Indications, techniques and complications associated with full-arch rehabilitation using trans-sinus implants: A systematic review and prevalence meta-analysis

Abstract

PURPOSE To evaluate the failure rate of trans-sinus implants for full-arch rehabilitation in atrophic maxillae, comparing their outcomes to those achieved with axial and tilted implants. MATERIALS AND METHODS The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, including studies where patients underwent rehabilitation with trans-sinus implants alone or in combination with axial or zygomatic implants. The review was registered on the International Prospective Register of Systematic Reviews (ID: CRD42024537320). A meta-analysis using Haldane and hybrid corrections compared failure rates between implant types. RESULTS Out of 2,359 articles, 10 studies employing trans-sinus implants were selected. In the meta-analysis, the trans-sinus group was composed of 232 implants, 5 of which failed, compared to 5 of the 675 implants in the axial/tilted group. There were no statistically significant differences in failure rate between the groups (RRHaldane = 2.80, 95% confidence interval 0.89 to 8.77, P = 0.076; RRHybrid = 2.74, 95% confidence interval 0.91 to 8.17, P = 0.070). The pooled analysis indicated a comparable success rate. CONCLUSIONS Trans-sinus implants represent a viable alternative, in terms of survival rate, to axial/tilted implants for rehabilitation of the atrophic maxilla, minimising the need for invasive procedures such as extensive bone grafting; however, further controlled clinical trials with longer follow-up periods are needed to confirm these results.