Transcrestal Maxillary Sinus Membrane Elevation using Osseodensification Compared with Alveolar Ridge Augmentation using the Lateral Window or Osteotome Technique: a Systematic Review and Meta-Analysis.

Abstract

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in implant outcome following transcrestal maxillary sinus membrane elevation using osseodensification compared with osteotome-mediated sinus floor elevation or maxillary sinus floor augmentation applying the lateral window technique.

Material and methods: MEDLINE (PubMed), Embase, and Cochrane Library search combined with hand-search of relevant journals were conducted through March 19, 2025. Randomised controlled trials with an observation period of at least six months were included. Survival of suprastructures and implants were primary outcome, while duration of surgery, implant stability quotient (ISQ), peri-implant marginal bone loss, complications, endo-sinus bone gain, bone density, and patient-reported outcome were secondary outcome, as evaluated by descriptive statistics and meta-analysis including 95% CI.

Results: Six short-term randomised controlled trials characterised by high risk of bias and low GRADE fulfilled inclusion criteria. Comparable high implant survival was revealed. Transcrestal maxillary sinus membrane elevation using osseodensification (TSMEOD) disclosed statistically significant higher ISQ, at implant placement and abutment connection compared with osteotome-mediated sinus floor elevation (OMSFE) and maxillary sinus floor augmentation (MSFA). Duration of surgery, complications, and days using analgesics were diminished following TSMEOD. Endo-sinus bone gain was statistically significant reduced following TSMEOD compared with MSFA, while no statistically significant difference was revealed between TSMEOD and OMSFE.

Conclusions: Transcrestal maxillary sinus membrane elevation using osseodensification is associated with equivalent implant survival compared with osteotome-mediated sinus floor elevation and maxillary sinus floor augmentation, in short-term studies. Long-term randomized controlled trials are, therefore, needed before one treatment may be considered superior to another.