Treatment and Quality of Life Outcomes Following Guided Bone Regeneration

Method: Ten non-smokers (mean age 60±5 yrs; 7 males), treatment planned to receive GBR for a single large size (≥2 adjacent missing teeth) defect, were recruited. Ridge width (RW) and height (RH), flap thickness (FT), keratinized tissue width (KTW) and clinical evaluation of the wound were recorded at surgery, 10 days, 1 month and 4 months. Wound fluid was sampled. Pre- and post-surgical evaluation of perceived stress, depressive symptoms, anxiety, coping and general health assessments were conducted as well as General Health (GHQ-12) and Oral Health Related Quality of Life (OHIP-49) questionnaires.

Result: Size and anatomic location (posterior sextants) of wounds were similar. Average RW and RH gain was 1 mm (range: -1.6 to +2.7) and 1.13mm (-6 to +5.4), respectively. Average FT was 1.45 mm (0.6-2.5). KTW remained unchanged. Primary wound closure was obtained in all cases except one. Nine (90%) and 4 (40%) wounds had exposure at 10 days and 1 month, respectively. Wound fluid volume decreased 2 fold by 1 month. GHQ-12 and OHIP-49 scores were stable. Four patients reported discomfort and moderate pain at 10 days. Pre-surgical depressive symptoms were a clinical cut-off ≥ 16 for two patients. Five additional patients had elevated depressive symptoms at 10 days; these scores decreased toward the individual’s baseline by 4 months. During early healing, some changes were also noted in perceived stress and sleep quality.

Conclusion: Within the limits of this study, it appears that GBR outcomes to treat large size defects are not predictable. Some, but not all, quality of life scores are affected.