Análise da morbidade pós-operatória de áreas doadoras das regiões de sínfise e ramo mandibular para procedimento de enxerto ósseo autógeno em reabilitação com implantes: estudo prospectivo comparativo in vivo

Abstract

This prospective study focused on a comparative analysis of the postoperative morbidity of symphysis and mandibular ramus donor areas for the autogenous bone graft procedure in dental implant patients. A total of 16 patients (10 women and 6 men, average age of 51.6 ± 9.4 years) were distributed in two groups (n = 8): SG – symphysis and RG – mandibular ramus. Four equal and standardized evaluations were performed (T0, T10, T30, and T60) to perceive the pain, edema, healing process, and sensitivity. This study used the surface sensitivity test, the visual analogue scale test, the application of two questionnaires (self-evaluation over seven days) and intra and extraoral clinical evaluations. The variables were described in absolute and relative frequencies, and their differences were compared using the Fischer and Kruskal-Wallis tests. The significance level established was p < 0.05, using STATA 15 analyses. In the first postoperative week, the SG patients presented higher levels of pain, with a greater need for medication (p < 0.05). Edema was reported in a more expressive manner by the RG patients (p < 0.05). OHIP-14 showed that the quality of life of the patients was not harmed, especially those from the SG group. Cronbach’s alpha showed a reliability of 0.89, presenting three distinct days (1, 3, and 7) with a significant difference for “pain and sensitivity” (p = 0.042) and “pain, edema, and sensitivity” (p = 0,027). Over time, the sensitivity showed no sharp impact on patients from both groups. The “moderate” pain remained over time (T10-T60) in one of the SG patients. No patient presented infection or dehiscence of the stitches. No statistically significant differences were observed in the healing process (p > 0.05). It can be concluded that patients operated on in the symphysis region exhibited a lower incidence of edema, good healing process, better sensorineural recovery and less damage to quality of life in the first postoperative week.