7%–100.0% 60.6%–100.0%

.202

0.123 0.088 NE

92 (88–94) 86 (69–92) NE (NE)

4 6

0.89 1.07

0.48, 1.29 0.49, 1.66

.641

0.149 0.527

90 (79–99) 99 (98–100)

8a 6a

0.89 1.21

0.50, 1.27 0.65, 1.76

.323

0.291 0.453

99 (97–100) 96 (91–99)

6a 5a 3a –

1.21 0.87 0.93 –

0.65, 1.76 0.30, 1.43 0.43, 1.44 –

.425

0.453 0.408 0.170 –

96 (91–99) 99 (98–100) 91 (80–100) –

2 8

0.34 1.17

0.29, 0.39 0.78, 1.56

.059

0.001 0.297

26 (0–97) 97 (93–99)

5 3

0.99 1.37

0.40, 1.58 0.86, 1.88

.410

0.440 0.182

98 (96–100) 91 (78–100)

7 3

1.05 0.87

0.59, 1.52 0.11, 1.62

.673

0.374 0.439

98 (96–100) 99 (96–100)

n = studies; CI = confidence interval; P SG = P value for differences between subgroups; AUG = autograft; XEN = xenograft; SYN = synthetic alloplastic graft; NE = not estimable. aMultiple experimental groups from included studies analyzed separately.

The International Journal of Oral & Maxillofacial Implants e53 © 2018 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER.

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robustness of included studies, where no significant difference could be found.

DISCUSSION The present systematic review summarizes evidence from RCTs and prospective NRSs on human patients receiving dental implants after MSFA and a minimum postoperative follow-up of 3 years. The results from the identified 17 clinical studies with 637 patients and 1,607 implants indicate excellent overall medium-term (3 to 6 years) survival and success (97.7% and 97.0%, respectively) and minimal overall peri-implant marginal bone loss (0.99 mm), while limited data from three studies indicate excellent survival/success up to 10 years. These findings must be interpreted with caution, due to the considerable variation across studies in their design/reporting quality, the various type of grafts used, and the use of barrier membranes. Previous systematic reviews on the survival and success of dental implants in conjunction with MSFA22,46 found slightly lower survival rates, but as stated earlier, this could be influenced by differences in the eligibility criteria and review methods that were used, as well as the risk of bias due to flawed study designs. The effect of preoperative residual bone quality or quantity and specifically bone height on the rate of complications and the implant success/survival in augmented sinuses is empirically known, yet has been only scarcely demonstrated by MSFA studies.60,61 There was one study by Geurs and co-workers where residual bone height perfectly accounted for all implant losses.49 While this and other studies are supportive of a minimum requirement of 4 mm of residual bone63 or the rule of thumb of 25% to 35%64 of the total implant length to be inserted in residual bone, other trials do not support such rules65,66 and stress instead the importance of initial stability regardless of bone height. In the present review, no statistically significant associations were found between residual bone height and implant success/survival, which may be attributed to the fragmented reporting of the variable in the original studies. As far as complications leading to implant loss are concerned, more were reported in the direct MSFA procedure than in the indirect MSFA. Regarding complications not leading to implant loss, again, higher frequency was found in direct MSFA (Table 3). Sinus membrane laceration is commonly observed, especially in direct MSFA, and can have a substantial impact on the fate of the procedure or the implants.6 In direct MSFA, case membrane laceration was reported in two studies,77,78 and it was reported in the indirect MSFA case in two studies85,93 as well. In one of these

two indirect MSFA studies, three patients with this complication were excluded85 for this reason. Other uncommon complications such as nose bleeding, acute infection, and material exfoliation showed low frequency and no detrimental consequences. Regarding factors influencing implant survival in the present study, only smoking exerted a markedly detrimental influence on implant survival (absolute increase of failure by 12.6%; NNT = 8). Smoking is known to be associated with poor outcomes in guided tissue regeneration,50,63 implant therapy in general,64 or their combination.54 This effect might be attributed to impaired wound healing from toxic by-products of smoke,52 disturbed function of fibroblasts and polymorphonuclear leukocytes,53 and hampered bone formation and resorption.54 Although a short-term RCT on implant placement after sinus floor augmentation did not find a statistically significant influence of smoking on implant prognosis 1 year postloading,55 this could be explained by the limited statistical power, since the results agreed in direction with the present review (re-analyzed here as RR of 1.89 for smokers, P > .05.55 A previous systematic review by Chambrone and co-workers56 failed to identify a statistically significantly higher implant failure risk for smokers, based on robust prospective meta-analytic evidence. In the present meta-analysis, such a detrimental influence of smoking on implant prognosis could be identified, and was large in magnitude (Fig 3). Smoking has already been linked to impaired healing around titanium implants in general,48,58 but not in the clinical scenario of MSFA in combination with dental implant insertion. It is, however, important to note that the evidence base for the effect of smoking on implant survival was a meager sample of two studies, and therefore, this needs to be confirmed by future studies. In the present review, no significant difference could be found in the prognosis of implants placed regardless of the presence of the various graft materials. These findings are in line with the findings of the systematic review of Silva et al59 and seem to agree with empirical radiographic and histologic data showing newly formed bone around implants placed after sinus floor augmentation even without grafts.60,61 This might indicate that the void space established through elevation of the sinus membrane can stabilize the clot and take advantage of the bony walls’ osteogenic potential,60,61 in a procedure similar to guided bone regeneration procedures.62 As far as peri-implant marginal bone loss is concerned, a pooled weighted mean of 0.99 mm (95% CI = 0.62 to 1.37 mm) was found, which is slightly higher than the estimates of a previous systematic review by Duan et al (2017)24 that found 0.91 mm (95% CI = 0.69 to 1.113 mm), which was significantly related to


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postoperative follow-up. However, the differences were small, while discrepancies in the results might be attributed to specificities of the previously increased risk of bias due to including retrospective study designs, improper handling of publications stemming from the same trial as separate trials, and the wide variation in follow-up in the review by Duan and coworkers (7 to 120 months).24 Finally, use of membrane in MSFA with the lateral window approach was associated with improved bone outcomes (ie, less marginal bone loss) around the subsequently placed dental implants, although this was not reflected in improved implant survival or success. It is, by and large, accepted that barrier membranes promote guided bone regeneration by containing the graft, preventing soft tissue encleftation. In MSFA, the reported amount of regenerated vital bone varies from 5% to 60%.8 However, evidence from clinical studies in humans on the optimal characteristics of the membrane and surgical protocol per clinical scenario are not abundant.65,66

Strengths and Limitations

The strengths of this systematic review include a priori registration in PROSPERO25 with all post hoc changes noted (see additional files43); the extensive unrestricted literature search; the use of robust methodology pertaining to the qualitative and quantitative synthesis of data,41 including the robust Paule-Mandel random-effects estimator42 instead of the commonly used DerSimonian and Laird one wherever possible; the exclusion of biased retrospective study designs26,67; transparent reporting of quantitative data for all outcomes from included studies; assessment of the quality of evidence with the GRADE approach43; the use of sensitivity analyses to check the robustness of the results to the risk of bias. However, several limitations are also present. A relative limitation is that a research protocol with rigid selection criteria was implemented and limited the inclusion of additional studies. Additionally, a single identified large study77 accounted for approximately one-quarter of the total number of implants, since most other studies were relatively smaller. One dominant factor on the survival and success of dental implants placed in conjunction with MSFA is the residual bone height bias.68,69 Second, the healing period in sinus elevation procedures is strictly dictated by the surgical protocol. In direct two-stage MSFA, the surgeon normally needs to allow more time for graft healing and then continue with implant insertion, which extends the treatment time required. This variation was an unavoidable source of potential bias. Third, due to reporting deficiencies and variability in the study design of the identified trials, it was impossible to assess

the effect of this factor, which presumably affected early, medium-, and long-term clinical performance of the implants. In terms of methodology, the included studies were NRSs, and although only prospective studies were included, this might still lead to bias.26,28,70 Second, this systematic review included mostly small trials (71% of included trials had less than 100 implants), which can influence the results of the meta-analyses.72 Despite the authors’ attempts, no clarifications or additional outcome data could be obtained from many authors of included studies. This also precluded the robust assessment of implant failure considering its clustered nature (ie, in most cases multiple implants are placed per patient), and this might impact the results.71 It should also be noted that drop-outs or losses to follow-up were poorly reported, as only 3 of the 17 studies reported these.75,78,80 It is uncommon to conduct clinical trials and have so few lost to follow-up, but this could be partly explained by the relatively small sample size of the trials and their observational character. Additionally, the authors planned and performed the analysis by taking the patient as the measurement unit, which precludes assessment of clinical attachment loss in a site-specific manner, although this would be anyways not possible due to the poor reporting quality of existing studies. Finally, the limited number of included trials precluded robust assessments of heterogeneity, subgroup analyses for many factors (including, among others, specific bone graft products, type of prosthetic reconstruction, and operator’s experience), and formal assessment of publication bias. However, the authors considered the literature search to be comprehensive, and all efforts have been made to identify unpublished material; hence, the probability of publication bias is considered low.

CONCLUSIONS The results of this systematic review indicate that dental implants placed in conjunction with MSFA show an overall excellent survival after 3 to 6 years of followup. Although smoking seems to adversely affect implant survival, clinical evidence for other important factors pertaining to characteristics of the patient, technique, and materials is either missing or of very low quality.

ACKNOWLEDGMENTS The authors would like to thank Philip Sahrmann (University of Zurich, Zurich, Switzerland) for providing clarifications on his study. The authors declare that there was no conflict of interest during the elaboration of this study.


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62. Dahlin C, Sennerby L, Lekholm U, Linde A, Nyman S. Generation of new bone around titanium implants using a membrane technique: An experimental study in rabbits. Int J Oral Maxillofac Implants 1989;4:19–25. 63. Avera SP, Stampley WA, McAllister BS. Histologic and clinical observations of resorbable and nonresorbable barrier membranes used in maxillary sinus graft containment. Int J Oral Maxillofac Implants 1997;12:88–94. 64. Wallace SS, Froum SJ, Cho SC, et al. Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabsorbable membranes placed over the lateral window: Histomorphometric and clinical analyses. Int J Periodontics Restorative Dent 2005;25:551–559. 65. McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol 2007;78:377–396. 66. Dimitriou R, Mataliotakis GI, Calori GM, Giannoudis PV. The role of barrier membranes for guided bone regeneration and restoration of large bone defects: Current experimental and clinical evidence. BMC Med 2012;10:81. 67. Ioannidis JP, Haidich AB, Pappa M, et al. Comparison of evidence of treatment effects in randomized and nonrandomized studies. JAMA 2001;286:821–830. 68. Pommer B, Ulm C, Lorenzoni M, Palmer R, Watzek G, Zechner W. Prevalence, location and morphology of maxillary sinus septa: Systematic review and meta-analysis. J Clin Periodontol 2012;39:769–773. 69. van den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res 2000;11:256–265. 70. Papageorgiou SN, Kloukos D, Petridis H, Pandis N. Publication of statistically significant research findings in prosthodontics & implant dentistry in the context of other dental specialties. J Dent 2015;43:1195–1202. 71. Cappelleri JC, Ioannidis JP, Schmid CH, et al. Large trials vs metaanalysis of smaller trials: How do their results compare? JAMA 1996;276:1332–1338. 72. Fleming PS, Koletsi D, Polychronopoulou A, Eliades T, Pandis N. Are clustering effects accounted for in statistical analysis in leading dental specialty journals? J Dent 2013;41:265–270. 73. Agliardi EL, Tetè S, Romeo D, Malchiodi L, Gherlone E. Immediate function of partial fixed rehabilitation with axial and tilted implants having intrasinus insertion. J Craniofac Surg 2014;25:851–855. 74. Bassi AP, Pioto R, Faverani LP, Canestraro D, Fontão FG. Maxillary sinus lift without grafting, and simultaneous implant placement: A prospective clinical study with a 51-month follow-up. Int J Oral Maxillofac Surg 2015;44:902–927. 75. Bornstein MM, Chappuis V, von Arx T, Buser D. Performance of dental implants after staged sinus floor elevation procedures: 5-year results of a prospective study in partially edentulous patients. Clin Oral Implants Res 2008;19:1034–1043. 76. Butz SJ, Huys LW. Long-term success of sinus augmentation using a synthetic alloplast: A 20 patients, 7 years clinical report. Implant Dent 2005;14:36–42. 77. Cha HS, Kim A, Nowzari H, Chang HS, Ahn KM. Simultaneous sinus lift and implant installation: Prospective study of consecutive two hundred seventeen sinus lift and four hundred sixty-two implants. Clin Implant Dent Relat Res 2014;16:337–347. 78. Cricchio G, Sennerby L, Lundgren S. Sinus bone formation and implant survival after sinus membrane elevation and implant placement: A 1- to 6-year follow-up study. Clin Oral Implants Res 2011;22:1200–1212. 79. Di Stefano DA, Gastaldi G, Vinci R, Cinci L, Pieri L, Gherlone E. Histomorphometric comparison of enzyme-deantigenic equine bone and anorganic bovine bone in sinus augmentation: A randomized clinical trial with 3-year follow-up. Int J Oral Maxillofac Implants 2015;30:1161–1167. 80. Hallman M, Sennerby L, Zetterqvist L, Lundgren S. A 3-year prospective follow-up study of implant-supported fixed prostheses in patients subjected to maxillary sinus floor augmentation with a 80:20 mixture of deproteinized bovine bone and autogenous bone: Clinical, radiographic and resonance frequency analysis. Int J Oral Maxillofac Surg 2005;34:273–280.


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81. Kahnberg KE, Ekestubbe A, Gröndahl K, Nilsson P, Hirsch JM. Sinus lifting procedure. I. One-stage surgery with bone transplant and implants. Clin Oral Implants Res 2001;12:479–487. 82. Kahnberg KE, Vannas-Löfqvist L. Sinus lift procedure using a 2-stage surgical technique: I. Clinical and radiographic report up to 5 years. Int J Oral Maxillofac Implants 2008;23:876–884. 83. Özkan Y, Akoğlu B, Kulak-Özkan Y. Maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement: A 5-year prospective follow-up study. Implant Dent 2011;20:455–459. 84. Valentini P, Abensur D, Wenz B, Peetz M, Schenk R. Sinus grafting with porous bone mineral (Bio-Oss) for implant placement: A 5-year study on 15 patients. Int J Periodontics Restorative Dent 2000;20:245–253. 85. Calvo-Guirado JL, Gómez-Moreno G, López-Marí L, Ortiz-Ruiz AJ, Guardia-Muñoz J. Atraumatic maxillary sinus elevation using threaded bone dilators for immediate implants. A three-year clinical study. Med Oral Patol Oral Cir Bucal 2010;15:e366–370. 86. Crespi R, Capparè P, Gherlone E. Osteotome sinus floor elevation and simultaneous implant placement in grafted biomaterial sockets: 3 years of follow-up. J Periodontol 2010;81:344–349. 87. Nedir R, Bischof M, Vazquez L, Nurdin N, Szmukler-Moncler S, Bernard JP. Osteotome sinus floor elevation technique without grafting material: 3-year results of a prospective pilot study. Clin Oral Implants Res 2009;20:701–717.

88. Nedir R, Nurdin N, Abi Najm S, El Hage M, Bischof M. Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study. Clin Oral Implants Res 2017;28:877–886. 89. Nedir R, Nurdin N, Khoury P, Bischof M. Short implants placed with or without grafting in atrophic sinuses: The 3-year results of a prospective randomized controlled study. Clin Implant Dent Relat Res 2016;18:10–18. 90. Nedir R, Nurdin N, Vazquez L, Abi Najm S, Bischof M. Osteotome Sinus Floor Elevation without Grafting: A 10-Year Prospective Study. Clin Implant Dent Relat Res 2016;18:609–617. 91. Nedir R, Nurdin N, Vazquez L, Szmukler-Moncler S, Bischof M, Bernard JP. Osteotome sinus floor elevation technique without grafting: A 5-year prospective study. J Clin Periodontol 2010;37:1023–1028. 92. Nedir R, Bischof M, Vazquez L, Szmukler-Moncler S, Bernard JP. Osteotome sinus floor elevation without grafting material: A 1-year prospective pilot study with ITI implants. Clin Oral Implants Res 2006;17:679–686. 93. Si MS, Zhuang LF, Gu YX, Mo JJ, Qiao SC, Lai HC. Osteotome sinus floor elevation with or without grafting: A 3-year randomized controlled clinical trial. J Clin Periodontol 2013;40:396–403.


Original Fig 3 (prior to journal re-formatting) Contour-enhanced forest plots with random-effects (Paule-Mandel) metaanalyses of factors affecting implant survival. (a) Implant failure according to patient smoking status. (b) Implant failure according to tear of the sinus membrane. (c) Implant failure according to use of bone graft.

Study

Smokers Fail (%)

Non-smokers Fail (%)

Cha 2014 Hallman 2005adjusted

7 (14.6%) 11 (20.8%)

9 (2.2%) 4 (5.7%)

a) Implant failure according to patient smoking status

RR (95% CI)

Overall (Paule-Mandel random-effects) 0.05

0.2

.5

1

Fewer failures in smokers

2

5

Weight

6.71 (2.62, 17.20) 3.09 (0.74, 12.86)

57 43

4.82 (1.20, 19.40)

100

RR (95% CI)

Weight

20

More failures in non-smokers

Study

Tear Yes Fail (%)

Tear No Fail (%)

b) Implant failure according to tear of the sinus membrane

Cha 2014

3 (4.4%)

13 (3.3%)

1.34 (0.39, 4.57)

61

Cricchio 2011

1 (4.0%)

2 (0.9%)

4.28 (0.40, 45.53)

39

2.10 (0.26, 16.82)

100

RR (95% CI)

Weight

Overall (Paule-Mandel random-effects) 0.056

0.2

.5

1

Fewer failures with tear of the Schneiderian membrane

2

5

18

More failures with tear of the Schneiderian membrane

Study

Graft Fail (%)

No graft Fail (%)

c) Implant failure according to use of bone graft

Nedir 2016collated

2 (10.0%)

1 (5.9%)

1.70 (0.17, 17.16)

24

Si 2013

1 (4.8%)

1 (5.0%)

0.95 (0.06, 14.22)

19

Hallman 2005adjusted

9 (11.4%)

6 (20.7%)

0.66 (0.47, 0.93)

57

0.89 (0.21, 3.82)

100

Overall (Paule-Mandel random-effects) .0625

0.2

Fewer failures with graft

.5

1

2

5

16

More failures with graft

Antonoglou et al

Appendix 1 Details of the Performed Literature Searches Electronic databases

Search query

Hits

Updates (July 22, 2016)

MEDLINE searched via PubMed www. ncbi.nlm.nih.gov/sites/entrez/

("sinus lift" OR "sinus lift procedures" OR "maxillary sinus" OR "sinus floor" OR "sinus-floor") AND ("dental implant" OR "oral implant" OR "implant supported" OR "endosseous implant")

650

74

Scopus http://www.scopus.com

("sinus lift" OR "sinus lift procedures") AND ("dental implant" OR "oral implant" OR "implant supported" OR "endosseous implant*")

530

93

The Cochrane Library (Trials) http://www.onlinelibrary.wiley. com/cochranelibrary/search

("sinus lift" OR "sinus lift procedures" OR "maxillary sinus" OR "sinus floor" OR "sinus-floor") AND ("dental implant*" OR "oral implant*" OR "implant supported" OR "endosseous implant*")

128

0

Thomson Reuters Web of Science http://apps.webofknowledge. com

("sinus lift" OR "sinus lift procedures") AND ("clinical study" OR "clinical trial" OR "clinical research study" OR "pilot study") AND ("dental implant*" OR "oral implant*" OR "implant supported" OR "endosseous implant*")

67

12

Cochrane Register of controlled trials http://bvsalud.org/en/

("sinus lift" OR "sinus lift procedures") OR ("maxillary sinus" OR "sinus floor" OR "sinus-floor") AND ("dental implant" OR "oral implant" OR "implant supported" OR "endosseous implant")

Cochrane Database of Abstracts of Reviews of Effects http://bvsalud.org/en/

("sinus lift" OR "sinus lift procedures") OR ("maxillary sinus" OR "sinus floor" OR "sinus-floor") AND ("dental implant" OR "oral implant" OR "implant supported" OR "endosseous implant")

67

1

Virtual Health Library (including LILACS, BBO, and DECS) http://bvsalud.org/en/

("sinus lift" OR "sinus lift procedures") OR ("maxillary sinus" OR "sinus floor" OR "sinus-floor") AND ("dental implant" OR "oral implant" OR "implant supported" OR "endosseous implant") 1,442

180

Total

Appendix 2 Details of Bone Substitutes Origin of bone graft Autograft

Description by the Authors “The autogenous bone donor sites described in these studies were referred to as follows: ‘autogenous bone chips left on the drill during the drilling procedure’”46 “autogenous bone taken from tuberosity and from the mandibular ramus buccal shelf”63 “the autogenous bone chips were harvested locally within the same flap extension, from the chin, from the retromolar area/mandibular ramus, and from the posterior ilium”61 “cortico-cancellous chin grafts were harvested under local anesthesia”38 “the graft was harvested from the anterior part of the iliac crest os ileum with combined cortical and cancellous bone in a block”55 “the bone graft was taken from the iliac crest”65

Xenograft

“porcine bone MP3 Osteobiol® of 600 µm (Osteogenos, Madrid, Spain)”59 “anorganic bovine bone (Bio-Oss®; Geistlich PharmaAG, Wolhusen, Switzerland; granulometry: 0.25–1 mm)”59 “deproteinized bovine bone mineral (DBBM; Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland)”64 “xenogenic bone (Bio-Oss®, Geistlich Pharma, Wolhusen, Switzerland),66 ABB (Bio-Oss, Geistlich)”56” ”bovine hydroxyapatite (Bio-OssR spongiosa 0.25–1.0 mm granules, Geistlich Pharma AG, Wolhusen,Switzerland)”38 “Bovine bone (Bio-Oss; spongious granule, particle size 0.25 to 1 mm; Geistlich Pharmaceutical, Wolhusen, Switzerland)”67 “and natural bone mineral of bovine origin (Bio-Oss,Osteohealth)”68

Allograft

“MHA Ca10-xMgx(PO4)6(OH)2 in granule form”69 “synthetic b-tricalcium phosphate (b-TCP) (CEROS TCP, Mathys AG)”61 “synthetic bone substitute material used was Bioplant®HTR®. Synthetic Bone™ allograft (Kerr Corporation, Orange,CA)”70


Antonoglou et al

Appendix 3 Risk of Bias in Included RCT Study

Random sequence generation

Allocation concealment

Blinding assessment

Si et al (2013)

Low risk

Low risk

Low risk

Support of judgment

Patients eligible for this study were assigned to two groups using the random numbers table (Complete randomization) by an assistant.

The assignment was concealed from the clinical operators until the sealed, numbered envelopes were opened before OSFE application during implant surgery.

The outcome examiners and the patients were kept blinded to the assignment.

Review of support

Probably done

Probably done

Probably done

Appendix 4 Risk of Bias in Included Prospective Clinical Trials Transcrestal

Reporting 1. Is the hypothesis/aim/objective of the study clearly described? 2. Are the main outcomes to be measured clearly described in the Introduction or Methods section? 3. Are the characteristics of the patients included in the study clearly described? 4. Are the interventions of interest clearly described? 5. Are the main findings of the study clearly described? 6. Have all important adverse events that may be a consequence of the intervention been reported? 7. Have the characteristics of patients lost to follow-up been described? 8. H ave actual probability values been reported (eg, .035 rather than < .05) for the main outcomes except where the probability value is less than .001? External validity 9. Were the subjects asked to participate in the study representative of the entire population from which they were recruited? 10. W ere those subjects who were prepared to participate representative of the entire population from which they were recruited? 11. Were the staff, places, and facilities where the patients were treated, representative of the treatment the majority of patients receive? Internal validity - bias 12. If any of the results of the study were based on “data dredging”, was this made clear? 13. In trials and cohort studies, do the analyses adjust for different lengths of follow-up of patients, or in case-control studies, is the time period between the intervention and outcome the same for cases and controls ? 14. Were statistical tests used to assess outcomes appropriate? 15. Was compliance with the intervention/s reliable? 16. Were the main outcome measures used accurate (valid and reliable)? Internal validity - confounding (selection bias) 17. Were the patients in different intervention groups (trials and cohort studies) or were the cases and controls (case-control studies) recruited from the same population? 18. Were study subjects in different intervention groups (trials and cohort studies) or were the cases and controls (case-control studies) recruited over the same period of time? 19. Was there adequate adjustment for confounding in the analyses from which the main findings were drawn? 20. Were losses of patients to follow-up taken into account? Power 21. Did the study have sufficient power to detect a clinically important effect where the probability value for a difference being due to chance is less than 5%? Sum

Crespi (2013)

CalvoGuirado (2010)

1 1 1 1 1 1 0 1

1 1 1 0 1 1 1 0

1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1

NR

NR

NR

NR

0

0

0

0

0

0

0

0

1 0

1 1

1 1

1 1

1 1 1

1 1 1

1 1 1

1 1 1

NR

NR

1

1

1

1

1

1

0

0

0

1

0

NR

1

1

0

0

0

1

12

12

16

18

Nedir Nedir (2006) (2016)

NR = not reported.


Antonoglou et al

Blinding of outcome

Selective reporting

Incomplete outcome data

Other bias

Low risk

Low risk

Unclear risk

Low risk

The radiographic and clinical assessments were conducted by two assistants, who were blinded to the group allocation.

Forty-five patients (18 women and 27 men), aged 19–78 years (mean 48.5 years), were included at first. Three patients were excluded from the study because of sinus membrane perforation during surgery. One patient dropped out during the follow-up period due to death. Thus, 21 patients in Group 1 and 20 patients in Group 2 completed the study. Their data were used for statistical analysis.

Not reported

None

Unclear

Probably done

Unclear

No additional concerns

Study Lateral window Agliardi (2014)

Bassi (2015)

Bornstein (2008)

Butz (2005)

Cha (2014)

Di Stefano (2015)

Hallman (2005)

Johansson (2010)

Kahnberg (2001)

Özkan (2011)

Kahnberg (2008)

Valentini (2000)

1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1

0 0 1 1 0 1 1 0

1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1

1 1 1 1 1 1 0 1

0 1 0 1 1 1 0 1

0 0 0 1 1 1 1 1

0 0 1 1 1 1 0 0

0 0 1 1 1 1 0 0

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

0

0

0

0

1 0

1 1

1 1

1 0

1 0

1 1

1 0

1 1

1 0

1 0

1 0

1 0

1 1 1

1 1 1

1 1 1

0 1 0

1 1 1

1 1 1

1 0 1

1 1 1

1 0 1

1 0 1

1 1 1

1 1 1

1

NR

1

NR

1

1

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

NR

1

NR

NR

NR

NR

NR

0

0

0

0

0

0

1

0

0

0

0

0

0

1

1

1

1

1

1

0

0

1

0

1

0

1

0

0

0

0

0

0

0

1

0

0

13

15

15

8

14

15

14

12

8

10

8

9


Antonoglou et al

Appendix 5 Re-analysis of Data from the Hallman et al (2005) Study Using Generalized Linear Models and Accounting for Within-Patient Clustering with Robust Standard Errors Univariable RR

SE

1.10

0.06

3.40

2.68

Multivariable

95% CI

P

RR

SE

95% CI

P

0.99, 1.22

.075

1.06

0.06

0.95, 1.19

.300

0.73, 15.94

.121

2.57

1.54

0.79, 8.31

.115

2.25

0.74, 12.86

.121

0.12

0.47, 0.93

.019

Age Per year increase Sex Male Female

Reference

Reference

Smoking Yes

4.32

No

Reference

3.38

0.93, 20.03

.061

3.09 Reference

Graft use Yes

0.55

0.24

0.23, 1.29

.170

0.66

RR = relative risk; SE = standard error; CI = confidence interval.

Appendix 6 Results of Mixed-Effects Meta-Regression (Paule-Mandel Method) and Egger’s Test on Implant Complication or Implant Failure Rate Over a 3-year Follow-up Period Outcome/factor

n

Coefficient

95% CI

P

Age

7

0.02

–0.02, 0.05

.333

Male % (per 10% increase)

8

–0.02

–0.01, 0.06

.611

Follow-up (per 12 mo)

8

–0.01

–0.05, 0.03

.456

Meta-regressions Implant failure

Implant complications Age

8

0.01

–0.02, 0.05

.424


9

–0.01

–0.09, 0.06

.703


9

–0.01

–0.05, 4.18

.507

Age

7

0.02

–0.02, 0.05

.333


8

–0.02

–0.01, 0.06

.611


8

–0.01

–0.05, 0.03

.456

Age

10

0.05

–0.09, 0.18

.443


10

0.20

–0.12, 0.53

.189


10

0.05

–0.37, 0.47

.802

9

2.95

0.49, 5.41

.025

IMP failure (relative to survival)

Bone loss

Egger’s test Implant failure Implant complication

10

2.97

0.08, 5.86

.045

Bone loss

10

8.00

1.03, 14.97

.029

n = studies; CI = confidence interval; IMP = implant.


Antonoglou et al

Appendix 7 Meta-analyses of Factors Influencing Failure of Implants Placed After Sinus Elevation (Direct Data from Within-Study Comparison; Paule-Mandel Random-Effects) Estimated effects Outcome

Factor

n

Estimate

95% CI

Heterogeneity 𝛕2

P

I2% (95% CI)

Implant failure

Patient sex: male (Reference: female)

1

RR: 2.57

0.79, 8.31

.115

NE

NE

Implant failure

Patient age (per year increase)

1

RR: 1.06

0.95, 1.19

.300

NE

NE

Implant failure

Smoking status (Reference: no smoking)

2

RR: 4.82

1.20, 19.40 .027 .874

50.000 0.943

99 (NE)

Implant failure

Graft use (Reference: no graft)

3

RR: 0.89

0.21, 3.82

Implant failure

Sinus membrane tear (Reference: no tear)

2

RR: 2.10

0.26, 16.82 .485

Implant failure

Residual bone level 3 mm to 5 mm (Reference: < 3 mm)

1

RR: 0.42

0.06, 2.90

.375

NE

NE

Implant failure

Residual bone level > 5 mm (Reference: < 3 mm)

1

RR: 0.37

0.03, 4.03

.414

NE

NE

Bone loss Graft use (Reference: no graft) around implant

4

MD: –0.13

–0.65, 0.39

.627

0.223

84 (71–98)

Implant stability Graft use (Reference: no graft) quotient

1

MD: –1.80 –4.62, 1.02

.211

NE

NE

0

53 (0–93) 0 (NE)

n = number of studies directly comparing implant failure per factor; CI = confidence interval; RR = relative risk; NE = not estimable; MD = mean difference.

Appendix 8 GRADE Summary of Findings Table Supporting Factors Influencing Failure of Implants Placed After Sinus Elevation (Within-Studies Comparison) Factor/studies (implants) Patient sex 1 study1 (108 implants) Patient age 1 study1 (108 implants) Smoking 2 studies1,2 (581 implants) Residual bone height 1 study 2 (462 implants)

Relative effects (95% CI)

Anticipated absolute effectsa (95% CI) Control

RR 2.57 (0.79 to 8.31)

Female 7.4%b

RR 1.06 (0.95 to 1.19)

Overall 2.2%h

Case

Difference 11.6% more failure (1.6% less to 150.6% more) 0.1% more failure (0.1% less to 0.6% more) per year 12.6% more failure (0.7% to 60.7% more)

Male 19.0% (5.8% to 158.0%) –

RR 4.82 No (1.20 to 19.40) smokers 3.3%b

Smokers 15.9% (4.0% to 64.0%)

RR 0.42 (0.06 to 2.90)

Residual bone be tween 3 and 5 mm 0.8% (0.1% to 5.8%) Residual bone > 5 mm 0.7% (0.1% to 8.1%) Membrane tear 4.4% (0.5% to 74.2%) Graft 9.5% (2.2% to 40.9%)

< 3 mm bone 2.0%b

RR 0.37 (0.03 to 4.03) Sinus membrane tear RR 2.10 (0.26 to 16.82) 2 studies2,3 (701 implants) RR 0.89 Graft use (0.21 to 3.82) 3 studies1,4,5 (186 implants)

No tear 2.1%b No graft 10.7%b

1.2% less failure (1.9% less to 3.8% more) 1.3% less failure (1.9% less to 6.1% more) 2.3% more failure (1.6% less to 72.1% more) 1.2% less failure (8.5% less to 30.2% more)

Quality of the evidence (GRADE) ⊕⊕○○ lowc,g due to bias and imprecision ⊕⊕○○lowc,g due to bias and imprecision ⊕⊕⊕○moderatec,e due to bias; large effect ⊕⊕○○lowc,g due to bias and imprecision ⊕⊕○○lowc,g due to bias and imprecision ⊕⊕○○ lowc,f due to bias and imprecision ⊕⊕○○ lowc,d due to bias and inconsistency

What happens There may be little or no difference in implant failure There may be little or no difference in implant failure Smoking considerably increases implant failure There may be little or no difference in implant failure There may be little or no difference in implant failure There may be little or no difference in implant failure There may be little or no difference in implant failure

CI = confidence interval; RR = relative risk; GRADE = Grading of Recommendations Assessment, Development and Evaluation. Factors influencing the prognosis (failure) of dental implants placed with a 1- or 2-stage protocol in maxillary sinuses after sinus elevation procedures (with or without bone graft). Patient or population: adult patients with partial or complete edentulism of the posterior maxilla and reduced residual bone. Settings: university clinics (Brazil, China, Italy, South Korea, Spain, Sweden, Switzerland, Turkey), private practices (Belgium, France, South Africa, Switzerland), and hospitals (Sweden). aThe basis for the risk in the control group (eg, the median control group risk across studies) is provided in footnotes. The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). b Pooled incidence (random-effects meta-analysis) among the specific arm of the eligible for GRADE studies. cDue to the inclusion of non-randomized trials. dDue to the wide distribution of effect estimates on both sides of the forest plot. eUpgraded by one based on large to very large effect magnitude. f Imprecision judged from the wide confidence intervals crossing the line of no effect. gImprecision judged by the small number of included studies with limited sample sizes. hPooled incidence (random-effects meta-analysis) from all studies included in the main analysis (19 studies). 1Hallman et al (2005). 2Cha et al (2014). 3Cricchio et al (2011). 4Nedir et al (2016). 5Si et al (2013).


Antonoglou et al

Appendix 9 Contour-enhanced funnel plots for the inspection of reporting bias

Appendix 10 Sensitivity Analyses Implant success Sample

n

% rate

Large studies

5

95.1

84.8–99.9

Small studies

12

97.8

94.3–99.8

6

96.9

94.2–98.9

11

97.2

91.9–100.0

Methodologically robusta Methodologically not robust

95% CI

PSG .623

I2% (95% CI) 97 (95–98) 72 (44–83)

.761

0 (0–61) 93 (91–95)

n = studies; CI = confidence interval; PSG = P value for differences between subgroups. aIncluding the one RCT and all NRS with > 14 points in the Downs-Black scale.


Antonoglou et al

Implant survival n

% rate

Bone loss around implants

95% CI

P SG

I2% (95% CI)

.717

5

96.3

87.5–100.0

12

98.3

95.0–100.0

6

97.8

95.0–99.6

11

97.7

93.0–100.0

.880

n

Mean

95% CI

P SG

96 (94–97)

1

73 (46–83)

9

1.60

1.48–1.72

.290

0.93

0.53–1.32

17 (0–67)

4

0.81

0.34–1.28

93 (90–95)

6

1.12

0.56–1.67

I2% (95% CI) – 99 (97–100)

.449

96 (91–100) 99 (98–100)


Additional Appendices (cut during post-acceptance processing) Appendix A. List of included and excluded studies with reasons. Nr

1 2 3 4 5 6 7 8 9 10 11 12 13 14

15

16

17 18 19 20 21

22 23 24 25 26

27

28 29 30 31

32 33

REFERENCE Excluded 1997 -12-1-88-94--Journal Article Att,W.;Bernhart,J.;Strub,J. R.-Fixed rehabilitation of the edentulous maxilla: possibilities and clinical outcomeJournal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.2009-Nov-67-11 Suppl2000 -11 Suppl 1- -69-82--Journal Article Weingart,D.;ten Bruggenkate,C. M.-Treatment of fully edentulous patients with ITI implants-Clinical oral implants research-Clin.Oral Implants Res.-2000- -11 Suppl 1- 2000 -21-7-585-590; quiz 592--Journal Article Zide,M. F.-Autogenous bone harvest and bone compacting for dental implants-Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995)-Compend.Contin.Educ.Dent.-2000-Jul-21-72003 Nov-Dec-18-6-826-834--Journal Article Lambert,F.;Lecloux,G.;Rompen,E.-Sinus floor bone augmentation: implementation of the concept of sinus-lift-Revue belge de mÃƒÂ©decine dentaire.Belgisch tijdschrift voor tandheelkunde- -2009- -64-42006 -21-5-696-710--Journal Article Esposito,M.;Felice,P.;Worthington,H. V.-Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus-The Cochrane database of systematic reviews-Cochrane Database Syst.Rev.-2014-May 13-5- 2007 May-103-5-623-625--Journal Article John,V.;Lane,B.;Chu,G.-Complications associated with the placement and restoration of dental implants-Journal (Indiana Dental Association)-J.Indiana Dent.Assoc.-2013-Summer-92-32008 -28-3-273-281--Journal Article Froum,S. J.;Wallace,S. S.;Cho,S. C.;Elian,N.;Tarnow,D. P.-Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot studyThe International journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2008-Jun-28-32008 -34-6-313-318--Journal Article Fugazzotto,P. A.;Vlassis,J.-Long-term success of sinus augmentation using various surgical approaches and grafting materials-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-1998-Jan-Feb-13-12012 -27-5-1151-1162--Journal Article Lindgren,C.;Mordenfeld,A.;Johansson,C. B.;Hallman,M.-A 3-year clinical follow-up of implants placed in two different biomaterials used for sinus augmentation-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants2012-Sep-Oct-27-52013 -40-4-396-403--Journal Article Si,M. S.;Zhuang,L. F.;Gu,Y. X.;Mo,J. J.;Qiao,S. C.;Lai,H. C.-Osteotome sinus floor elevation with or without grafting: a 3-year randomized controlled clinical trial-Journal of clinical periodontology-J.Clin.Periodontol.-2013-Apr-40-42013 FEB 2013-15-1-7-14--Journal Article Dasmah,A.;Thor,A.;Ekestubbe,A.;Sennerby,L.;Rasmusson,L.-Marginal bone-level alterations at implants installed in block versus particulate onlay bone grafts mixed with platelet-rich plasma in atrophic maxilla. a prospective 5-year followup study of 15 patients-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2013- -15-1Choucroun, G., Mourlaas, J., Kamar Affendi, N. H., Froum, S. J., & Cho, S.-C. (2016). Sinus Floor Cortication: Classification and Prevalence. Clinical Implant Dentistry and Related Research. http://doi.org/10.1111/cid.12434 Shi, J.-Y., Gu, Y.-X., Qiao, S.-C., Zhuang, L.-F., Zhang, X.-M., & Lai, H.-C. (2015). Clinical evaluation of short 6-mm implants alone, short 8-mm implants combined with osteotome sinus floor elevation and standard 10-mm implants combined with osteotome sinus floor elevation in posterior maxillae: study protocol for a randomized controlled trial. Trials, 16, 324. http://doi.org/10.1186/s13063-015-0853-4 1997 -2-1-329-342--Journal Article Buser,D. A.;Tonetti,M.-Clinical trials on implants in regenerated bone.-Annals of Periodontology / The American Academy of Periodontology-Ann.Periodontol.-1997-1997-Mar-2-12012 SPR 2012-5-1-19-33--Journal Article Esposito,Marco;Cannizzaro,Gioacchino;Soardi,Elisa;Pellegrino,Gerardo;Pistilli,Roberto;Felice,Pietro-A 3-year post-loading report of a randomised controlled trial on the rehabilitation of posterior atrophic mandibles: short implants or longer implants in vertically augmented bone?-European Journal of Oral Implantology- -2011-WIN 2011-4-42009 -54-1-70-71--Journal Article Esposito,M.;Grusovin,M. G.;Coulthard,P.;Worthington,H. V.-The efficacy of various bone augmentation procedures for dental implants: A Cochrane systematic review of randomized controlled clinical trials-International Journal of Oral and Maxillofacial Implants- -2006- -21-52008 Jul 16-(3):CD003607. doi-3-CD003607- --Journal Article Esposito,M.;Grusovin,M. G.;Kwan,S.;Worthington,H. V.;Coulthard,P.Interventions for replacing missing teeth: Bone augmentation techniques for dental implant treatment-Australian Dental Journal-Aust.Dent.J.2009- -54-12009 Feb-29-1-23-29--Journal Article Correia,F.;Faria Almeida,R.;Lemos Costa,A.;Carvalho,J.;Felino,A.-Lifting of the maxillary sinus by the lateral window technique: Grafts types-Revista Portuguesa de Estomatologia, Medicina Dentaria e Cirurgia Maxilofacial- -2012- -53-32010 -41-4-321-326--Journal Article Chao,Y. -L;Chen,H. -H;Mei,C. -C;Tu,Y. -K;Lu,H. -K-Meta-regression analysis of the initial bone height for predicting implant survival rates of two sinus elevation procedures-Journal of clinical periodontology-J.Clin.Periodontol.-2010- -37-52010 May-Jun-25-3-613-619--Book, Section GarcÃƒÂa,E. G.;Carretero,J. L. C.-Bone graft donor sites in implantology-Bone Grafts: Procedures, Complications and Alternatives- -2013- - - 2010 SPR 2010-3-1-7-26--Journal Article Esposito,Marco;Grusovin,Maria Gabriella;Rees,Jonathan;Karasoulos,Dimitrios;Felice,Pietro;Alissa,Rami;Worthington,Helen V.;Coulthard,Paul-Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus-Cochrane Database of Systematic Reviews- -2010-2010- -3Kao, S.-Y., Lui, M.-T., Cheng, D.-H., & Chen, T.-W. (2015). Lateral trap-door window approach with maxillary sinus membrane lifting for dental implant placement in atrophied edentulous alveolar ridge. Journal of the Chinese Medical Association, 78(2), 85–88. http://doi.org/10.1016/j.jcma.2014.05.016 2010 -78-7-145-149--Journal Article Ãƒâ€―zyuvaci,H.;Aktas,I.;Yerit,K.;Aydin,K.;Firatli,E.-Radiological evaluation of sinus lift operation: What the general radiologist needs to know-Dentomaxillofacial Radiology- -2005- -34-41994 Jun-13-6-70-71--Journal Article Lindgren,C.;Sennerby,L.;Mordenfeld,A.;Hallman,M.-Clinical histology of microimplants placed in two different biomaterials-International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2009- -24-61996 Jul-Aug-11-4-466-475--Journal Article Hure,G.-Original endosseous implant therapy to resolve the problem of posterior unilateral or bilateral edentulousness of the upper jaw-Les Cahiers de prothese-Cah.Prothese-1989-Sep--67-672000 Oct-11-5-487-493--Journal Article van den Bergh,J. P.;ten Bruggenkate,C. M.;Groeneveld,H. H.;Burger,E. H.;Tuinzing,D. B.-Recombinant human bone morphogenetic protein-7 in maxillary sinus floor elevation surgery in 3 patients compared to autogenous bone grafts. A clinical pilot study-Journal of clinical periodontology-J.Clin.Periodontol.-2000-Sep-27-92002 -13-4-420-427--Journal Article Artzi,Z.;Nemcovsky,C. E.;Dayan,D.-Nonceramic hydroxyapatite bone derivative in sinus augmentation procedures: Clinical and histomorphometric observations in 10 consecutive cases-International Journal of Periodontics and Restorative Dentistry- -2003- -23-42002 -22-1-45-53--Journal Article Froum,S. J.;Wallace,S. S.;Cho,S. C.;Elian,N.;Tarnow,D. P.-Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot studyInternational journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2008- -28-32002 Nov-Dec-17-6-861-865--Journal Article Bedrossian,E.-Rehabilitation of the edentulous maxilla with the zygoma concept: a 7-year prospective study-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2010-Nov-Dec-25-62003 -96-3-263-266--Journal Article Haas,R.;Mendorff-Pouilly,N.;Mailath,G.;Bernhart,Th-Five-year results of maxillary Intramobile Zylinder implants-British Journal of Oral and Maxillofacial Surgery- -1998- -36-22003 Apr-14-2-207-212--Journal Article Stievano,D.;Di Stefano,D. A.;Ludovichetti,M.;Pagnutti,S.;Gazzola,F.;Boato,C.;Stellini,E.-Maxillary sinus lift through heterologous bone grafts and simultaneous acid-etched implants placement: Five year follow-up-Minerva chirurgica-Minerva Chir.2008- -63-22004 - - -972- --Journal Article Saffarzadeh,A.;Gauthier,O.;Bilban,M.;Bagot D'Arc,M.;Daculsi,G.-Comparison of two bone substitute biomaterials consisting of a mixture of fibrin sealant (Tisseel) and MBCP (TricOs) with an autograft in sinus lift surgery in sheep-Clinical oral implants research-Clin.Oral Implants Res.-2009-Oct-20-102004 Dec-32-12-1011-1020--Journal Article Yu,Y. -C;Liu,H. -J;Wang,X. -P;Gu,Z. -Y;Jiang,X. -Q;Lin,J.;Zhang,X. -L-Study of osseointegraton on

REASON

Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate Duplicate

Not relevant

Not original aricle

Not original article Not original article Not original article Not original article Not original article

Not original article Not original study Participants Participants Participants

Participants

Participants Participants Participants Participants

Participants Participants

34 35 36

37

38

39

40 41 42 43 44 45 46

47

48 49 50

51

52 53 54 55

56 57 58 59 60

61

62 63 64 65 66 67

sinus lift grafting by tissue-engineered bone-Fudan University Journal of Medical Sciences- -2006- -33-62004 Sep-13-3-187-191--Journal Article Penarrocha-Diago,M.;Garcia,B.;Gomez,D.;Balaguer,J.-Zygomatic bone graft for oral-antral communication closure and implant placement-The Journal of oral implantology-J.Oral Implantol.-2007- -33-52004 Spring-84-2-28-30--Journal Article Timmenga,N. M.;Raghoebar,G. M.;Boering,G.;Van Weissenbruch,R.-Maxillary sinus function after sinus lifts for the insertion of dental implants-Journal of Oral and Maxillofacial Surgery- -1997- -55-92005 -14-3-261-266--Journal Article Steigmann,M.;Garg,A. K.-A comparative study of bilateral sinus lifts performed with platelet-rich plasma alone versus alloplastic graft material reconstituted with blood-Implant dentistry-Implant Dent.-2005- -14-32005 -20-4-519-525--Journal Article Barboni,B.;Mangano,C.;Valbonetti,L.;Marruchella,G.;Berardinelli,P.;Martelli,A.;Muttini,A.;Mauro,A.;Bedini,R.;Turriani,M.;Pecci,R.;Nardinocchi,D. ;Zizzari,V. L.;Tete,S.;Piattelli,A.;Mattioli,M.-Synthetic bone substitute engineered with amniotic epithelial cells enhances bone regeneration after maxillary sinus augmentation-PloS one-PLoS One-2013-May 17-8-52005 -7-2-79-86--Journal Article Thor,A.;Sennerby,L.;Hirsch,J. M.;Rasmusson,L.-Bone Formation at the Maxillary Sinus Floor Following Simultaneous Elevation of the Mucosal Lining and Implant Installation Without Graft Material: An Evaluation of 20 Patients Treated With 44 Astra Tech Implants-Journal of Oral and Maxillofacial Surgery- -2007- -65-72005 -7-3-159-165--Journal Article Becktor,J. P.;Hallstrom,H.;Isaksson,S.;Sennerby,L.-The use of particulate bone grafts from the mandible for maxillary sinus floor augmentation before placement of surface-modified implants: results from bone grafting to delivery of the final fixed prosthesis-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.-2008-Apr-66-42005 Sep-14-3-232-236--Journal Article Nowzari,H.;Aalam,A. A.-Mandibular cortical bone graft part 2: surgical technique, applications, and morbidity-Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995)-Compend.Contin.Educ.Dent.-2007-May-28-52006 -17-2-194-205--Book, Section Ferri,J.;Lauwers,L.;Elia,P.;Dubois,H.-Bone grafting and Le fort I osteotomy in cases of major atrophy of the maxilla-Preprosthetic and Maxillofacial Surgery: Biomaterials, Bone Grafting and Tissue Engineering- -2011- - - 2006 -33-6-819-822--Journal Article Yu,H.;Yu,H. -G;Xu,S.;Liu,Z. -H-Clinical study of maxillary sinus lift with bone graft and simultaneous placement of ITI implants-Journal of Dalian Medical University- -2010- -32-52006 Dec-77-12-1991-1997--Journal Article Kaptein,M. L.;Hoogstraten,J.;de Putter,C.;de Lange,G. L.;Blijdorp,P. A.-Dental implants in the atrophic maxilla: measurements of patients' satisfaction and treatment experience-Clinical oral implants research-Clin.Oral Implants Res.-1998Oct-9-52007 -22 Suppl- -49-70--Journal Article Aghabeigi,B.;Bousdras,V. A.-Rehabilitation of severe maxillary atrophy with zygomatic implants. Clinical report of four cases-British dental journal-Br.Dent.J.-2007-Jun 9-202-112007 -65-11-2324-2328--Journal Article Chen,L.;Cha,J.;Chen,H. C.-Two different clinical indications using hydraulic sinus condensing (HSC) technique: ten years follow-up-Dental implantology update-Dent.Implantol.Update-2009-May-20-52007 Jul-Aug-22-4-603-608--Journal Article Becktor,J. P.;Isaksson,S.;Abrahamsson,P.;Sennerby,L.-Evaluation of 31 zygomatic implants and 74 regular dental implants used in 16 patients for prosthetic reconstruction of the atrophic maxilla with cross-arch fixed bridges-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2005- -7-32008 -118-3-203-212--Journal Article Smedberg,J. I.;Johansson,P.;Ekenback,D.;Wannfors,D.-Implants and sinus-inlay graft in a 1-stage procedure in severely atrophied maxillae: prosthodontic aspects in a 3-year follow-up study-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2001-Sep-Oct-16-52008 -76-9-33-43--Journal Article Bran,S.;Onisor-Gligor,F.;Lucaciu,D.;Campian,R. S.;Lucaciu,O. P.;Dudea,D.-Sinus lift and dental implant treatment as an option for enhancing the quality of life of our patients-Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie-Rom.J.Morphol.Embryol.-2013- -54-12009 -8-3-127-134--Journal Article Rao,G. S.;Reddy,S. K.-Antral balloon sinus elevation and grafting prior to dental implant placement: review of 34 cases-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2014-Mar-Apr-29-22009 2009-Oct-2-4-2-10--Journal Article Gonzalez-Santana,H.;Penarrocha-Diago,M.;Guarinos-Carbo,J.;Balaguer-Martinez,J.-Pain and inflammation in 41 patients following the placement of 131 dental implants-Medicina oral, patologia oral y cirugia bucal-Med.Oral Patol.Oral Cir.Bucal-2005-May-Jul-10-32009 Oct-18-5-402-412--Journal Article Riecke,B.;Heiland,M.;Hothan,A.;Morlock,M.;Amling,M.;Blake,F. A.-Primary implant stability after maxillary sinus augmentation with autogenous mesenchymal stem cells: a biomechanical evaluation in rabbits-Clinical oral implants researchClin.Oral Implants Res.-2011-Nov-22-112009 Spring-2-1-25-38--Generic Cannizzaro,G.;Felice,P.;AF,Minciarelli;Leone,M.;Viola,P.;Esposito,M.-Early implant loading in the atrophic posterior maxilla: 1-stage lateral versus crestal sinus lift and 8 mm hydroxyapatite-coated implants. A 5-year randomised controlled trial.\îen- ----2010 -36-2-113-121--Journal Article Agamy,E. M.;Niedermeier,W.-Indirect sinus floor elevation for osseointegrated prostheses. A 10-year prospective study-The Journal of oral implantology-J.Oral Implantol.-2010- -36-22010 -68-7-1642-1645--Journal Article Uchida,Y.;Goto,M.;Katsuki,T.;Soejima,Y.-Measurement of Maxillary Sinus Volume Using Computerized Tomographic Images-International Journal of Oral and Maxillofacial Implants- -1998- -13-62010 -95-4-1048-1054--Journal Article Hu,X.;Luo,J.;Li,J.;Qiu,L.;Di,P.;Lin,Y.-A 10-year retrospective analysis of clinical results of implantretained/ supported prostheses in full edentulous patients-Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology-Zhonghua Kou Qiang Yi Xue Za Zhi-2014-Jun-49-62011 Dec-112-6-e97-102--Journal Article Cehreli,M. C.;Akkocaoglu,M.;Comert,A.;Tekdemir,I.;Akca,K.-Bone strains around apically free versus grafted implants in the posterior maxilla of human cadavers-Medical & biological engineering & computing-Med.Biol.Eng.Comput.-2007-Apr-4542012 - -4-314-324--Journal Article Schaudy,C.;Vinzenz,K.-Osteoplastic reconstruction of severely resorbed maxilla by stack plasty: Combining sinus augmentation with lateral and vertical onlay bone grafting-British Journal of Oral and Maxillofacial Surgery- -2014- -52-72012 Jan-23-1-e12-4--Journal Article Corrente,G.;Abundo,R.;des Ambrois,A. B.;Savio,L.;Perelli,M.-Short porous implants in the posterior maxilla: a 3-year report of a prospective study-The International journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2009-Feb-29-12012 Nov-108-5-286-297--Journal Article Pozzi,A.;Moy,P. K.-Minimally Invasive Transcrestal Guided Sinus Lift (TGSL): A Clinical Prospective Proof-of-Concept Cohort Study up to 52 Months-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2013- - - 2013 -15-1-7-14--Journal Article Dasmah,A.;Thor,A.;Ekestubbe,A.;Sennerby,L.;Rasmusson,L.-Marginal Bone-Level Alterations at Implants Installed in Block versus Particulate Onlay Bone Grafts Mixed with Platelet-Rich Plasma in Atrophic Maxilla. A Prospective 5-Year Follow-Up Study of 15 Patients-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2013- -15-12013 SPR 2013-6-1-13-25--Journal Article Cannizzaro,Gioacchino;Felice,Pietro;Leone,Michele;Viola,Paolo;Esposito,Marco-Early loading of implants in the atrophic posterior maxilla: lateral sinus lift with autogenous bone and Bio-Oss versus crestal mini sinus lift and 8-mm hydroxyapatite-coated implants. A randomised controlled clinical trial-European Journal of Oral Implantology- -2009-SPR 2009-2-12014 - - - - --Journal Article Farzad,P.;Andersson,L.;Gunnarsson,S.;Johansson,B.-Rehabilitation of severely resorbed maxillae with zygomatic implants: an evaluation of implant stability, tissue conditions, and patients' opinion before and after treatment-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2006-May-Jun-21-3-30-2-592-598--Journal Article de Moraes,P. H.;Costa,M. V. O. C.;Olate,S.;Caria,P. H. F.;Barbosa,J. R. A.-Morphometric study of maxillary sinus by computed tomography. assessment of sinus floor bone reconstruction-International Journal of Morphology- -2012- -30-2Anitua, E., Alkhraist, M. H., Piñas, L., & Orive, G. (2015). Association of transalveolar sinus floor elevation, platelet rich plasma, and short implants for the treatment of atrophied posterior maxilla. Clinical Oral Implants Research, 26(1), 69–76. http://doi.org/10.1111/clr.12282 Berberi, A., Nader, N., Noujeim, Z., Scardina, A., Leone, A., & Salameh, Z. (2015). Horizontal and vertical reconstruction of the severely resorbed maxillary jaw using subantral augmentation and a novel tenting technique with bone from the lateral buccal wall. Journal of Oral and Maxillofacial Surgery, 14(2), 263–270. http://doi.org/10.1007/s12663-014-0635-7 Clemm, R., Neukam, F. W., Rusche, B., Bauersachs, A., Musazada, S., & Schmitt, C. M. (2015). Management of anticoagulated patients in implant therapy: a clinical comparative study. Clinical Oral Implants Research. http://doi.org/10.1111/clr.12732 Favato, M. N., Vidigal, B. C. L., Cosso, M. G., Manzi, F. R., Shibli, J. A., & Zenóbio, E. G. (2015). Impact of human maxillary sinus volume on

Participants Participants Participants

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68 69 70 71 72 73 74 75 76

77 78 79 80 81 82 83 84 85

86 87 88 89

90

91

92 93 94 95 96 97 98 99 100

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grafts dimensional changes used in maxillary sinus augmentation: A multislice tomographic study. Clinical Oral Implants Research, 26(12), 1450–1455. http://doi.org/10.1111/clr.12488 Felice, P., Checchi, L., Barausse, C., Pistilli, R., Sammartino, G., Masi, I., … Esposito, M. (2016). Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: One-year post-loading results from a multicenter randomised controlled trial. European Journal of Oral Implantology, 9(1), 35–45. Felice, P., Pistilli, R., Barausse, C., Bruno, V., Trullenque-Eriksson, A., & Esposito, M. (2015). Short implants as an alternative to crestal sinus lift: A 1-year multicentre randomised controlled trial. European Journal of Oral Implantology, 8(4), 375–384. Franceschetti, G., Rizzi, A., Minenna, L., Pramstraller, M., Trombelli, L., & Farina, R. (2016). Patient-reported outcomes of implant placement performed concomitantly with transcrestal sinus floor elevation or entirely in native bone. Clinical Oral Implants Research. http://doi.org/10.1111/clr.12774 Guo, J., Weng, J., Rong, Q., Zhang, X., Zhu, S., Huang, D., … Chen, S. (2015). Investigation of multipotent postnatal stem cells from human maxillary sinus membrane. Scientific Reports, 5, 11660. http://doi.org/10.1038/srep11660 Insua, A., Monje, A., Chan, H.-L., Zimmo, N., Shaikh, L., & Wang, H.-L. (2016). Accuracy of Schneiderian membrane thickness: A cone-beam computed tomography analysis with histological validation. Clinical Oral Implants Research. http://doi.org/10.1111/clr.12856 Nedir, R., Nurdin, N., Abi Najm, S., El Hage, M., & Bischof, M. (2016). Short implants placed with or without grafting into atrophic sinuses: The 5-year results of a prospective randomized controlled study. Clinical Oral Implants Research. http://doi.org/10.1111/clr.12893 Ozturan, S., Sirali, A., & Sur, H. (2015). Effects of Nd:YAG laser irradiation for minimizing edema and pain after sinus lift surgery: Randomized controlled clinical trial. Photomedicine and Laser Surgery, 33(4), 193–199. http://doi.org/10.1089/pho.2014.3823 Pigache, P., Anavekar, N., Raoul, G., & Ferri, J. (2016). Maxillary reconstruction for sinus lift complications with oro-antral fistula: The le fort i approach. Journal of Craniofacial Surgery, 27(2), 464–468. http://doi.org/10.1097/SCS.0000000000002383 Prins, H.-J., Schulten, E. A. J. M., Ten Bruggenkate, C. M., Klein-Nulend, J., & Helder, M. N. (2016). Bone Regeneration Using the Freshly Isolated Autologous Stromal Vascular Fraction of Adipose Tissue in Combination With Calcium Phosphate Ceramics. Stem Cells Translational Medicine. http://doi.org/10.5966/sctm.2015-0369 Rancitelli, D., Borgonovo, A. E., Cicciù, M., Re, D., Rizza, F., Frigo, A. C., & Maiorana, C. (2015). Maxillary sinus septa and anatomic correlation with the Schneiderian membrane. Journal of Craniofacial Surgery, 26(4), 1394–1398. http://doi.org/10.1097/SCS.0000000000001725 Agliardi EL, Pozzi A, Stappert CF, Benzi R, Romeo D, Gherlone E. Immediate fixed rehabilitation of the edentulous maxilla: a prospective clinical and radiological study after 3 years of loading. Clin Implant Dent Relat Res. 2014 Apr;16(2):292-302. Dimonte M, Inchingolo F, Dipalma G, Stefanelli M. [Maxillary sinus lift in conjunction with endosseous implants. A long-term follow-up scintigraphic study]. Minerva Stomatol. 2002 May;51(5):161-5. Peleg M, Garg AK, Mazor Z. Predictability of simultaneous implant placement in the severely atrophic posterior maxilla: A 9-year longitudinal experience study of 2132 implants placed into 731 human sinus grafts. Int J Oral Maxillofac Implants. 2006 Jan-Feb;21(1):94-102. Mazor Z, Peleg M, Gross M. Sinus augmentation for single-tooth replacement in the posterior maxilla: a 3-year follow-up clinical report. Int J Oral Maxillofac Implants. 1999 Jan-Feb;14(1):55-60. - - - - --Journal Article Ferrigno,N.;Laureti,M.;Fanali,S.-Dental implants placement in conjunction with osteotome sinus floor elevation: A 12-year life-table analysis from a prospective study on 588 ITIÃ‚Â® implants-Clinical oral implants research-Clin.Oral Implants Res.-2006- -17-2- - - - --Journal Article Jungner,M.;Cricchio,G.;Salata,L. A.;Sennerby,L.;Lundqvist,C.;Hultcrantz,M.;Lundgren,S.-On the Early Mechanisms of Bone Formation after Maxillary Sinus Membrane Elevation: An Experimental Histological and Immunohistochemical Study-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2014-41944- - -10-5-595-600--Journal Article Mandelli,F.;Ghensi,P.;Vinci,R.;Mandelli,G.-Sinus floor elevation with crestal approach and immediately loaded post-extraction implants-Journal (Indiana Dental Association)-J.Indiana Dent.Assoc.-2013-Winter-92-1-11-3-323-328--Journal Article Cor\'a Gilberto Garcia;Faloni,Ana Paula de Souza;Faeda,Rafael Silveira;Betoni Jr Walter;Queiroz,Thallita Pereira-Bio-Oss versus Bone Ceramic para eleva\cc\~ao bilateral de seio maxilar no mesmo paciente: avalia\cc\~ao histol\'ogica qualitativa ap\'os seis meses-ImplantNews- - - -11-31991 -17-2-152-164--Journal Article Wagner,J. R.-A 3 1/2-year clinical evaluation of resorbable hydroxylapatite OsteoGen (HA Resorb) used for sinus lift augmentations in conjunction with the insertion of endosseous implants.-The Journal of oral implantology-J.Oral Implantol.-19911991-17-21992 -36-1-151-186; discussion 187--Journal Article Smiler,D. G.;Holmes,R. E.-Sinus lift procedure using porous hydroxyapatite: a preliminary clinical report-The Journal of oral implantology-J.Oral Implantol.-1987- -13-21992 -4-9-14-19--Journal Article Vannini,F.;Nardone,M.-Use of the circular soft-tissue punch in maxillary sinus lifts with a crestal approach: A preliminary report-Italian Oral Surgery- -2011- -10-11993 -13-3-255-275--Journal Article Bagoff,R.;Mamidwar,S.;Chesnoiu-Matei,I.;Ricci,J. L.;Alexander,H.;Tovar,N. M.-Socket preservation and sinus augmentation using a medical grade calcium sulfate hemihydrate and mineralized irradiated cancellous bone allograft composite-The Journal of oral implantology-J.Oral Implantol.-2013-Jun-39-31993 -15-1-5-9--Journal Article Leder,A. J.;McElroy,J.;Deasy,M. J.-Reconstruction of the severely atrophic maxilla with autogenous iliac bone graft and hydroxylapatite/decalcified freeze-dried bone allograft in the same patient: a preliminary report-Periodontal clinical investigations : official publication of the Northeastern Society of Periodontists-Periodontal Clin.Investig.-1993-Fall-15-11993 Nov-51-11-1198-203; discussion 1203-5--Journal Article Raghoebar,G. M.;Batenburg,R. H.;Timmenga,N. M.;Vissink,A.;Reintsema,H.Morbidity and complications of bone grafting of the floor of the maxillary sinus for the placement of endosseous implants-Mund-, Kiefer- und Gesichtschirurgie : MKG-Mund Kiefer Gesichtschir.-1999-May-3 Suppl 1- 1995 Nov-Dec-10-6-682-688--Journal Article Krekmanov,L.-Placement of posterior mandibular and maxillary implants in patients with severe bone deficiency: a clinical report of procedure-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2000-SepOct-15-51996 Jan-Feb-11-1-26-34--Journal Article Wetzel,A. C.;Stich,H.;Caffesse,R. G.-Bone apposition onto oral implants in the sinus area filled with different grafting materials. A histological study in beagle dogs-Clinical oral implants research-Clin.Oral Implants Res.-1995-Sep-6-31996 Jul-Aug-11-4-476-488--Journal Article Wikesjo,U. M.;Sorensen,R. G.;Wozney,J. M.-Augmentation of alveolar bone and dental implant osseointegration: clinical implications of studies with rhBMP-2-The Journal of bone and joint surgery.American volume-J.Bone Joint Surg.Am.2001- -83-A Suppl 1-Pt 21998 -36-2-123-128--Journal Article Haas,R.;Mailath,G.;DÃƒÂ¶rtbudak,O.;Watzek,G.-Bovine hydroxyapatite for maxillary sinus augmentation: Analysis of interfacial bond strength of dental implants using pull-out tests-Clinical oral implants research-Clin.Oral Implants Res.-1998- -9-21998 Apr-170-4-1085-1091--Journal Article Abi Najm,S.;Malis,D.;El Hage,M.;Rahban,S.;Carrel,J. P.;Bernard,J. P.-Potential adverse events of endosseous dental implants penetrating the maxillary sinus: long-term clinical evaluation-The Laryngoscope-Laryngoscope-2013-Dec-123-121999 -8-1-49-53--Journal Article Scheiderbauer,G. C.-Clinical application of piezo-surgical hydrodynamic sinus lift procedures in combination with augmentation and implantation-Zeitschrift fur Zahnarztliche Implantologie- -2012- - -41999 1999-May-3 Suppl 1- -S70-3--Journal Article Bastos,A. S.;Spin-Neto,R.;Conte-Neto,N.;Galina,K.;Boeck-Neto,R. J.;Marcantonio,C.;Marcantonio,E.;Marcantonio,E.,Jr-Calvarial autogenous bone graft for maxillary ridge and sinus reconstruction for rehabilitation with dental implants-The Journal of oral implantology-J.Oral Implantol.-2014-Aug-40-41999 Apr-10-2-103-110--Generic Buchmann,R.;Khoury,F.;Faust,C.;DE,Lange-Peri-implant conditions in periodontally compromised patients following maxillary sinus augmentation. A long-term post-therapy trial.\îen- - - - - - 1999 Dec-70-12-1564-1573--Journal Article Pecora,G. E.;De Leonardis,D.;Della Rocca,C.;Cornelini,R.;Cortesini,C.-Short-term healing following the use of calcium sulfate as a grafting material for sinus augmentation: a clinical report-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-1998-Nov-Dec-13-61999 May-3 Suppl 1- -S65-9--Journal Article QuiÃƒÂ±ones,C. R.;HÃƒÂ¼rzeler,M. B.;SchÃƒÂ¼pbach,P.;Arnold,D. R.;Strub,J. R.;Caffesse,R. G.-Maxillary sinus augmentation using different grafting materials and dental implants in monkeys: Part IV. Evaluation of hydroxyapatite-coated implants-Clinical oral implants research-Clin.Oral Implants Res.-1997- -8-62002 -17-5- - --Journal Article Hallman,M.;Mordenfeld,A.;Strandkvist,T.-A retrospective 5-year follow-up study of two different titanium implant

Participants Participants Participants Participants Participants Participants Participants Participants Participants

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surfaces used after interpositional bone grafting for reconstruction of the atrophic edentulous maxilla-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2005- -7-32002 Mar-60-3-277-84; discussion 285-6--Journal Article Haas,R.;Watzak,G.;Baron,M.;Tepper,G.;Mailath,G.;Watzek,G.-A preliminary study of monocortical bone grafts for oroantral fistula closure-Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics-Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod.-2003- -96-32003 -12-3-206-210--Journal Article Murakami,K.;Ltoh,T.;Watanabe,S.;Itoh,T.;Naito,T.;Yokota,M.-Periodontal and computer tomography scanning evaluation of endosseous implants in conjunction with sinus lift procedure. A 6-Case series-Journal of periodontology-J.Periodontol.1999- -70-102003 -12-4-3-9--Journal Article Antoun,H.;Bouk,H.;Ameur,G.-Bilateral sinus graft with either bovine hydroxyapatite or ÃŽÂ² tricalcium phosphate, in combination with platelet-rich plasma: A case report-Implant dentistry-Implant Dent.-2008- -17-32003 -14-5-548-555--Journal Article Xu,H.;Shimizu,Y.;Asai,S.;Ooya,K.-Grafting of deproteinized bone particles inhibits bone resorption after maxillary sinus floor elevation-Clinical oral implants research-Clin.Oral Implants Res.-2004- -15-12003 Feb-24-2-95-100, 103-4, 106 passim; quiz 113--Journal Article Petrungaro,P. S.-An update on implant placement and provisionalization in extraction, edentulous, and sinus-grafted sites. A clinical report on 3200 sites over 8 years-Compendium of continuing education in dentistry (Jamesburg, N.J.: 1995)-Compend.Contin.Educ.Dent.-2008-Jun-29-52005 -43-1-40-45--Journal Article Xu,H.;Shimizu,Y.;Asai,S.;Ooya,K.-Experimental sinus grafting with the use of deproteinized bone particles of different sizes-Clinical oral implants research-Clin.Oral Implants Res.-2003- -14-52005 -43-4-309-313--Journal Article Panico, René; Fernández Bodereau Hijo, Enrique; Sosa, Federico.-Intrusión de implante dental en el seno maxilar. Complicaciones y tratamiento: presentación de un caso clínico / Dental implant migration to maxillary sinus. Complications and treatment: a case report-Rev Asoc Odontol Argent-Rev.Asoc.Odontol.Argent.- - -102-12005 -43-6-493-499--Journal Article Xu,H.;Shimizu,Y.;Onodera,K.;Ooya,K.-Long-term outcome of augmentation of the maxillary sinus using deproteinised bone particles experimental study in rabbits-British Journal of Oral and Maxillofacial Surgery- -2005- -43-12005 -76-3-482-491--Journal Article Chen,L.;Cha,J.-An 8-year retrospective study: 1,100 patients receiving 1,557 implants using the minimally invasive hydraulic sinus condensing technique-Journal of periodontology-J.Periodontol.-2005-Mar-76-32005 Apr 1-10 Suppl 1- -E45-56--Journal Article Soltan,M.;Smiler,D. G.-Trephine bone core sinus elevation graft-Implant dentistry-Implant Dent.-2004- -13-22005 Jan-93-1-38-44--Journal Article Knabe,C.;Hoffmeister,B.-The Use of Implant-Supported Ceramometal Titanium Prostheses Following Sinus Lift and Augmentation Procedures: A Clinical Report-International Journal of Oral and Maxillofacial Implants- -1998- -13-12005 Mar-Apr;20(2):231-7. Int J Oral Maxillofac Implants. Implants in the posterior maxilla: a comparative clinical and radiologic study. Rodoni LR1, Glauser R, Feloutzis A, Hämmerle CH. 2005 Oct-32-10-741-746--Journal Article Guerrero,J. S.;Al-Jandan,B. A.-Allograft for maxillary sinus floor augmentation: a retrospective study of 90 cases-Implant dentistry-Implant Dent.-2012-Apr-21-22006 -101-3-299-303--Journal Article Choukroun,J.;Diss,A.;Simonpieri,A.;Girard,M. O.;Schoeffler,C.;Dohan,S. L.;Dohan,A. J.;Mouhyi,J.;Dohan,D. M.-Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift-Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics-Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod.-2006- -101-32006 -15-3-248-253--Journal Article MuÃƒÂ±oz-Guerra,M. F.;Naval-GÃƒÂas,L.;Capote-Moreno,A.-Le Fort I Osteotomy, Bilateral Sinus Lift, and Inlay Bone-Grafting for Reconstruction in the Severely Atrophic Maxilla: A New Vision of the Sandwich Technique, Using Bone Scrapers and Piezosurgery-Journal of Oral and Maxillofacial Surgery- -2009- -67-32006 -21-1-94-102--Journal Article Peleg,M.;Chaushu,G.;Mazor,Z.;Ardekian,L.;Bakoon,M.-Radiological findings of the post-sinus lift maxillary sinus: A computerized tomography follow-up-Journal of periodontology-J.Periodontol.-1999- -70-122006 -21-3-455-458--Journal Article Suba,Z.;TakÃ¡cs,D.;Matusovits,D.;BarabÃ¡s,J.;Fazekas,A.;SzabÃ³,G.-Maxillary sinus floor grafting with beta-tricalcium phosphate in humans: density and microarchitecture of the newly formed bone-Clinical oral implants research-Clin.Oral Implants Res.-2006- -17-12006 -21-6-907-913--Journal Article Krekmanov,L.;Heimdahl,A.-Bone grafting to the maxillary sinus from the lateral side of the mandible-British Journal of Oral and Maxillofacial Surgery- -2000- -38-62006 -32-1-38-40--Journal Article Penarrocha-Diago,M.;Aloy-Prosper,A.;Penarrocha-Oltra,D.;Guirado,J. L.;Penarrocha-Diago,M.-Localized lateral alveolar ridge augmentation with block bone grafts: simultaneous versus delayed implant placement: a clinical and radiographic retrospective study-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2013-May-Jun-28-32006 -32-3-122-131--Journal Article Mangano,C.;Piattelli,A.;Tettamanti,L.;Mangano,F.;Mangano,A.;Borges,F.;Iezzi,G.;d'Avila,S.;Shibli,J. A.Engineered bone by autologous osteoblasts on polymeric scaffolds in maxillary sinus augmentation: histologic report-The Journal of oral implantology-J.Oral Implantol.-2010- -36-62006 -64-11-1635-1638--Journal Article Halpern,K. L.;Halpern,E. B.;Ruggiero,S.-Minimally invasive implant and sinus lift surgery with immediate loading-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial SurgeonsJ.Oral Maxillofac.Surg.-2006-Nov-64-112006 -64-6-931-935--Journal Article Serafini,A.-Crestal sinus lift and guided surgery: Proposal of a new simplified technique-Dental CadmosDent.Cadmos-2012- -80-52006 2006- -1-CD003607-CD003607--Journal Article Esposito,M.;Grusovin,M. G.;Rees,J.;Karasoulos,D.;Felice,P.;Alissa,R.;Worthington,H. V.;Coulthard,P.-Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus-Cochrane database of systematic reviews (Online)- -2010- -3- 2006 Jan-23-1-31-5, 70--Journal Article Levin,L.;Ophir,S.;Schwartz-Arad,D.-Atrophic ridge augmentation using intra-oral onlay bone grafts-expanding the limits-Refuat Hapeh Vehashinayim-Refuat Hapeh Vehashinayim-2006- -23-12006 Mar-41-3-136-139--Journal Article Pripatnanont,P.;Nuntanaranont,T.;Chungpanich,S.-Two Uncommon Uses of Bio-Oss for GTR and Ridge Augmentation Following Extractions: Two Case Reports-International Journal of Periodontics and Restorative Dentistry- -2002- -22-32007 -117-1-28-41--Journal Article Nolan,P. J.;Freeman,K.;Kraut,R. A.-Correlation between schneiderian membrane perforation and sinus lift graft outcome: A retrospective evaluation of 359 augmented sinus-Journal of Oral and Maxillofacial Surgery- -2014- -72-12007 -16-1-42-53--Journal Article Smeets,R.;Grosjean,M. B.;Jelitte,G.;Heiland,M.;Kasaj,A.;Riediger,D.;Yildirim,M.;Spiekermann,H.;Maciejewski,O.-Hydroxyapatite bone substitute (Ostim) in sinus floor elevation. Maxillary sinus floor augmentation: bone regeneration by means of a nanocrystalline in-phase hydroxyapatite (Ostim)-Schweizer Monatsschrift fur Zahnmedizin = Revue mensuelle suisse d'odonto-stomatologie = Rivista mensile svizzera di odontologia e stomatologia / SSO-Schweiz.Monatsschr.Zahnmed.-2008- -118-32007 -18-2-252-262--Journal Article Conrad,H. J.;Jung,J.;Barczak,M.;Basu,S.;Seong,W. J.-Retrospective cohort study of the predictors of implant failure in the posterior maxilla-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2011-Jan-Feb-2612007 -6-5-7-15--Journal Article Gherlone,E. F.;Vinci,R.;D'Aversa,L.-Autologus parietal grafts in preprosthethic surgery-ORAL & implantologyOral Implantol.(Rome)-2009-Apr-2-22007 -75-2-33-39--Journal Article Di Stefano,D. A.;Cazzaniga,A.;Andreasi Bassi,M.;Ludovichetti,M.;Ammirabile,G.;Celletti,R.-The use of cortical heterologous sheets for sinus lift bone grafting: A modification of tulasne's technique with 7-year follow-up-International Journal of Immunopathology and Pharmacology-Int.J.Immunopathol.Pharmacol.-2013- -26-22007 2007 Nov 01-12-7-E532-6--Journal Article Aguirre Zorzano,L. A.;RodrÃƒÂguez Tojo,M. J.;Aguirre Urizar,J. M.-Maxillary sinus lift with intraoral autologous bone and B--tricalcium phosphate: histological and histomorphometric clinical study-Medicina oral, patologÃƒÂa oral y cirugÃƒÂa bucal- -2007- -12-72007 Apr-45-4-395-402--Journal Article Caubet,J.;Ramis,J. M.;Ramos-Murguialday,M.;Morey,M. A.;Monjo,M.-Gene expression and morphometric parameters of human bone biopsies after maxillary sinus floor elevation with autologous bone combined with Bio-Oss((R)) or BoneCeramic((R))-Clinical oral implants research-Clin.Oral Implants Res.-2015-Jun-26-62007 Sep-9-3-128-135--Journal Article Xuan,F.;Lee,C. U.;Son,J. S.;Jeong,S. M.;Choi,B. H.-A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss(R) and commercial fibrin-mixed Bio-Oss(R): an experimental study-Journal of cranio-

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maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery-J.Craniomaxillofac.Surg.-2014-Jun-4242008 -19- -159-161--Journal Article Luo,Z. -B;Zhang,Q. -B;Zhang,Z. -Q;Chen,D.;Yan,W. -X;Li,K. -F;Chen,Y.-Performance of coralline hydroxyapatite in sinus floor augmentation: A retrospective study-Clinical oral investigations-Clin.Oral Investig.-2013- -17-92008 -19-5-522-529--Journal Article Gruber,R. M.;Ludwig,A.;Merten,H. A.;Achilles,M.;Poehling,S.;Schliephake,H.-Sinus floor augmentation with recombinant human growth and differentiation factor-5 (rhGDF-5): a histological and histomorphometric study in the Goettingen miniature pigClinical oral implants research-Clin.Oral Implants Res.-2008-May-19-52008 -66-11-2314-2317--Journal Article Redemagni,M.;Garlini,G.;Donini,M.-Maxillary sinus floor augmentation with allopiastic material and implants: All years clinical and radiological follow-up-Dental Cadmos-Dent.Cadmos-2008- -76-92008 -7-2-29-38--Journal Article Mori,S.;Kurita,K.;Umemura,E.;Nakatsuka,K.;Fukuta,K.;Kuroiwa,Y.;Nabeshima,H.;Naitoh,M.;Ariji,E.-Volume changes of grafted bone after sinus lift procedure using tibia bone: 3 years after prosthesis radiological study-Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology- -2015- -27-22008 -76-7-73-87--Journal Article Trombelli,L.;Franceschetti,G.;Trisi,P.;Farina,R.-Incremental, Transcrestal Sinus Floor Elevation With a Minimally Invasive Technique in the Rehabilitation of Severe Maxillary Atrophy. Clinical and Histological Findings From a Proof-of-Concept Case Series-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.-2015-May-73-52008 Apr-79-4-728-736--Journal Article Keller,E. E.;Tolman,D. E.;Eckert,S. E.-Maxillary antral-nasal inlay autogenous bone graft reconstruction of compromised maxilla: a 12-year retrospective study-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants1999-Sep-Oct-14-52008 Feb-99-2-85-90--Journal Article Cheng,A. C.;Tee-Khin,N.;Siew-Luen,C.;Lee,H.;Wee,A. G.-The management of a severely resorbed edentulous maxilla using a bone graft and a CAD/CAM-guided immediately loaded definitive implant prosthesis: A clinical report-Journal of Prosthetic Dentistry-J.Prosthet.Dent.-2008- -99-22008 Sep-Oct-23-5-947-952--Journal Article Payer,M.;Lohberger,B.;Strunk,D.;Reich,K. M.;Acham,S.;Jakse,N.-Effects of directly autotransplanted tibial bone marrow aspirates on bone regeneration and osseointegration of dental implants-Clinical oral implants researchClin.Oral Implants Res.-2014- -25-42008 Spring-3-1-66-88--Journal Article Beretta,M.;Poli,P. P.;Grossi,G. B.;Pieroni,S.;Maiorana,C.-Long-term survival rate of implants placed in conjunction with 246 sinus floor elevation procedures: Results of a 15-year retrospective study-Journal of dentistry-J.Dent.-2015- -43-12009 -10-3-1-9--Journal Article Kolhatkar,S.;Bhola,M.;Thompson-Sloan,T. N.-Sinus floor elevation via the maxillary premolar extraction socket with immediate implant placement: a case series-Journal of periodontology-J.Periodontol.-2011-Jun-82-62009 -107-2-204-211--Journal Article Kim,Y. -K;Lee,J.;Yun,J. -Y;Yun,P. -Y;Um,I. -W-Comparison of autogenous tooth bone graft and synthetic bone graft materials used for bone resorption around implants after crestal approach sinus lifting: A retrospective study-Journal of Periodontal and Implant Science- -2014- -44-52009 -11- -e23-e31--Journal Article Anitua,E.;Prado,R.;Orive,G.-Bilateral sinus elevation evaluating plasma rich in growth factors technology: A report of five cases-Clinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2012- -14-12009 -1-1-29-34--Journal Article Degidi,M.;Piattelli,A.;Perrotti,V.;Iezzi,G.-Histologic and histomorphometric evaluation of an implant retrieved 8 years after insertion in a sinus augmented with anorganic bovine bone and anorganic bovine matrix associated with a cell-binding peptide: a case report-The International journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2012-Aug-32-42009 -35-5-225-231--Journal Article AlGhamdi,A. S.-Management of combined ridge defect and osteotome sinus floor elevation with simultaneous implant placement--a 36-month follow-up case report-The Journal of oral implantology-J.Oral Implantol.-2009- -35-52009 Jul-22-5-563-570--Journal Article Koyama,K.;Hasegawa,T.;Uchida,I.;Yoshida,S.-Simple and less invasive technique for fixation of iliac inlay bone block using dental implants in the atrophied posterior maxilla-Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology- 2014- -26-42009 Jul-2-3-4-10--Journal Article Clementini,M.;Boniello,R.;Gasparini,G.;Moro,A.;Pelo,S.-Surgical treatment of severe athropic maxilla by means of multiple extraoral harvesting.-ORAL & implantology- -2009-2009-Jul-2-32009 Mar-107-3-375-380--Journal Article Sohn,D. S.;Lee,J. K.;An,K. M.;Shin,H. I.-Histomorphometric evaluation of mineralized cancellous allograft in the maxillary sinus augmentation: a 4 case report-Implant dentistry-Implant Dent.-2009-Apr-18-22009 Mar-80-3-422-428--Journal Article Chappuis,V.;Suter,V. G.;Bornstein,M. M.-Displacement of a dental implant into the maxillary sinus: report of an unusual complication when performing staged sinus floor elevation procedures-The International journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2009-Feb-29-12009 Oct-20-10-1133-1139--Journal Article Saffarzadeh,A.;Gauthier,O.;Bilban,M.;Bagot D'Arc,M.;Daculsi,G.-Comparison of two bone substitute biomaterials consisting of a mixture of fibrin sealant (Tisseel) and MBCP (TricOs) with an autograft in sinus lift surgery in sheep-Clinical oral implants research-Clin.Oral Implants Res.-2009- -20-102010 -25-6-1233-1240--Journal Article Chow,J.;Wat,P.;Hui,E.;Lee,P.;Li,W.-A new method to eliminate the risk of maxillary sinusitis with zygomatic implants-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2010-Nov-Dec-25-62010 -36-6-485-489--Journal Article Santagata,M.;Guariniello,L.;Rauso,R.;Tartaro,G.-Immediate loading of dental implant after sinus floor elevation with osteotome technique: a clinical report and preliminary radiographic results-The Journal of oral implantology-J.Oral Implantol.2010- -36-62010 -37-5-456-465--Journal Article Chanavaz,M.-Sinus grafting related to implantology. Statistical analysis of 15 years of surgical experience (1979-1994)-The Journal of oral implantology-J.Oral Implantol.-1996- -22-22010 -40-2-56-60--Journal Article Lee,J. K.-Outfracture osteotomy on lateral maxillary wall as a modified sinus graft technique-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.-2010-Jul-68-72010 -68-9-2291-2298--Journal Article Nikzad,S.;Azari,A.;Ghassemzadeh,A.-Modified flapless dental implant surgery for planning treatment in a maxilla including sinus lift augmentation through use of virtual surgical planning and a 3-dimensional model-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.-2010-Sep-68-92010 40483-21-3-346-349--Journal Article Kim,H. -R;Choi,B. -H;Xuan,F.;Jeong,S. -M-The use of autologous venous blood for maxillary sinus floor augmentation in conjunction with sinus membrane elevation: An experimental study-Clinical oral implants research-Clin.Oral Implants Res.-2010- -21-32010 Apr-124-4-433-436--Journal Article Rammelsberg,Peter;Mahabadi,Jaleh;Eiffler,Constantin;Koob,Andreas;Kappel,Stefanie;Gabbert,OlafRadiographic Monitoring of Changes in Bone Height after Implant Placement in Combination with an Internal Sinus Lift without Graft MaterialClinical implant dentistry and related research-Clin.Implant Dent.Relat.Res.-2015-JAN 2015-17- 2010 Autumn-3-3-221-232--Journal Article Chaves,M. D.;De,Souza Nunes;De Oliveira,R. V.;Holgado,L. A.;Filho,H. N.;Matsumoto,M. A.;Ribeiro,D. A.-Bovine hydroxyapatite (Bio-OssÃ‚Â®) induces osteocalcin, RANK-L and osteoprotegerin expression in sinus lift of rabbitsJournal of Cranio-Maxillofacial Surgery- -2012- -40-82010 Dec-38-8-571-579--Journal Article Gutwald,R.;Haberstroh,J.;Stricker,A.;RÃƒÂ¼ther,E.;Otto,F.;Xavier,S. P.;Oshima,T.;Marukawa,E.;Seto,I.;Enomoto,S.;Hoogendijk,C. F.;Schmelzeisen,R.;Sauerbier,S.-Influence of rhBMP-2 on bone formation and osseointegration in different implant systems after sinus-floor elevation. An in vivo study on sheep-Journal of Cranio-Maxillofacial Surgery- 2010- -38-82010 Jul-Sep-6-3-161-166--Journal Article Davies,J. E.;Matta,R.;Mendes,V. C.;Carvalho,Perri De-Development, characterization and clinical use of a biodegradable composite scaffold for bone engineering in oro-maxillo-facial surgery-Organogenesis- -2010- -6-32010 Jun-16-3-295-303--Journal Article Kiyokawa,K.;Rikimaru,H.;Kiyokawa,M.;Fukaya,H.;Sakaguchi,S.-Treatment outcomes of implants performed after regenerative treatment of absorbed alveolar bone due to the severe periodontal disease and endoscopic surgery for maxillary sinus lift without bone grafts-Journal of Craniofacial Surgery-J.Craniofac.Surg.-2013- -24-52010 May-68-5-1148-1151--Journal Article Cortes,A. R.;Cortes,D. N.;Arita,E. S.-Cone beam computed tomographic evaluation of a maxillary alveolar ridge reconstruction with iliac crest graft and implants-The Journal of craniofacial surgery-J.Craniofac.Surg.-2012-Jan-23-12010 Nov-68-11-2856-2860--Journal Article Lin,T. H.;Chen,L.;Cha,J.;Jeffcoat,M.;Kao,D. W.;Nevins,M.;Fiorellini,J. P.-The effect of cigarette smoking and native bone height on dental implants placed immediately in sinuses grafted by hydraulic condensation-The International journal of periodontics & restorative dentistry-Int.J.Periodontics Restorative Dent.-2012-Jun-32-3-


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2010 Nov-Dec-25-6-1203-1212--Journal Article Urban,I. A.;Jovanovic,S. A.;Lozada,J. L.-Vertical ridge augmentation using guided bone regeneration (GBR) in three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after loading-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2009-May-Jun-24-32011 - - -158-172--Journal Article Ferri,J.;Dujoncquoy,J. -P;Carneiro,J. M.;Raoul,G.-Maxillary reconstruction to enable implant insertion: A retrospective study of 181 patients-Head and Face Medicine- -2008- -4-12011 - -1-60-67--Journal Article Rossi,A.;Maccarini,L.;Pozzobon,L.;Chiapasco,M.-Sinus lift in implant dentistry-Dental Cadmos-Dent.Cadmos2007- -75-52011 -111-2-164-169--Journal Article Kim,Y. -K;Hwang,V. -W;Yun,P. -Y-Closure of large perforation of sinus membrane using pedicled buccal fat pad graft: A case report-International Journal of Oral and Maxillofacial Implants- -2008- -23-62011 -111-4-e8-e14--Journal Article Ahmed,M. S.;Askar,N. A.-Combined bony closure of oroantral fistula and sinus lift with mandibular bone grafts for subsequent dental implant placement-Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics-Oral Surg.Oral Med.Oral Pathol.Oral Radiol.Endod.-2011-Apr-111-42011 -16-1-e79-e82--Journal Article Ewers,R.-Maxilla sinus grafting with marine algae derived bone forming material: A clinical report of longterm results-Journal of Oral and Maxillofacial Surgery- -2005- -63-122011 -20-6-460-464--Journal Article Won,Y. H.;Kim,S. G.;Oh,J. S.;Lim,S. C.-Clinical evaluation of demineralized bone allograft for sinus lifts in humans: a clinical and histologic study-Implant dentistry-Implant Dent.-2011-Dec-20-62011 -22-6-606-612--Journal Article Martuscelli,R.;Toti,P.;Sbordone,L.;Guidetti,F.;Ramaglia,L.;Sbordone,C.-Five-year outcome of bone remodelling around implants in the maxillary sinus: Assessment of differences between implants placed in autogenous inlay bone blocks and in ungrafted maxilla-International journal of oral and maxillofacial surgery-Int.J.Oral Maxillofac.Surg.-2014- -43-92011 -22-6-669-672--Journal Article Salvato,G.;Agliardi,E.-Calvarial bone grafts in severe maxillary atrophy: Preprosthetic surgery with sedation-Implant dentistry-Implant Dent.-2007- -16-42011 -24-2-163-167--Journal Article Vittorini-Velasquez,P.;Falisi,G.;Galli,M.;Gallegos-Rivera,J.-Self-bone graft and simultaneous application of implants in the upper jawbone. (Fit lock technique)-Acta odontolÃƒÂ³gica latinoamericana : AOL- -2011- -24-22011 -26-6-1317-1323--Journal Article Butura,C. C.;Galindo,D. F.-Implant placement in alveolar composite defects regenerated with rhBMP-2, anorganic bovine bone, and titanium mesh: a report of eight reconstructed sites-The International journal of oral & maxillofacial implantsInt.J.Oral Maxillofac.Implants-2014-Jan-Feb-29-12011 -40-8-815-820--Journal Article Benlidayi,M. E.;Kurkcu,M.;Oz,I. A.;Sertdemir,Y.-Comparison of two different forms of bovine-derived hydroxyapatite in sinus augmentation and simultaneous implant placement: an experimental study-The International journal of oral & maxillofacial implants-Int.J.Oral Maxillofac.Implants-2009-Jul-Aug-24-42011 -42-10-851-862--Journal Article Sivolella,S.;Bressan,E.;Gnocco,E.;Berengo,M.;Favero,G. A.-Maxillary sinus augmentation with bovine bone and simultaneous dental implant placement in conditions of severe alveolar atrophy: a retrospective analysis of a consecutively treated case series-Quintessence international (Berlin, Germany : 1985)-Quintessence Int.-2011-Nov-Dec-42-102011 -52-4-1293-1297--Journal Article FLORIN ONIȘOR-GLIGOR,1 MIHAI JUNCAR,1 GRIGORE BĂCIUȚ,1 SIMION BRAN,2 RALUCA-IULIA JUNCAR,3 DINU-IULIU DUMITRAȘCU,4 and MIHAELA-FELICIA BĂCIUȚ2-Subantral augmentation with A 1/1 alloplastic and autologous material mixture. histological characteristics and dimensional stability of the newly formed bone-Clujul Medical- -2015- -88-12011 -69-9-2339-2344--Journal Article Hwang,J. H.;Jung,B. Y.;Lim,C. S.;Cha,I. H.;Park,W.-Posterior maxillary segmental osteotomy concomitant with sinus lift using a piezoelectric device-Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons-J.Oral Maxillofac.Surg.-2011-Sep-69-92011 -82-9-1245-1255--Journal Article Preusse,F. E.;Preusse,F. A.;Eymer,H.;Streckbein,Ph-Sinus lift and simultaneous insertion of dental implants with a residual bone height less than 5 mm - A 10-year retrospective clinical evaluation-Zeitschrift fur Zahnarztliche Implantologie- 2012- - -12011 Apr-39-3-192-199--Journal Article Acocella,A.;Bertolai,R.;Nissan,J.;Ellis,E.;Sacco,R.-Maxillary sinus lift using fresh frozen bone chips in presence of sinus cyst: Clinical and histological report-Cell and Tissue Banking-Cell Tissue Banking-2012- -13-22011 Dec-20-6-439-444--Journal Article Bernardello,F.;Righi,D.;Cosci,F.;Bozzoli,P.;Soardi Carlo,M.;Spinato,S.-Crestal sinus lift with sequential drills and simultaneous implant placement in sites with