Consensus Report of Group 3 of the 1st Global Consensus for Clinical Guidelines for the Rehabilitation of the Edentulous Maxilla: Advanced Diagnostic Imaging, Augmentation Techniques, and Management of Complications
Joseph P. Fiorellini, Guo-Hao Lin, Isabella Rocchietta, Sean Mojaver, Tara Aghaloo, Kang-Min Ahn et al. · 2026 · 3 citationsRead the paper
OBJECTIVES: The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an evidence-based, patient-centered framework for rehabilitating the edentulous maxilla. Working Group 3 aimed to develop clinical recommendations on advanced diagnostic imaging, soft and hard tissue augmentation, and management of complications. MATERIALS AND METHODS: Recommendations were developed following the S2k-level guideline framework of the AWMF and a structured nominal group technique. The evidence base included two systematic reviews on clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), supplemented by single-round international surveys of expert clinicians, patients, and cross-disciplinary experts. Survey content addressed diagnostics, treatment planning, clinical procedures, and maintenance care. Draft recommendations were discussed at the in-person consensus meeting in Boston (June 16-18, 2025) and finalized through anonymous plenary voting. Consensus thresholds were predefined as ≥ 75% but ≤ 95% agreement for consensus and > 95% agreement for strong consensus. RESULTS: Working Group 3 formulated four clinical recommendations spanning advanced diagnostic imaging, augmentation techniques, and complication management. All four recommendations reached consensus. Voting participation per recommendation ranged from 68 to 88 (mean 79) out of a possible 105 participants. CONCLUSIONS: The Working Group 3 consensus statements offer practical guidance on surgical procedures and complication management in the rehabilitation of the edentulous maxilla. These recommendations are grounded in current evidence, interdisciplinary clinical practice, and patient perspectives. Furthermore, important evidence gaps, particularly in standardized patient-reported outcome measures (PROMs), long-term outcomes, and maintenance protocols, highlight key priorities for future clinical research.
What the full text shows
Tested in real conditions- Experts favor delayed implant placement over immediate or early placement in posterior maxilla cases requiring sinus lift or bone grafting. — 76.7% of experts (Posterior maxilla requiring sinus lift or bone grafting)
- Strong consensus on the necessity of preoperative sinus assessment for lateral sinus lifts and suspected pathology. — 96.6% (lateral) and 95.8% (pathology) (Preoperative diagnostic phase)
- Strong recommendation for the use of CT/CBCT scans for diagnostics. — 96.5% agreement (Preoperative diagnostics)
- Experts recommend continuing surgery without interruption for sinus membrane perforations ≤ 5 mm, using resorbable membranes for repair. — 76.7% (continue surgery), 94.8% (resorbable membranes) (Sinus membrane perforation ≤ 5 mm during lateral sinus lift)
- Experts agree that soft tissue augmentation is typically performed at implant placement or second-stage surgery to establish keratinized mucosa. — 83.6% agreement (Cases with insufficient keratinized mucosa)
- Consensus on performing full-mouth pocket charting and intraoral radiographs annually during long-term follow-up. — 85.4% (charting), 78.5% (radiographs) (Long-term maintenance in the absence of complications)
- Setup
- 105 participating experts (including 27 in Working Group 3: 5 prosthodontists, 13 periodontists, 9 oral surgeons), 217 invited clinician experts, 68 patients, and 68 cross-disciplinary experts.
- How
- A multi-phase consensus process using the S2k-level guideline framework and Nominal Group Technique. Evidence was synthesized from two systematic reviews and three international surveys of clinicians, patients, and cross-disciplinary experts, followed by anonymous plenary voting.
- Limitations
- Heterogeneity in outcome reporting and measurement tools in existing studies · Lack of a universal standardized outcome set (COS) · Limited or heterogeneous evidence for certain bone augmentation indications · Lack of consensus on optimal healing intervals and grafting materials
Summarized by Gemma 4 from the open-access full text · 8 Oct 2026. Read it