Residual ridge height as a potential risk factor for membrane perforation during lateral-window sinus elevation surgery: a systematic review and meta-analysis.

PURPOSE: Perforation of the sinus membrane is a common complication during maxillary sinus lift surgery. This systematic review aimed to evaluate if the residual ridge height (RRH) is a risk factor for membrane perforations during the lateral-window sinus lift surgery. METHODS: PubMed, Embase, CENTRAL, Scopus, and Web of Science databases were searched for studies reporting the association between RRH and sinus membrane perforations during the lateral-window sinus lift surgery. The last date of the search was 17th June 2024. RESULTS: Ten studies were eligible. 1601 patients undergoing 1809 sinus lift procedures were included in the studies. The overall sinus membrane perforation rate was 19.2%. The meta-analysis found that mean RRH was significantly lower in the perforation group than the non-perforation group (MD: -0.89 95% CI: -1.47, -0.31 I2 = 90%). The included studies classified Small RRH as a 3–4 mm ridge. Meta-analysis showed a tendency of increased risk of perforation with small RRH, but the difference was not statistically significant (OR: 2.47 95% CI: 0.49, 12.21 I2 = 88%). The exclusion of one outlier study showed statistically significant results. CONCLUSIONS: Small RRH seems to be a potential risk factor for sinus membrane perforation during lateral-window sinus lift surgery. More evidence is needed for improving the validity of the current results.