Evaluation of implant stability and increase in bone height in indirect sinus lift done with the osseodensification and osteotome technique: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Whether the use of osseodensification burs for indirect sinus lift improves primary implant stability and bone height as compared with the osteotome technique to overcome the challenges of the pneumatization of the maxillary sinus and vertical bone loss after extraction in the edentulous posterior maxilla is unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the difference in primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique. MATERIAL AND METHODS: Two independent reviewers searched the MEDLINE/PubMed, EBSCO, and Cochrane Library databases and the Google Scholar Search engine for randomized clinical trials, nonrandomized clinical trials, and cross-sectional studies published from 2000 to 2022 to identify relevant studies evaluating the primary implant stability and increase in bone height in indirect sinus lift using osseodensification and the osteotome technique. A meta-analysis was performed to evaluate the cumulative data on primary implant stability and increase in bone height. RESULTS: A total of 8521 titles were obtained by electronic database search, of which 75 were duplicates. A total of 8446 abstracts were screened, and 8411 that were not relevant to the topic were excluded. Thirty-five articles were eligible for full-text assessment. After the screening of full-text articles as per the selection criteria, 26 studies were excluded. For qualitative synthesis, 9 studies were included. For quantitative synthesis, 5 studies were included. For an increase in bone height, no statistically significant difference was observed (I(2) = 89%, P=.15, pooled mean difference=0.30 [-0.11, 0.70], CI=95%). For primary implant stability, the osseodensification group showed higher values than the osteotome group (I(2) = 20%, P<.001, pooled mean difference=10.61 [7.14, 14.08], CI=95%). CONCLUSIONS: The evidence obtained from quantitative analysis of the studies determined that the osseodensification group showed higher primary implant stability than the osteotome group (P<.05). However, for mean increase in bone height, there was no statistically significant difference between the groups.