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Objective: The objective was to assess the one year implant treatment outcome and patient‐related outcome measures (PROMs) following maxillary sinus floor augmentation (MSFA) with autogenous bone graft (ABG) from the zygomatic buttress (control) compared with 1:1 mixture of ABG and anorganic porcine bone mineral (APBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Materials and Methods: Sixty healthy patients (34 females, 26 males) were randomly allocated to either control or test groups. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of peri‐implant tissue, peri‐implant marginal bone loss, frequency of complications, and PROMs using Oral Health Impact Profile‐14 combined with questionnaire assessing patient perception of peri‐implant soft tissue, prosthetic solution, implant function, and implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was.05. Results: All suprastructures and implants were well‐functioning after one year of functional implant loading. There was no significant difference between control and test groups in any of the applied outcome measures. The implant stability significantly increased from implant placement to abutment connection within all groups (p <.001). High patient satisfaction and significant improvement in oral health‐related quality of life was also reported within all groups. Conclusion: This study demonstrates that MSFA with composite grafts containing minimal amounts of ABG reveals comparable implant treatment outcomes as compared with ABG alone, after one year of functional implant loading. Extensive ABG harvesting in conjunction with MSFA therefore seems not to be needed. [ABSTRACT FROM AUTHOR]

Objective: To assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB). Materials and Methods: Eighteen edentulous patients with an alveolar ridge of ≤4 mm were included in this split‐mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation. Results: The gained widths were 4.9 (±2.4) mm (100:0) and 4.5 (±2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (±1.3) mm (100:0) and 4.6 (±2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (±23.8) (100:0) and 38.2% (±23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (±10.7) (100:0) and 46.4% (±11.3) (90:10), DBBM were 31.6% (±12.6) (100:0) and 35.4% (±14.8) (90:10), and non‐mineralized tissue were 17.6% (±11.7; 100:0) and 18.2% (±18.2) (90:10). No significant differences were evident between in any evaluated parameters. Conclusions: There were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing. [ABSTRACT FROM AUTHOR]

Objective: The aim was to evaluate the 1‐year implant outcome and patient‐related outcome measures (PROMs) after maxillary sinus membrane elevation and coagulum (test) compared with maxillary sinus floor augmentation and a 1:1 ratio of autogenous bone graft from the buccal antrostomy and deproteinised porcine bone mineral (DPBM) (control). Materials and methods: Forty patients (30 female, 10 male) with a mean age of 50 years (range 25–71 years) and an alveolar ridge height between 4 and 7 mm were randomly allocated to test or control. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of the peri‐implant tissue, peri‐implant marginal bone loss, frequency of complications and PROMs using Oral Health Impact Profile‐14 combined with questionnaires assessing patient's perception of the peri‐implant soft tissue, implant crown, function of the implant, and total implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was 0.05. Results: All suprastructures and implants were well‐functioning after 1‐year of functional implant loading. No significant difference in any of the applied outcome measures was observed between test and control. Both treatments revealed high patient satisfaction scores and significant improvement in oral health‐related quality of life. Conclusion: There were no significant differences in implant outcome and PROMs between test and control, after 1‐year of functional implant loading. Neither of the treatments can therefore be considered better than the other. Thus, long‐term randomized controlled trials are needed before definitive conclusions can be provided about the two treatment modalities. [ABSTRACT FROM AUTHOR]

Objective: Test the hypothesis of no difference in bone regeneration after maxillary sinus floor augmentation (MSFA) with different ratios of iliac or mandibular autogenous bone (AB) graft and deproteinized bovine bone mineral (DBBM). Materials and Methods: Forty minipigs were randomly allocated to bilateral MSFA using: (A) 100% AB, (B) 75% AB and 25% DBBM, (C) 50% AB and 50% DBBM, (D) 25% AB and 75% DBBM, or (E) 100% DBBM. The animals were euthanized 12 weeks after surgery. Percentage of bone, non‐mineralized tissue, and residual DBBM were estimated by histomorphometric analysis in a randomly selected region of interest and summarized as mean percentage with 95% confidence interval (CI). Results: Mean percentage of bone following MSFA with iliac or mandibular AB graft was: (A) 55.5% and 64.2%, (B) 60.3% and 61.6%, (C) 54.4% and 52.1%, (D) 51.8% and 53.1%, and (E) 47.6%, respectively. There was a significant trend toward a higher percentage of bone, with a higher ratio of AB within the graft (p <.01), regardless of the origin of AB graft (iliac or mandible). Conclusions: The hypothesis was rejected since percentage of bone was significantly increased with larger proportions of AB within the graft. Consequently, AB or a mixture of AB and diminutive quantities of DBBM seem to be the preferred graft for MSFA based solely on histomorphometric assessment. However, it should be emphasized that newly formed bone and residual AB graft particles could not be distinguished by the applied histologic procedure. [ABSTRACT FROM AUTHOR]

Objective: The objective was to assess patient's perception of recovery after maxillary sinus membrane elevation (MSME) and blood coagulum (test) compared with maxillary sinus floor augmentation (MSFA) and 1:1 mixture of autogenous bone graft from the buccal antrostomy and deproteinized porcine bone mineral (DPBM) (control). Materials and methods: Forty healthy patients were randomly allocated to test or control. Oral health‐related quality of life (OHRQoL) was evaluated by Oral Health Impact Profile‐14 (OHIP‐14) at enrollment and 1 week postsurgical. Recovery was estimated by 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. Mean differences were expressed with 95% confidence interval (CI). Association between OHRQoL and recovery was estimated. p‐value below.05 was considered statistically significant. Results: Maxillary sinus membrane elevation revealed 2.1 less days of pain (p =.03, 95% CI: 0.2–4.1) and 1.2 days of sick leave (p =.01, 95% CI: 0.3–2.1) compared with MSFA. No significant difference was observed in eating and speaking ability, physical appearance, work performance, and sleep impairment. No significant association between impaired OHRQoL and recovery was observed. Females reported 4.77 higher OHIP‐14 score compared with males (p =.01, 95% CI: 1.60–7.94), while association between age and OHIP‐14 was −0.10 (p =.28, 95% CI: −0.28 to 0.08). Conclusion: Maxillary sinus membrane elevation revealed significantly less days of pain and sick leave compared with MSFA. Harvesting of autogenous bone graft seems, therefore, to have a significant impact on perception of recovery. [ABSTRACT FROM AUTHOR]

This review describes the role of modern preprosthetic surgery. The atrophic edentulous jaw can cause severe functional impairment for patients, leading to inadequate denture retention, reduced quality of life, and significant health problems. The aim of preprosthetic surgery is to restore function and form due to tooth loss arising from congenital deformity, trauma, or ablative surgery. Alveolar bone loss is due to disuse atrophy following tooth loss. The advent of dental implants and their ability to preserve bone heralded the modern version of preprosthetic surgery. Their ability to mimic natural teeth has overcome the age-old problem of edentulism and consequent jaw atrophy. Controversies with preprosthetic surgery are discussed: soft tissue versus hard tissue augmentation in the aesthetic zone, bone regeneration versus prosthetic tissue replacement in the anterior maxilla, sinus floor augmentation versus short implants in the posterior maxilla—interpositional bone grafting versus onlay grafts for vertical bone augmentation. Best results for rehabilitation are achieved by the team approach of surgeons, maxillofacial prosthodontists/general dentists, and importantly, informing patients about the available preprosthetic surgical options. [ABSTRACT FROM AUTHOR]

The objective was to test the hypothesis of no difference in facial swelling, pain, trismus and immediate quality of life after surgical removal of mandibular third molars, with or without post‐operative cryotherapy. A MEDLINE (PubMed), EMBASE database and Cochrane library search in combination with a hand search of relevant journals were conducted by including human randomised controlled trials published in English until 17 July 2018. The search identified 37 titles. Six studies with low or unclear risk of bias fulfilled the inclusion criteria. Intermittent cryotherapy for 30 minutes during the first post‐operative days significantly diminished facial swelling, pain and trismus compared with no cryotherapy. Patient's satisfaction and perception of recovery were significantly increased with cryotherapy. Therapeutic efficacy of intermittent cryotherapy on post‐operative facial swelling, pain and trismus seems to be improved compared with continuous cryotherapy. Considerable variations in study design, diversity of used evaluation methods, outcome measures and various methodological confounding factors posed serious restrictions to review the literature in a quantitative systematic manner. Thus, conclusions drawn from the results of this systematic review should be interpreted with caution. Further well‐designed randomised controlled trials including standardised protocol, larger patient sample, blinded outcome assessors, patient‐reported outcome measures and three‐dimensional volumetric analysis of facial swelling are required before evidence‐based recommendations can be provided. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to estimate the area fraction of different ratios of Bio‐Oss® and bone, prior to grafting in an in vitro model to demonstrate a histomorphometric baseline. Methods: Bio‐Oss® particles were mixed with autogenous bone from pig jaw in three different ratios (50:50, 80:20 and 100:0) and packed in rice paper in a standardized procedure. Histomorphometric analyses were performed in 25 specimens and 74 regions of interest. The area percentage of Bio‐Oss®, bone, and non‐mineralized tissue (NMT) were calculated. Results were reported as mean values and 95% confidence interval (CI). Results: The mean area fraction of Bio‐Oss® was 20.6% (CI: 18.2–23) in the 50:50 mixture, 33.6% (CI: 29.7–37.6) in the 80:20 mixture, and 43.4% (CI: 40.5–46.3) in the 100:0 mixture. The mean area fraction of NMT was 60.5% (CI: 57.9–63.1) in the 50:50 mixture, 59.6% (CI: 56.4–62.7) in the 80:20 mixture, and 56.6% (CI: 53.7–59.5) in the 100:0 mixture. The mean area fraction of bone was 18.9% (CI: 16.9–20.9) in the 50:50 mixture and 6.8% (CI: 5–8.6) in the 80:20 mixture. Conclusion: There is a great difference in the clinically estimated percentage and the histomorphometrically evaluated percentage of Bio‐Oss® at baseline, prior to grafting. The area fraction of different tissues presented in this study may be beneficial as guidance for histomorphometrical baseline calculations when different mixtures of Bio‐Oss® and autogenous bone are used as grafting materials. [ABSTRACT FROM AUTHOR]

Background The optimal ratio of deproteinized bovine bone (DPBB) and autogenous bone (AB) for lateral augmentation is presently unknown. Purpose To evaluate implant treatment outcome and radiological graft changes after lateral ridge augmentation with 2 different mixtures of DPBB and AB, 2 years after functional loading. Materials and methods Thirteen patients were included in a split mouth, randomized, controlled trial. Four partially edentulous and 10 totally edentulous jaws with an alveolar ridge width of <4 mm were augmented with a graft mixture of 90:10 (DPBB:AB) on one side and 60:40 (DPBB:AB) on the contra lateral side. Graft width changes were measured on CBCT scans at different time points. Implant survival and success rates were calculated. Resonance frequency analysis and marginal bone measurements were performed after 2 years of loading. Results The survival rate was 94.4% for implants installed in the 90:10 and 100% for implants installed in the 60:40. There were no statistically significant differences in survival rate or success rate between the mixtures. The width was 5.7 mm and 6.2 mm, respectively for the 2 groups without any significant difference between the groups after 2 years of loading. There was a significant difference in graft reduction between the groups, 54.4% (90:10) and 37.5% (60:40), respectively. There were no statistically significant differences in implant stability or marginal bone levels at any time points. Conclusions The 2 treatment modalities may be successfully used for lateral ridge augmentation and presented good clinical results after 2 years of loading. However, long-term RCTs are required before final conclusions can be provided on this specific topic. [ABSTRACT FROM AUTHOR]

Objectives: To test whether there is a difference in professional and patient‐reported outcome measures (PROM) after single‐crown restoration supported by short implants (SI) (6 mm) compared with standard length implants (SLI) (13 mm) in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Material and Methods: Forty patients were randomly allocated to SI or SLI/MSFA. PROM included Oral Health Impact Profile (OHIP‐14) questionnaire and subjective assessment of the peri‐implant soft tissue (A), implant crown (B), implant function (C) and overall implant treatment outcome (D) using visual analogue scale (VAS). Professional assessment included pink aesthetic score (PES) and white aesthetic score (WES). Results: No significant differences in professional or PROM between the two treatment modalities were revealed at any time point (p >.05). OHIP‐14 score decreased at baseline and 1 year after functional implant loading compared with preoperative measurements indicating improved quality of life with both treatment modalities. The 1‐year mean VAS score was 9.4 (A), 9.3 (B), 9.6 (C) and 9.3 (D) for SI compared with 9.3 (A), 9.6 (B), 9.7 (C) and 9.2 (D) for SLI. The 1‐year mean PES/WES scores were 11.3 and 8.1 for SI compared with 11.2 and 8.1 for SLI/MSFA. Conclusions: Prosthetic rehabilitation of the posterior part of the maxilla with SI or SLI/MSFA revealed no significant differences in professional and PROM after 1 year of implant loading. [ABSTRACT FROM AUTHOR]

Objective: Estimate changes in augmentation height and volume after lateral guided bone regeneration (GBR) augmentation with different ratios of deproteinized bovine bone mineral (DBBM) and particulate autogenous bone (PAB) and autogenous bone block (ABB), at different time points. Material and methods: Twenty‐four minipigs were randomly allocated into three healing periods. Lateral augmentation in 96 sites with standardized quantity of graft material was performed with different ratios of DBBM and PAB (50:50, 75:25, and 100:0) and ABB in combination with DBBM, covered by a collagen membrane. Changes in augmentation height and volume were assessed on CT volumes acquired 10, 20, and 30 weeks after surgery. Results: Reduction in bone augmentation height was as follows: 50:50–1.7 mm (−33.1%), 75:25–1.8 mm (−37.8%), 100:0–1.7 mm (−35.8%), and ABB ‐ 0.2 mm (−3.7%), after 30 weeks. The augmentation height was significantly better preserved with ABB compared to 50:50, 75:25, and 100:0, while no significant difference was present among particulate grafts. No significant difference in volumetric reduction was found among 50:50, 75:25, 100:0 and ABB after 30 weeks, while 100:0 presented significant less reduction compared to 50:50, 75:25 and ABB after 10 and 20 weeks. Conclusions: Augmentation height following GBR was better preserved with ABB covered with DBBM. Addition of PAB to DBBM did not affect the changes in height of the graft. The volumetric stability seems to be comparable for ABB covered by DBBM and all particulate grafts after 30 weeks. However, DBBM alone revealed significant less volume reduction in the early healing phase. [ABSTRACT FROM AUTHOR]

Objective: To test the hypotheses of no differences in (I) percentage of bone (POB), non‐mineralized tissue (NMT), and deproteinized bovine bone mineral (DBBM), and (II) ingrowth of mineralized bone after lateral guided bone regeneration (GBR) augmentation of the mandible with different ratios of DBBM and particulate autogenous bone (PAB) at different time points. Material and methods: Twenty‐four minipigs were randomly allocated into three groups. Lateral augmentation in 96 sites (4 in each animal) was performed unilaterally with a standardized quantity of grafting material in each animal with different ratios of DBBM and PAB (50:50, 75:25, 100:0) and autogenous bone block in combination with DBBM and covered with a collagen membrane. The percentage of different tissues in the graft and ingrowth of mineralized bone was assessed by histomorphometrical and histological analyses after 10, 20, and 30 weeks, respectively. Results: The POB was 54% (50:50), 50% (75:25), and 48% (100:0) after 10 weeks, 60% (50:50), 61% (75:25), and 60% (100:0) after 20 weeks, and 63% (50:50), 62% (75:25), and 62% (100:0) after 30 weeks. There was no significant difference between the groups at any time points. There was a significant increase in POB and a significant decrease in NMT for 75:25 and 100:0 from 10 to 30 weeks. All ratios demonstrated a non‐complete ingrowth of mineralized bone into the graft after 10 weeks and complete mineralization after 30 weeks. Conclusion: Within the limitations of the present study, it seems like addition of autogenous bone to DBBM for LRA did not affect the bone formation nor graft incorporation after 10–30 weeks of healing. However, a prolonged healing time seems to result in an increased POB for all ratios. [ABSTRACT FROM AUTHOR]

Background/aims: Management of maxillofacial trauma in the geriatric population poses a great challenge due to anatomical variations and medical comorbidities. The aim of this study was to analyze the management variables, timing, and outcomes of facial fractures in elderly patients (aged 70 years or more) at several European departments of oral and maxillofacial surgery.Materials and Methods: This study was based on a systematic computer-assisted database that allowed the recording of data from all geriatric patients with facial fractures from the involved maxillofacial surgical units across Europe between 2013 and 2017.Results: A total of 1334 patients were included in the study: 665 patients underwent closed or open surgical treatment. A significant association (P < .005) was found between the presence of concomitant injuries and a prolonged time between hospital admission and treatment. The absence of indications to treatment was associated with comorbidities and an older age (P < .000005).Conclusions: Elderly patients require specific attention and multidisciplinary collaboration in the diagnosis and sequencing of trauma treatment. A prudent attitude may be kept in selected cases, especially when severe comorbidities are associated and function is not impaired. [ABSTRACT FROM AUTHOR]