The Prognostic Outcome of Transalveolar Sinus Floor Elevation With or Without Grafting Materials: A Meta-analysis.

PURPOSE: To assess the effect of nongrafted and grafted materials on transalveolar sinus floor elevation (TSFE) with implant placement. MATERIALS AND METHODS: Relevant studies published between January 1, 1994, and July 31, 2021, were selected by searching Embase, PubMed/MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials. The study subjects were restricted to humans, and the language was limited to English. The study was confined to randomized controlled trials, controlled clinical trials, and observational studies (prospective and retrospective cohort) related to TSFE with and without bone-grafting materials. Two reviewers independently extracted study data and conducted quality assessments according to the Cochrane handbook and NOS scale. RevMan 5.3 and Stata 15.1 software were then used to analyze the research data that met the inclusion criteria. RESULTS: A total of nine articles were included, including 421 implants in the graft group and 502 implants in the nongraft group. Meta-analysis showed that there was no significant difference in the implant failure rate (RR = 1.03, 95% CI: 1.00, 1.06, P = .08) or marginal bone loss (SMD = 0.06, 95% CI: -0.23, -0.35, P = .69) between implants with and without graft materials after TSFE. The amount of endosinus bone gain in the nongraft group was significantly lower than that in the graft group (SMD = -1.07, 95% CI: -1.73: -0.41, P = .0001). CONCLUSION: TSFE in implants with or without grafting can achieve similar results, but there may be more bone gain in TSFE with grafting.

Zoledronic acid inhibits osteoclast differentiation and function through the regulation of NF-κB and JNK signalling pathways.

It is well known that extensive osteoclast formation plays a key role in osteoporosis in post­menopausal women and the elderly. The suppression of extensive osteoclastogenesis and bone resorption may be an effective preventive strategy for osteoporosis. Zoledronic acid (ZOL) has been indicated to play an essential role in regulating bone mineral density and has already been used in large clinical trials. However, the effects of ZOL on osteoclastogenesis remain to be fully elucidated. Therefore, the present study aimed to determine the effects of ZOL on osteoclastogenesis, and to explore the corresponding signalling pathways. By using a cell viability assay, as well as in vitro osteoclastogenesis, immunofluorescence and resorption pit assays, we demonstrated that ZOL (0.1­5 µM) suppressed receptor activator of nuclear factor­κB ligand (RANKL)­induced osteoclast differentiation and bone resorptive activity. Furthermore, western blot analysis and reverse transcription­quantitative PCR indicated that ZOL inhibited the RANKL­induced activation of NF­κB and the phosphorylation of JNK in RAW264.7 cells, and subsequently decreased the expression of osteoclastogenesis­associated genes, including calcitonin receptor, tartrate­resistant acid phosphatase and dendritic cell­specific transmembrane protein. ZOL inhibited osteoclast formation and resorption in vitro by specifically suppressing NF­κB and JNK signalling. On the whole, the findings of this study indicate that ZOL may serve as a potential agent for the treatment of osteoclast­associated diseases, including osteoporosis.