ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Patients Needing A Sinus Augmentation Procedure, The Use of A Membrane Was The Most Significant Factor for Obtaining Long Lasting Implant Survival
Clinical Question In a patient needing a sinus augmentation procedure, does applying a membrane increase the implant survival rate, compared to not using a membrane?
Clinical Bottom Line In patients needing a sinus augmentation procedure, the use of a membrane was the most effective way to obtain long lasting implant survival compared to surgical technique, timing of implant placement, and grafting materials. The systematic review determined no preference for technique, but did find the membrane placement extended survivability independent to the surgeon’s skills and preferences.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24058679Duttenhoefer/2013Data collected from 106 publications with n=11,714 endosseous implants placed with a minimum of 10 patients per publication. Systematic review of randomized trials
Key resultsThe meta-analysis review identified 1960 potential articles and ended up finding 106 studies that fit their criteria. The criteria were determined by including randomized control trials and clinical trials. Using the articles, a prolonged implant survival for the membrane group was highly significant (p=0.002). The results ranged from -0.21 to 1.09 of the logarithmic hazard ratio. A significant increase in the hazard ratio between the membrane and no_membrane group was noted from 0.26 to 0.67. This shows that while looking at all the data the only clear evidence is in fact that the use of a membrane is more effective than not using a membrane.
Evidence Search (((("implants") OR "implants, experimental"[MeSH Terms]) AND "grafted") AND "maxillary sinus") AND "long term survival"
Comments on
The Evidence
This was a systematic review of randomly controlled trials and clinical trials with over 106 articles and n=11,714 implants placed. The risk for bias is very low as it was well-designed study with a detailed search for each trial. There were a total of 106 publications used with a minimum of 10 patients per publication. The meta-analysis used parameters on approach, study type, placement, and grafting materials to determine their results. The study looked at studies with as little as 6 months of implant loading. Longer follow up may provide additional information relative to factors affecting implant survival.
Applicability The use of a membrane was more effective than not using a membrane in patients needing a sinus augmentation procedure. The study did not find any other significant data with any of the numerous other factors listed above. Additional data will be needed to address other procedures to improve the clinical evidence.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Implants, membrane, sinus augmentation
ID# 2991
Date of submission: 03/01/2016spacer
E-mail Heisch@livemail.uthscsa.edu
Author Troy Heisch
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Thomas Oates, DMD, PhD
Faculty mentor/Co-author e-mail OATES@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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