Patient-reported outcomes and complication rates after lateral maxillary sinus floor elevation: a prospective study.

OBJECTIVES: Oral surgery morbidity is highly variable based on patients' characteristics and kind of surgical intervention. However, poor data are available in the literature regarding patient outcomes after oral surgery. The aim of this retrospective study was to evaluate patient-reported outcome and complication rates after maxillary sinus floor elevation. MATERIALS AND METHODS: Data from the records of patients undergoing maxillary sinus elevation have been collected from a private dental office. Patient-reported outcome has been assessed using a 100-mm visual analog scale to evaluate the post-operative pain (VASpain) experienced in the first week following surgery and visual rating scales to evaluate discomfort level (VRSdiscomfort: 0 to 4) and willingness to repeat the same surgical procedure (VRSwillingness: 0 to 3). Analgesics intake, swelling onset and duration, and ecchymosis have been also recorded. RESULTS: VASpain showed moderate values in the first 2 days (< 50) post-surgery, with a tendency to progressively decrease over the next 2 days. Average assumption of painkillers was 3.93 ± 3.03. Discomfort level (VRSdiscomfort) after surgery was low (median: 1; IR: 1-0), while willingness to undergo the same surgical procedure was very high (77.63% of patients). Swelling and ecchymosis were experienced by 97.36% and 51.32% of patients, respectively, with a mean duration of 4.09 ± 1.43 and 2.21 ± 2.31 days, respectively. Membrane perforation occurred in 4 cases. Other post-operative complications were not observed. CONCLUSIONS: Maxillary sinus grafting is a safe procedure, with a low complication rate and moderate morbidity that is well tolerated by patients. Particular attention is needed in case selection, surgical planning and operator expertise. CLINICAL RELEVANCE: The analysis of patient-reported outcomes can be of great help in surgical planning and in providing correct and adequate treatment.

Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study.

BACKGROUND: One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. METHODS: Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. RESULTS: All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. CONCLUSIONS: The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.

Translucent fiber post cementation using light- and dual-curing adhesive techniques and a self-adhesive material: push-out test.

OBJECTIVES: To compare, by means of the push-out test, the interfacial strength of two dual resin cements and one light-curing cement when used in translucent fiber post cementation. METHODS: Thirty-nine, endodontically treated, single canal, extracted human bicuspids were selected. Translucent fiber posts (RelyX Fiber Post) were luted into the root canal using three resinous luting systems (n=13). Dual-curing technique (DC): the specimens were treated with Excite DSC and RelyX ARC, which were light-cured simultaneously through the post for 60s. Self-adhesive dual-curing technique (SADC): the specimens were treated with RelyX Unicem, which was light-cured through the post for 60s. Light-curing technique (LC): the specimens were treated with Excite DSC and Tetric Flow, which were simultaneously light-cured through the post for 60s. The specimens were transversally sectioned into six slices in order to perform the push-out test. Data were analyzed by two-way ANOVA followed by the Tukey-Kramer test for post-hoc comparisons at alpha=0.05. RESULTS: At every region, results did not show any statistical difference between the DC and LC techniques. With the LC technique bond strength values were lower at the apical region than those recorded at the coronal and middle regions. At the coronal and middle regions, bond strength values for the SADC technique were lower than those resulting when using the other two techniques. At the apical region, there was not significant difference in bond strength between the luting techniques tested. CONCLUSIONS: The interfacial strength between light-curing cement and root canal is equivalent to the interfacial strength between dual-curing cement and root canal.