Abstract

BackgroundAutogenous bone graft is considered as the preferred grafting material for maxillary sinus floor augmentation (MSFA). However, harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. From a clinical and patient perspective, it would therefore be an advantage, if postoperative discomfort could be minimized by diminishing the need for autogenous bone graft harvesting. The objective of the present study was to test the hypothesis of no difference in patient’s perception of recovery after MSFA with autogenous bone graft from the zygomatic buttress (control) compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral (DPBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Sixty healthy patients were randomly allocated to either control or test groups. Oral Health-related Quality of Life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment. Recovery was estimated by self-administrated questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment and discomfort after 1 week and 1 month. Descriptive statistics was expressed as mean with standard deviation (SD). Correlation between OHRQoL at enrollment and recovery were assessed by linear regression. p-value below 0.05 was considered significant.ResultsTreatment satisfaction and willingness to undergo similar surgery were high in all groups. Average numbers of days with pain and sick leave were 3.5 (SD 3.9) and 0.5 (SD 1.2), respectively, with no significant difference between groups. Moreover, no significant difference in eating and speaking ability, physical appearance, work performance and sleep impairment were seen between groups. Mean OHIP-14 score at enrollment was 9.30 (SD 9.25) (control), 9.95 (SD 7.96) (Test I) and 8.15 (SD 9.37) (Test II), with no significant differences between groups. Impaired OHRQoL, gender or age seems not to predispose for delayed recovery or increased postoperative discomfort.ConclusionsMSFA with diminutive autogenous bone graft harvesting is associated with high patient satisfaction, limited postoperative discomfort and willingness to undergo similar surgery. Presurgical OHRQoL, gender or age seems not to be associated with impaired patient’s perception of recovery.

Highlights

  • Vertical bone augmentation is often required prior to or in conjunction with implant placement in the posterior maxilla due to atrophy of the alveolar ridge and pneumatization of the maxillary sinus

  • Maxillary sinus floor augmentation (MSFA) applying the lateral window technique is the most frequently used method to increase the bone height of the posterior maxilla and high survival rates of suprastructures and implants as well as limited peri-implant marginal bone loss have been reported in several systematic reviews and meta-analyses regardless of used grafting material [1,2,3,4,5,6]

  • Autogenous bone graft from extraoral or intraoral donor sites are generally considered as the preferred grafting material for MSFA due to its osteoinductive, osteoconductive and osteogenic features [7, 8]

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Summary

Introduction

Vertical bone augmentation is often required prior to or in conjunction with implant placement in the posterior maxilla due to atrophy of the alveolar ridge and pneumatization of the maxillary sinus. Autogenous bone graft from extraoral or intraoral donor sites are generally considered as the preferred grafting material for MSFA due to its osteoinductive, osteoconductive and osteogenic features [7, 8]. Harvesting of autogenous bone graft is associated with supplementary surgery, risk of donor site morbidity and impaired postoperative Oral Health-related Quality of Life (OHRQoL) [9,10,11,12]. The impact of diminutive autogenous bone graft harvesting from the surgical site on patient-reported outcome measures and OHRQoL in conjunction with MSFA are presently unknown. Harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. Correlation between OHRQoL at enrollment and recovery were assessed by linear regression. p-value below 0.05 was considered significant

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