经牙槽嵴入路与侧壁开窗入路行上颌窦底提升术的比较：随机对照试验的系统评价与Meta分析
Crestal Versus Lateral Window Approaches for Maxillary Sinus Floor Augmentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
文献信息
| PMID | 42942504 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Heera Lee |
| 作者单位 | Department of Medicine, Graduate School, The Catholic University of Korea, Seoul 06591, Republic of Korea. |
| 期刊 | Medicina (Kaunas, Lithuania) |
| SCI 分区 | Q1 |
| IF | 3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景与目的： 直接比较经牙槽嵴入路与侧壁开窗入路行上颌窦底提升术的证据仍不确定。我们比较了两种入路的结局，并评估了证据确定性。
材料与方法： 纳入直接比较两种入路的随机试验。检索MEDLINE/PubMed、Embase和Cochrane Library，检索时间自建库至2026年7月30日，并补充非系统性Google Scholar检索。使用RoB 2和GRADE评估偏倚风险和证据确定性。结局以风险比（RR）、均数差（MD）或标准化均数差（SMD）合并，并计算95%置信区间（CI）。方案已在PROSPERO注册（CRD420261447905）。
结果： 共纳入13项随机试验（17篇报告）。种植体失败（RR 0.50，95% CI 0.10-2.61）、膜穿孔（RR 0.63，95% CI 0.29-1.38）、12个月时边缘骨丢失（MD -0.08 mm，95% CI -0.31-0.15）、12个月时垂直骨增量（MD -0.81 mm，95% CI -1.94-0.33）或6个月时垂直骨增量（MD -1.07 mm，95% CI -2.50-0.36）、术后疼痛（SMD -1.56，95% CI -3.31-0.20）均未发现统计学显著差异。证据确定性为低至极低。
结论： 当前证据未能确立任一入路的优越性。选择应结合剩余骨高度、窦腔解剖、治疗目标和术者经验。
英文摘要
Background and Objectives: Evidence directly comparing crestal and lateral approaches for maxillary sinus floor augmentation remains uncertain. We compared their outcomes and assessed certainty of evidence. Materials and Methods: Randomized trials directly comparing both approaches were included. MEDLINE/PubMed, Embase, and the Cochrane Library were searched from inception to 30 July 2026, supplemented by non-systematic Google Scholar searches. Risk of bias and evidence certainty were assessed using RoB 2 and GRADE. Outcomes were pooled as risk ratios (RRs), mean differences (MDs), or standardized mean differences (SMDs), with 95% confidence intervals (CIs). The protocol was registered in PROSPERO (CRD420261447905). Results: Thirteen randomized trials (17 reports) were included. No statistically significant differences were found for implant failure (RR 0.50, 95% CI 0.10-2.61), membrane perforation (RR 0.63, 95% CI 0.29-1.38), marginal bone loss at 12 months (MD -0.08 mm, 95% CI -0.31-0.15), vertical bone gain at 12 months (MD -0.81 mm, 95% CI -1.94-0.33) or 6 months (MD -1.07 mm, 95% CI -2.50-0.36), or postoperative pain (SMD -1.56, 95% CI -3.31-0.20). Certainty was low to very low. Conclusions: Current evidence does not establish superiority of either approach. Selection should reflect residual bone height, sinus anatomy, treatment objectives, and operator experience.