Is balloon-assisted maxillary sinus floor augmentation before dental implant safe and promising? A systematic review and meta-analysis.

We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.

Evaluating cortico-cancellous ratio using virtual implant planning and its relation with immediate and long-term stability of a dental implant- A CBCT-assisted prospective observational clinical study.

BACKGROUND: Primary and long-term implant stabilities are crucial in predicting the success of dental implants. We aimed to evaluate corticocancellous ratio (CCR) around virtual implant using cone beam computed tomography (CT) and assess its relationship with immediate and long-term stability of the implants placed. MATERIALS AND METHODS: A total of 135 image records of posterior mandibular implant sites planned for dental implant were included in our study. CCR was calculated using CT images and implants were placed after stent preparation. Implant stability was calculated immediately, 4 months later, and 2 years later. RESULTS: Pearson's correlation test showed a significant correlation (P and lt; 0.001) between CCR and implant stability. ANOVA and post-hoc Tukey tests showed a significant difference in implant stability between groups with different CCRs at all follow-up timepoints. No significant difference was found between mean implant stability quotient values for low CCR at 2-year follow-up and high CCR immediately after implant placement. CONCLUSIONS: Implant stability is improved with greater CCR. Cortical bone seems to be crucial factor for immediate and long-term stability of a dental implant. Virtual planning using CT can assess implant stability. Further histological studies are required to confirm the relation between CCR and implant stability. The escalating demand of the implant treatment in the dental practice necessitates measuring the several predictors of procedure success. This study introduces a novel predictor (CCR) around virtual implant for detecting the immediate and long-term stability of a dental implant.