A review of survival rates for implants placed in grafted maxillary sinuses using meta-analysis.

A variety of materials and procedures are used to create adequate bone volume in the maxillary sinus for placement of endosseous implants in the posterior atrophic maxilla. This review used the structured method of meta-analysis to evaluate the survival of the implants placed into various materials that have been used in the maxillary sinus with the sinus lift procedure. A MEDLINE computer search of the English literature yielded 28 studies that reported using the maxillary sinus augmentation procedure to increase bone volume for placement of endosseous implants; only 10 of these met the inclusion criteria for meta-analysis. Data regarding immediate or delayed placement of implants were combined to simplify analysis. Implant survival was 90% for autogenous bone (484 implants in 130 patients followed for 6 to 60 months), 94% for the combination of hydroxyapatite (HA) and autogenous bone (363 implants in 104 patients followed for 18 months), 98% for the combination of demineralized freeze-dried bone (DFDB) and HA (215 implants in 50 patients followed for 7 to 60 months), and 87% for HA alone (30 implants in 11 patients followed for 18 months). The results for autogenous bone were based on six reports, for the combination of autogenous bone and HA on three reports, and for DFDB/HA and HA alone on one study each. The results of single studies cannot be weighted as heavily as the results combining several studies; however, the analysis of these studies suggests that implant survival rates were similar for autogenous bone, HA/autogenous bone mix, HA/DFDB, and HA alone.