Objective: To compare healing of collagenated and non-collagenated xenografts used for maxillary sinus floor elevation. Materials and Methods: Two different xenografts were used: deproteinized bovine bone (DBBM group) and collagenated corticocancellous porcine bone (collagenated group). Healing was studied after 2, 4, and 8 weeks. The loss of dimensions of the elevated area and the percentages of new bone, xenograft remnants, osteoclastic zones, vessels, inflammatory infiltrates, and soft tissues were analyzed. Three regions were evaluated: close to the bone walls (bone wall region), subjacent the sinus mucosa (submucosa region), and the center of the elevated area (middle region). The primary variables were the percentage of new bone and xenograft remnants. Results: Between 2 and 8 weeks, the elevated areas showed a reduction of 16.3% and 52.2% in the DBBM and collagenated groups, respectively (p < 0.01 between the two areas after 8 weeks). After 8 weeks, the highest content of new bone was observed in the bone wall region, which was higher in the collagenated group than in the DBBM group (41.6% and 28.6%, respectively; p < 0.01). A similar quantity of new bone was found between the two groups in other regions. A higher percentage of vessels in all regions evaluated (p < 0.01) and soft tissue in the sub-mucosa region (p < 0.05) was found in the collagenated group than in the DBBM group. Conclusions: The present study showed that both xenografts allowed new bone formation. In comparison with the non-collagenated xenograft, the collagenated xenograft underwent higher resorption, resulting in greater shrinkage of the elevated space after sinus lifting and a higher content of new bone in the regions close to the bone walls. Clinical relevance: In this study, the region adjacent to the bone wall showed the highest new bone content. This region resembles the base of the sinus, closest to the sinus floor and walls, and is the most important region from a clinical point of view because it is where the implant will be installed. Residues of the biomaterial remained after 8 weeks of healing. Other reports have shown that these biomaterial residues may interfere with the integration of implants.

This study evaluates the cost-effectiveness of implants (Implant), insurance fixed dental prosthesis (IFDP) and private fixed dental prosthesis (PFDP) for a single intermediate missing tooth in the molar region to calculate the Incremental Cost Effectiveness Ratio (ICER). The Markov model for cost-effectiveness analysis of the Implant, IFDP and PFDP was carried over maximum 30 years. The starting age for prosthetic treatment was decided to be 50 years. The General Oral Health Assessment Index (GOHAI) was used for the indicator of effectiveness as an oral health QOL value. The GOHAI value was collected from patients who visited the Department of Oral Implantology of Osaka Dental University between September 2014 and March 2016. In addition, the Tornado diagram was drawn and Monte-Carlo simulations made for sensitivity analysis. From the analysis of survey of QOL of each stage and treatment, the selection of an Implant led to a higher QOL value than FDP. However, the estimated 30-year cost for IFDP was lower than Implant. It also became evident that PFDP had an extended dominated condition compared with IFDP and Implants. The ICER on the Implant versus IFDP was €1423.00. These results suggest that a better of QOL value can be obtained from an Implant than from IFDP or PFDP. An evaluation form using an indexed scale for oral health-related aspects needs to be developed that is also consistent as an indicator of effect.

Background: This investigation focused on the influence of collagen on the integrity of the Schneiderian membrane during maxillary sinus augmentation in a rabbit model. The aim of this study was to elucidate the relationship between membrane integrity and bone regeneration in augmented maxillary sinuses using collagenated and non-collagenated grafts, through detailed histological and histomorphometric analyses. Methods: In this forward-looking, randomized, split-mouth design, bilateral maxillary sinus augmentation was conducted on 12 rabbits. One sinus was filled with deproteinized bovine bone material (DBBM) as the grafting material (non-collagenated; control), while a combination of DBBM particles integrated with 10% porcine-derived type I collagen was used in the contralateral sinus (collagenated; test). Histological analyses were carried out following healing periods of 2 and 12 weeks. Results: At the 2-week time point, six sites of thinned mucosa (<40 µm) and no perforations were observed in the collagenated group, while twenty-one thinned mucosa sites (p = 0.027 between test and control) and two perforations (p = 0.175 between test and control) were found in the non-collagenated group. After 12 weeks of healing, the number of sites with thinned mucosa was 20 in the collagenated group and 19 in the non-collagenated group, with four perforations observed in each group. These perforations were distributed across three sinuses in the collagenated group and two sinuses in the non-collagenated group. No statistically significant differences were found between the groups. Conclusions: The addition of 10% collagen to deproteinized bovine bone mineral initially provided protection against mucosal thinning and perforation after 2 weeks of healing. However, by week 12, this protective effect diminished, resulting in similar rates of mucosal thinning and perforations in both groups.