Non-Cochrane · prognostic · PM42240171
Incidence of sinus membrane perforation in transcrestal graftless maxillary sinus augmentation: a meta-analysis.
Huang Zhi-Cheng, Wang Xiao-Ling, Jin Qi-Qi, et al. · Acta odontologica Scandinavica · 2026 · PubMed · doi:10.2340/aos.v85.46021
Findings
Population Adults undergoing graftless transcrestal maxillary sinus floor elevation
25 findings
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Brizuela 2014 | Pooled proportion 0.04 [0.02, 0.09] GRADE not reported 13 studies · 2083 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Alzoubi 2024 | Pooled proportion 0.03 [0.02, 0.07] GRADE not reported 13 studies · 2090 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Nedir 2016 | Pooled proportion 0.05 [0.02, 0.09] GRADE not reported 13 studies · 2102 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Zill 2016 | Pooled proportion 0.04 [0.02, 0.09] GRADE not reported 13 studies · 1886 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Study design: retrospective studies | Pooled proportion 0.01 [0, 0.17] GRADE not reported 4 studies · 1472 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Albadani 2024 | Pooled proportion 0.05 [0.02, 0.10] GRADE not reported 13 studies · 2059 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery | Pooled proportion (incidence) 0.0109 [0.0019, 0.0597] Very low Downgraded: inconsistency, publication bias 14 studies · 2119 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Mazor 2024 | Pooled proportion 0.04 [0.02, 0.09] GRADE not reported 13 studies · 1870 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery · Follow-up <=12 months | Pooled proportion (incidence) 0.01 [0, 0.08] GRADE not reported 8 studies · 1322 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Early implant failure (<=12 months) <=12 months after implant placement · Dental implant surgery | Pooled proportion (incidence) 0.0115 [0.0022, 0.0575] Very low Downgraded: imprecision, indirectness, publication bias 11 studies · 711 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery · Meta-regression: mean residual bone height (univariate) | Meta-regression coefficient -0.0064 GRADE not reported 14 studies |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting French 2016 | Pooled proportion 0.06 [0.03, 0.12] GRADE not reported 13 studies · 1193 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery · Meta-regression: mean residual bone height adjusted for surgical technique | Meta-regression coefficient 0.0183 GRADE not reported 14 studies |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Markovic 2015 | Pooled proportion 0.05 [0.02, 0.10] GRADE not reported 13 studies · 1939 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Nedir 2012 | Pooled proportion 0.05 [0.02, 0.09] GRADE not reported 13 studies · 2102 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Si 2016 | Pooled proportion 0.05 [0.02, 0.10] GRADE not reported 13 studies · 2023 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Rammelsberg 2020 | Pooled proportion 0.03 [0.02, 0.08] GRADE not reported 13 studies · 1902 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Postoperative complications (acute sinusitis, epistaxis) Postoperative · Dental implant surgery | Pooled proportion (incidence) 0 [0, 0.01] Very low Downgraded: imprecision, indirectness 14 studies · 2119 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Study design: prospective studies | Pooled proportion 0.04 [0, 0.24] GRADE not reported 5 studies · 165 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery · Follow-up >12 months | Pooled proportion (incidence) 0.01 [0, 0.17] GRADE not reported 6 studies · 797 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Qian 2020 | Pooled proportion 0.05 [0.02, 0.09] GRADE not reported 13 studies · 2100 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Karaca 2022 | Pooled proportion 0.04 [0.02, 0.09] GRADE not reported 13 studies · 2105 participants |
| Graftless transcrestal sinus floor elevation (all techniques) | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Sensitivity analysis: leave-one-out, omitting Rawat 2019 | Pooled proportion 0.04 [0.02, 0.09] GRADE not reported 13 studies · 2093 participants |
| Graftless transcrestal sinus floor elevation (any technique) | None (single-arm incidence) | Schneiderian membrane perforation Intraoperative · Dental implant surgery · Study design: RCTs | Pooled proportion (incidence) 0 [0, 0.01] GRADE not reported 4 studies · 233 participants |
| Osteotome sinus floor elevation (OSFE), graftless transcrestal | None (single-arm incidence) | Schneiderian membrane perforation incidence Intraoperative · Graftless transcrestal sinus floor elevation, clinical studies · Surgical technique: conventional OSFE | Pooled proportion 0 [0, 0.04] GRADE not reported 10 studies · 1564 participants |
Included primary studies 25
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Mazor 2024 Maxillary sinus membrane perforation rate utilizing osseodensification-mediated transcrestal sinus floor elevation: A multicenter clinical… PMID:39187444 | 2024 | 1 other review | Schneiderian membrane perforation | not extracted yet |
| Albadani 2024 A graftless maxillary sinus lifting approach with simultaneous dental implant placement: a prospective clinical study DOI:10.1186/s12903-024-03949-9 | 2024 | this review only | not stated | not extracted yet |
| Albadani 2024 A graftless maxillary sinus lifting approach with simultaneous dental implant placement: a prospective clinical study. PMID:38350895 | 2024 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Alzoubi 2024 Implant Stability After Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study DOI:10.1563/aaid-joi-d-24-00015 | 2024 | this review only | not stated | not extracted yet |
| Alzoubi 2024 Implant Stability After Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study. PMID:38961753 | 2024 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Brizuela 2014 Osteotome sinus floor elevation without grafting material: Results of a 2-year prospective study. PMID:25674312 | 2014 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| French 2016 Survival and Success Rates of Dental Implants Placed Using Osteotome Sinus Floor Elevation Without Added Bone Grafting: A Retrospective… DOI:10.11607/prd.2191 | 2016 | this review only | not stated | not extracted yet |
| French 2016 Survival and Success Rates of Dental Implants Placed Using Osteotome Sinus Floor Elevation Without Added Bone Grafting: A Retrospective… PMID:27031637 | 2016 | this review only | Schneiderian membrane perforation | not extracted yet |
| Karaca 2022 Evaluation of Sinus Membrane Perforation in Osteotome Sinus Floor Elevation With and Without Grafting DOI:10.1563/aaid-joi-d-20-00358 | 2022 | this review only | not stated | not extracted yet |
| Karaca 2022 Evaluation of Sinus Membrane Perforation in Osteotome Sinus Floor Elevation With and Without Grafting. PMID:35503963 | 2022 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Markovic 2015 Two‐Center Prospective, Randomized, Clinical, and Radiographic Study Comparing Osteotome Sinus Floor Elevation with or without Bone Graft… DOI:10.1111/cid.12373 | 2015 | this review only | not stated | not extracted yet |
| Markovic 2015 Two-Center Prospective, Randomized, Clinical, and Radiographic Study Comparing Osteotome Sinus Floor Elevation with or without Bone Graft… PMID:26315564 | 2016 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Mazor 2024 Maxillary sinus membrane perforation rate utilizing osseodensification‐mediated transcrestal sinus floor elevation: A multicenter clinical… DOI:10.1111/cid.13368 | 2024 | this review only | not stated | not extracted yet |
| Nedir 2012 Osteotome sinus floor elevation with and without grafting material in the severely atrophic maxilla. A 1‐year prospective randomized… DOI:10.1111/j.1600-0501.2012.02569.x | 2012 | this review only | not stated | not extracted yet |
| Nedir 2012 Osteotome sinus floor elevation with and without grafting material in the severely atrophic maxilla. A 1-year prospective randomized… PMID:22925088 | 2013 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Nedir 2016 Short implants placed with or without grafting into atrophic sinuses: the 5‐year results of a prospective randomized controlled study DOI:10.1111/clr.12893 | 2016 | this review only | not stated | not extracted yet |
| Nedir 2016 Short implants placed with or without grafting into atrophic sinuses: the 5-year results of a prospective randomized controlled study. PMID:27296955 | 2017 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Qian 2020 Long‐term outcomes of osteotome sinus floor elevation with or without bone grafting: The 10‐year results of a randomized controlled trial DOI:10.1111/jcpe.13260 | 2020 | this review only | not stated | not extracted yet |
| Qian 2020 Long-term outcomes of osteotome sinus floor elevation with or without bone grafting: The 10-year results of a randomized controlled trial. PMID:31976567 | 2020 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Rammelsberg 2020 Long-term apical bone gain after implant placement combined with internal sinus-floor elevation without graft DOI:10.1186/s12903-020-01178-4 | 2020 | this review only | not stated | not extracted yet |
| Rammelsberg 2020 Long-term apical bone gain after implant placement combined with internal sinus-floor elevation without graft. PMID:32646503 | 2020 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Rawat 2019 Indirect Sinus Floor Elevation Technique with Simultaneous Implant Placement without Using Bone Grafts. PMID:31293935 | 2019 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Si 2016 Long‐term outcomes of osteotome sinus floor elevation without bone grafts: a clinical retrospective study of 4–9 years DOI:10.1111/clr.12752 | 2016 | this review only | not stated | not extracted yet |
| Si 2016 Long-term outcomes of osteotome sinus floor elevation without bone grafts: a clinical retrospective study of 4-9 years. PMID:26754021 | 2016 | this review only | Schneiderian membrane perforation; Early implant failure (<=12 months) | not extracted yet |
| Zill 2016 Implants inserted with graftless osteotome sinus floor elevation - A 5-year post-loading retrospective study. PMID:27722225 | 2016 | this review only | Schneiderian membrane perforation | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Incidence and Associated Factors of Schneiderian Membrane Perforation in Maxillary Sinus Floor Elevation: A Meta-Analysis. (2026) | 1 | 0.02 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult patients undergoing graftless transcrestal maxillary sinus floor elevation | Adults with graftless transcrestal sinus lift; 1370 patients and 2119 sites (n=14) |
| Intervention | Graftless transcrestal sinus floor elevation (OSFE, OD-TSFE, minimally invasive techniques) | OSFE (n=10), OD-TSFE (n=1), motor-driven OD (n=1), MISE (n=1), ISFE (n=1) |
| Comparison | Not restricted; comparative and single-arm studies included | None (graftless arms only; single-arm incidence) |
| Outcomes | Schneiderian membrane perforation incidence (primary); early implant failure <=12 months; postoperative complications (acute sinusitis, epistaxis) | Membrane perforation (n=14); early implant failure <=12 months (n=11); postoperative sinusitis/epistaxis (n=14) |
| Study designs | RCTs, prospective and retrospective cohort studies in English | 4 RCTs and 10 non-randomised studies (n=14), published 2012 to 2024 |
| Timing | Not specified | Follow-up 0 months to 10 years (median 24 months) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | NR | Yes | no |
| 2Protocol established before the reviewcritical | NR | No | no |
| 3Choice of study designs explained | NR | No | no |
| 4Comprehensive literature searchcritical | NR | No | no |
| 5Study selection in duplicate | NR | Yes | no |
| 6Data extraction in duplicate | NR | Yes | no |
| 7List of excluded studies with reasonscritical | NR | No | no |
| 8Included studies described in detail | NR | Partial Yes | no |
| 9Risk of bias assessed satisfactorilycritical | NR | RCT: Yes · NRSI: Yes | no |
| 10Funding of included studies reported | NR | No | no |
| 11Appropriate meta-analysis methodscritical | NR | RCT: Yes · NRSI: Yes | no |
| 12Impact of risk of bias on the pooled results | NR | Yes | no |
| 13Risk of bias accounted for in interpretationcritical | NR | Yes | no |
| 14Heterogeneity explained | NR | Yes | no |
| 15Publication bias investigatedcritical | NR | Yes | no |
| 16Conflicts of interest reported | NR | Yes | no |
| Overall | NR | Critically Low | no |