Patient-Reported Outcome Measures (PROMs) and Clinician-Reported Outcomes (ClinROs) in Sinus Floor Elevation for Implant Rehab in the Edentulous Maxilla: A Systematic Review and COSMIN Analysis.

OBJECTIVES

To evaluate the current patient-reported outcome measures (PROMs) and clinician-reported outcomes (ClinROs) following sinus floor elevation (SFE) for implant-based rehabilitation in the fully edentulous maxilla.

METHODS

A systematic search was conducted across PubMed, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials, covering publications from 2013 to 2024. We included prospective studies assessing PROMs and ClinROs. The COSMIN checklist was used to evaluate PROMs quality.

RESULTS

Eighteen studies met the inclusion criteria, comprising randomized controlled trials, controlled clinical trials, and case series. Fourteen distinct ClinROs were identified, predominantly implant survival (61.11%) and peri-implant bone-level changes (50%). Conversely, ClinROs directly associated with SFE procedures-such as maxillary sinus bone height/volume changes (27.7%) and sinus membrane perforation (10.5%)-were underreported. Prosthetic outcomes were addressed in 11.11% of studies, and PROMs in 50% of the studies. Seven different PROMs were identified, with a focus on masticatory function and overall satisfaction. COSMIN analysis revealed that OHIP-49 and the denture satisfaction questionnaire (DSQ) were the most robust PROMs, scoring "very good" across multiple domains. Patients' overall satisfaction and complaint-based PROMs lacked validation.

CONCLUSIONS

Current reporting of ClinROs emphasizes implant-related metrics, while outcomes directly related to SFE are inconsistently reported. Validated PROMs are needed to ensure consistency and reliability in outcome assessment. OHIP-49 and DSQ demonstrated strong psychometric properties and are recommended as core PROMs. Future studies should incorporate early and long-term PROMs and adopt a standardized approach to outcome reporting.