Meta-analysis of the impact of sinus membrane perforation on long-term stability of dental implants

doi:10.19438/j.cjoms.2026.02.012

Abstract

Abstract: PURPOSE: To systematically evaluate the effect of sinus membrane perforation during maxillary sinus floor elevation(MSFE) on the long-term stability of implants by meta-analysis. METHODS: A comprehensive search was conducted in PubMed, Embase, The Cochrane Library, CNKI and VIP databases for relevant studies published from database inception to December 2023. Clinical studies investigating the effect of sinus membrane perforation during MSFE on implant outcomes were screened. Eligible studies underwent rigorous quality assessment, and those meeting the inclusion criteria were included in the meta-analysis. RESULTS: A total of 10 studies were included, comprising 2 758 patients and 6 695 implants. The overall quality of the included studies was high, and the incidence of membrane perforation was 26.86%. Meta-analysis revealed no significant difference in implant success rates between perforated and non-perforated cases [RR=0.99, 95%CI (0.97, 1.01)], and no correlation with follow-up duration. Subgroup analysis showed that when the perforation size was classified as small or moderate, implant success rates were comparable to those in non-perforated cases. However, large perforations were associated with a trend toward decreased success rates, though not statistically significant [RR=0.85, 95%CI (0.58, 1.26)]. Regarding complications, the incidence of postoperative bleeding was significantly higher in the perforation group [RR=18.79, 95%CI (1.09, 325.16)], as was the incidence of postoperative infection [RR= 13.05, 95%CI(2.13, 79.9)]. No significant difference was found in graft failure rates between the two groups[RR=0.86, 95%CI(0.34, 5.36)]. CONCLUSIONS: Sinus membrane perforation is the most common intraoperative complication during MSFE. While membrane perforation does not significantly impact overall implant success rates, larger perforations may compromise long-term stability. Moreover, membrane perforation is significantly associated with increased risks of postoperative infection and bleeding. Clinicians should pay close attention to the identification and classification of membrane perforations and adopt appropriate repair strategies accordingly.

Key words: Maxillary sinus floor elevation, Sinus membrane perforation, Implant success rate, Meta-analysis, Complications

CLC Number:

R782.1

Xia Liang, Xu Zonghe, Zou Duohong. Meta-analysis of the impact of sinus membrane perforation on long-term stability of dental implants[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(2): 166-175.

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