Table 3.
Level of evidence according to the GRADE rating system.
| Certainty assessment | Number of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | ridge preservation | normal healing | Relative (95% CI) | Absolute (95% CI) | ||
| Need for sinus floor augmentation at implant placement | ||||||||||||
| 6 |
4 RCTs 2 CCTs |
not serious | not serious | not serious | not serious | none | 27/107 (25.2%) | 45/76 (59.2%) | OR 0.20 (0.08 to 0.38) | 367 fewer per 1,000 (from 488 to 237 fewer) | ⨁⨁⨁⨁High | CRITICAL |
| Sinus pneumatization | ||||||||||||
| 5 |
3 RCTs 2 CCTs |
not serious | not serious | not serious | not serious | none | 71 | 65 | – | SMD − 1.01 SD lower (1.38 lower to 0.64 lower) | ⨁⨁⨁⨁High | CRITICAL |
| Ridge height | ||||||||||||
| 7 |
4 RCTs 3 CCTs |
not serious | not serious | not serious | not serious | none | 122 | 91 | – | SMD 0.72 SD higher (0.22 higher to 1.22 higher) | ⨁⨁⨁⨁High | CRITICAL |
| Ridge width | ||||||||||||
| 4 |
2 RCTs 2 CCTs |
not serious | seriousa | not serious | not serious | none | 71 | 58 | – | SMD 0.61 SD higher (0.27 lower to 1.49 higher) | ⨁⨁⨁◯Moderatea | IMPORTANT |
Note that the certainty of evidence was assessed based on the results of the meta-analyses of prospective studies only, to ensure more homogeneity.
CI: confidence interval; OR: odds ratio; SMD: standardized mean difference; RCT: randomized clinical trial; CCT: controlled clinical trial.
aContradicting outcomes from the included studies.