Day Care Surgery for Unilateral Alveolar Bone Grafting of Residual Clefts With Mandibular Symphyseal Bone-A Prospective Questionnaire Study.

OBJECTIVE: To evaluate patients' experiences of shortened hospitalization in relation to bone grafting of unilateral alveolar clefts with mandibular symphyseal bone grafts. DESIGN: Prospective cohort questionnaire study. SETTING: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. PATIENTS: Thirty-nine (male n = 26, female n = 13) patients with unilateral residual clefts after primary reconstruction, mean age 10.4 years. INTERVENTIONS: All patients underwent a standardized procedure with closure of the alveolar defect using mandibular symphyseal bone grafts. Patients were discharged within a day after surgery. Within 24 hours after discharge from surgery, patients and their parents filled in a 14-item psychometric questionnaire assessing the quality of their recovery. For all questions, a visual analogue scale (VAS) (0-10) was used. MAIN OUTCOME MEASURE: Patients' experience of shortened hospitalization in relation to secondary bone grafting of alveolar defects. Factors influencing the overall experience were measured using a VAS scale. RESULTS: A significant correlation between "Information from the hospital" and feeling worried and anxious was found (P = .04). Additionally, the ability to sleep correlated with pain (P = .003) and with nausea (P = .001). CONCLUSIONS: Although this study included a limited number of patients, the findings suggest that treatment of alveolar residual cleft with bone grafting from the mandibular symphyseal region in a day care surgery setting is characterized by very high patient satisfaction.

Factors influencing severity of peri-implantitis.

OBJECTIVES: To retrospectively assess the influence of potential risk factors, primarily smoking and a prior history of periodontitis, on the severity of peri-implantitis in patients referred for treatment of peri-implantitis. MATERIALS AND METHODS: Among 98 patients referred for treatment of peri-implantitis, 34 patients fulfilled the inclusion criteria: one or several implants with peri-implant marginal bone loss ≥2 mm concomitant with bleeding and/or pus on probing. Information about health status, smoking habits, reason for tooth loss, and performed implant treatment were obtained from the patient charts and interviews. Moreover, a detailed extra- and intraoral examination was performed, including intraoral radiographs of all implants. Risk factors were evaluated by a two-way anova at patient level. RESULTS: Smoking and a prior history of periodontitis were significant risk factors for increased severity of peri-implantitis. Furthermore, the presence of both smoking and a prior history of periodontitis did not further increase the severity of peri-implantitis, as compared to either of these two factors alone. Poor marginal fit of the suprastructure and extensive gingival imitations on implant-supported fixed full prostheses may also be potential risk factors. CONCLUSIONS: The study indicated that smoking and a prior history of periodontitis were important risk factors for increased severity of peri-implantitis, while concomitant presence of these two risk factors did not further increase the severity of peri-implantitis, as compared to either of these two risk factors alone. Therefore, early diagnosis and adequate treatment of peri-implantitis are important in patients with a prior history of periodontitis and in smokers to minimize the risk of advanced peri-implantitis in conjunction with focus on known risk factors, including meticulous infection control before implant treatment and a systematic maintenance care program.