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
Thomas Starch-Jensen, Kimie Bols Østergaard, Niels Henrik Bruun, Inleel Lundgaard Shino, Malene Halskov Hallund
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.
Objectives: Reduction of postoperative scarring after unilateral cleft lip cheiloplasty is a pertinent topic. Smaller scar formation results not only in a better lip function, but also - aesthetics. This systematic review aims to identify various supplementary treatment options which influence favourable scarring outcome after cheiloplasty.
Material and Methods: The systematic review was conducted following PRISMA guidelines and Cochrane methodologies, using databases including PubMed, ScienceDirect, The Cochrane Library, and Google Scholar. Articles published between 2012 and 2024 evaluating supplementary measures for reducing scar tissue post-unilateral cleft lip cheiloplasty were included. Studies were assessed for bias using the Joanna Briggs Institute Critical Appraisal Checklist, and outcomes were measured using Vancouver Scar Scale, Visual Analog Scale, Hollander Wound Evaluation Score, and scar width metrics.
Results: Nine studies were analysed, highlighting platelet-rich plasma and botulinum toxin A as effective in reducing scar width and improving aesthetics. Silicone-based products enhanced wound healing, while non-absorbable sutures and tissue adhesives showed superior outcomes compared to absorbable sutures. Overall, supplementary measures significantly improved postoperative scar appearance.
Conclusions: The use of platelet-rich plasma or botulinum toxin injections in musculus oribucalaris oris during the cheiloplasty significantly improves postoperative scar formation outcome. Wound edges approximation by non-absorbable sutures or tissue glue equally results in smaller scar formation and better aesthetic outcome. Suturing with absorbable sutures increases the incidence of complications and results in poor aesthetics. Postoperative wound care with products containing silicone significantly reduces scarring and aids in aesthetics.
Objectives: The aim of this systematic review is to assess how different types of surgical sutures impact the microbiological composition of bacterial plaque in patients undergoing impacted third molar teeth removal surgery.
Material and Methods: This systematic review followed PRISMA guidelines. Electronic literature searches were conducted across PubMed, Google Scholar, ResearchGate, and Web of Science databases, employing electronic databases and hand searches. Keywords such as “suture”, “third molar”, “wisdom teeth”, “impacted teeth”, “surgical extraction” were used in various combinations with Boolean operators. A 10-year filter, English language, and full-text access filter were applied. The research spanned the period from January 1, 2016, to January 1, 2025, and incorporated studies on humans published in English.
Results: The systematic literature review included 12 studies with 709 suture samples from 420 patients undergoing impacted third molar removal surgery. Twenty-five suture types were used, with silk being the most common but often accumulating the highest bacterial load. Prolene® and antibacterial sutures, like Monocryl® Plus, showed significantly lower bacterial colonization.
Conclusions: Sutures after third molar surgery can promote bacterial attachment, potentially leading to infections that impact wound healing. The evidence suggests that monofilament, synthetic, and antibacterial-coated sutures are preferable for reducing bacterial colonization, whereas multifilament silk sutures should be avoided when possible due to their high bacterial retention.
Objectives: The purpose of this systematic literature review was to evaluate the effects of local simvastatin on alveolar bone regeneration, pain and swelling after tooth extraction, with a minimum follow-up of two months.
Material and Methods: A literature search was conducted using PubMed (MEDLINE) database to identify studies published between January 2015 and January 2025 containing a minimum of 20 sockets per study to evaluate the effect of local simvastatin in promoting bone regeneration after tooth extraction. Data synthesis in test and control groups included following parameters: Extraction socket filling material and method, regenerated bone morphology, pain, and swelling. Quality and risk-of-bias assessment were evaluated by The Joanna Briggs Institute Critical Appraisal Tools. Descriptive statistics were used.
Results: A total of 628 articles were screened, with 6 articles meeting the inclusion criteria and being utilized for this review. A total of 326 sockets with different types were evaluated, the effect of local simvastatin on the morphology of regenerated bone showed statistically significant (P < 0.05) progressive improvement in most cases. Furthermore, pain and swelling assessments revealed a decrease in the test groups compared to the control groups suggesting that local simvastatin may promote bone regeneration while reducing post-treatment discomfort. However, different tools were used to measure regenerated bone morphology pain and swelling, making it hard to draw consistent conclusions about patient comfort.
Conclusions: Local simvastatin application promotes bone regeneration without increasing pain or swelling, supporting its use as a safe and effective supplement in regenerative bone treatment after tooth extraction.
Objectives: Plasma surface activation of dental implants has been proposed to enhance osseointegration by improving titanium surface chemistry. However, clinical data in humans remain limited. This randomized controlled clinical trial aimed to evaluate the effect of vacuum plasma treatment applied to titanium implants immediately prior to insertion on their stability pattern during the early phases of healing in human subjects.
Material and Methods: In this single-blind, split-mouth randomized controlled trial, 24 patients requiring two contralateral implants were enrolled. Each patient received one plasma-treated implant and one untreated control implant. Vacuum plasma activation was performed immediately before insertion using a specific system (Plasma X® Motion (MegaGen Implant Co., Ltd.). Implant stability was assessed at placement and at 7, 14, 21, 28, 42, 60, and 90 days using resonance frequency analysis (implant stability quotient [ISQ]).
Results: All 48 implants achieved osseointegration at 90 days, with no adverse events or complications. Mean insertion torque did not differ significantly between groups (P = 0.86). Both groups exhibited a typical initial reduction in stability, with the lowest ISQ values at 21 days. Plasma-treated implants showed a more favourable recovery pattern, with significantly higher ISQ values than controls at 60 and 90 days (P = 0.04 and P = 0.03, respectively). The absolute difference in ISQ values between groups remained limited.
Conclusions: Vacuum plasma activation of titanium implants may contribute to a more favourable early stability pattern, although both plasma-treated and untreated implants demonstrated predictable osseointegration outcomes. Further research with larger cohorts and longer follow-up is needed to assess the clinical significance of these findings.
Objectives: This preliminary in vitro study aimed to clarify the usefulness of the accumulated torque value as a new method for evaluating primary implant stability.
Material and Methods: Implants of different sizes (42-10ST and 37-6ST) and simulated bone blocks of different densities (D1 to D4) were used. The implant osteotomy was prepared following the manufacturer’s drilling protocol in simulated bone blocks, and the implants were inserted (n = 10). The implant insertion torque value was measured at 0.05 seconds intervals. The peak value was recorded as the peak torque value (PTV), and the sum of the torque values measured from the start to the end of the implant insertion was recorded as the accumulated torque value (ATV). After implantation, the implant stability quotient (ISQ) was measured. Correlations among ATV, PTV, and ISQ were analysed.
Results: The ATV increased with the density of the simulated bone block. A strong correlation was observed between the PTV value and ATV value (42-10ST [P < 0.05, r = 0.99], 37-6ST [P < 0.05, r = 0.99]). In addition, a correlation was observed between the ATV and ISQ ISQ (42-10ST [P < 0.05, r = 0.81], 37-6ST [P < 0.05, r = 0.83]). The PTV was higher in the 42-10ST group than in the 37-6ST group from D1 to D4.
Conclusions: The accumulated torque value varied according to the density of the simulated bone block, and a correlation was observed with the existing implant stability evaluation method. This suggests that this method may be useful as a novel approach for evaluating primary implant stability.