Patient’s perception of recovery after osteotome-mediated sinus floor elevation with Bio-Oss collagen compared with no grafting material: a randomized single-blinded controlled trial

Abstract

Background Osteotome-mediated sinus floor elevation with or without a grafting material is associated with high implant survival, intrasinus bone gain, and low frequency of complications. However, patient’s perception of recovery and satisfaction with the surgical intervention are rarely reported. The objective of the present randomized controlled trial was to assess patient’s perception of recovery after osteotome-mediated sinus floor elevation with Bio-Oss collagen compared with no grafting material. Forty healthy patients were randomly allocated to Bio-Oss collagen or no grafting material. Oral health-related quality of life was assessed by Oral Health Impact Profile-14 at enrollment. Patient’s perception of recovery was assessed by self-administrated questionnaires and visual analog scale evaluating pain, social and working isolation, physical appearance, duration and quality of life alterations, eating and speaking ability, diet variations, and sleep impairment after 1 week and 1 month, respectively. Descriptive statistics was expressed as mean percentage with standard deviation. Correlation between impaired oral health-related quality of life, age, gender, and recovery were assessed by T test. Level of significance was 0.05. Results Osteotome-mediated sinus floor elevation is associated with high patient satisfaction, limited postoperative discomfort, and willingness to undergo similar surgery. Influence on patient’s daily life activities seems to be minimal and limited to the first postoperative days. Most patients managed to return to work and their routine daily activities after 0-2 days. Impaired preoperative oral health-related quality of life, gender, or younger age seems not to predispose for delayed recovery. However, number of days with pain, eating difficulties, and sleep disturbances were significantly increased with Bio-Oss collagen compared with no grafting material (P<0.05). Conclusion Patient’s discomfort seems to be minimal and limited to the first postoperative days following osteotome-mediated sinus floor elevation with or without a grafting material. Impaired preoperative oral health-related quality of life, gender, or younger age seems not to predispose for delayed recovery.

Minimal invasiveness in the transcrestal elevation of the maxillary sinus floor: A systematic review

“…However, specific scores related to number of days with pain, eating difficulties, and sleep disturbances were significantly increased in the graft group. 56 Contrasting findings were reported for the adjunctive effect of the graft on vertical endo-sinus bone gain. Whereas one study reported greater bone gain and higher proportions of implants completely embedded in a radiopaque area for the graft group 53 even at longer follow-up intervals, 57,58 another study 54 or its follow-up 59 failed to find a significant adjunctive effect of the graft.…”

“…Two studies showed a tendency to higher incidence in the graft group, 52,54 whereas membrane perforation occurred only in the graftless group in the remaining study. 56 In general, biological complications manifested with low incidence rates irrespective of the adjunctive use of a graft, and peri-implantitis leading to implant loss (when occurred) was limited to one case per treatment arm. No evident differences were found in the incidence of biological complications or implant loss due to peri-implantitis in the studies available.…”

“…The list of studies comparatively evaluating the invasiveness of the intervention when a transcrestal sinus floor elevation procedure was performed with or without a graft material, [52][53][54][55][56] their follow-up [57][58][59] and their main findings are summarized in Table 5.…”

“…Membrane perforation was the only intraoperative complication, occurring in three out of five studies. 52,54,56 In two studies, the reported incidence was 0%. 53,55 The incidence of membrane perforation was low in both the graft and graftless groups, with no major intergroup differences.…”

“…The risk of bias as evaluated in studies comparatively evaluating the invasiveness of transcrestal sinus floor elevation performed with or without a graft material is illustrated in Figure 4C. Among randomized controlled trials, two studies 54,56 and the 10-year follow-up of the study by Si and coworkers 59 were judged to be of low risk of bias, one study 53 and its follow-up 57,58 were classified as having "some concerns," and one study 55 was characterized by a high risk of bias. One nonrandomized controlled study 52 was classified as "No information".…”