Patient experience following iliac crest-derived alveolar bone grafting and implant placement.

BACKGROUND: The objective of this study was to assess patient-reported outcomes such as satisfaction and quality of life after advanced alveolar bone augmentation with anterior iliac crest grafting and implant treatment in orally compromised patients. METHODS: This cross-sectional retrospective cohort study included 59 patients (29 women and 30 men) with major functional problems, who underwent advanced alveolar augmentation with autologous iliac bone grafts during a 100-year period (2002-2012). The self-administered questionnaire included 36 validated questions related to (1) demographics, (2) perceived general and oral health, (3) donor site and hospitalization, (4) status of implants and/or prosthesis, and (5) oral health-related quality of life (OHRQoL). RESULTS: Questionnaires were completed by 44 patients: 24 women and 20 men (response rate, 74.6%). Most patients reported good tolerance of the operative iliac bone harvesting (85%) and implant (90%) procedures. Post-operative pain at the donor site was reported by 38%, lasting 18.1 ± 16.1 days. An average of 4.3 ± 3.5 days of hospitalization and 20.2 ± 18.5 days of sick leave was reported. The overall satisfaction with prosthetic reconstruction was 90.5%. OHRQoL was reported with a mean Oral Health Impact Profile-14 (OHIP-14) score of 8.4. CONCLUSION: Favorable OHRQoL and satisfaction were reported after advanced reconstruction of alveolar ridges with iliac crest-derived grafting and implants in severely compromised patients. However, this treatment requires substantial resources including hospitalization and sick leave.

Effect of compressive force on human osteoblast-like cells and bone remodelling: an in vitro study.

OBJECTIVE: The aim of this study was to determine the effect of continuous compressive force (CF) on expression by human alveolar bone-derived osteoblasts (HOBs) of some specific molecules involved in bone remodelling. DESIGN: HOBs were cultured with or without CF (control, 2.0, 4.0gcm(-2)) for 1, 3 and 7 days. Expression of alkaline phosphatase (ALP), type I collagen (Col I), osteopontin (OPN), osteocalcin (OCN), transcription factor Runx2, receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG) and prostaglandin E2 (PGE2) was analysed by real-time-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and/or immunostaining. RESULTS: The results revealed that CF upregulated ALP and Col I expression at both messenger RNA (mRNA) and protein levels but did not affect expression of OPN and OCN mRNA. Runx2 mRNA was inhibited by CF, which also altered the expression of molecules involved in osteoclastogenesis, by enhancing RANKL expression and suppressing OPG expression. At 4.0gcm(-2) of CF, the expression of RANKL and PGE2 was significantly upregulated. CONCLUSION: The results suggest that initial application of CF on HOBs can simultaneously affect expression of markers related to both osteogenesis and osteoclastogenesis.