{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:58:18Z","timestamp":1790593098486,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Maxillary sinus floor augmentation (MSFA) via the lateral approach is a well-established procedure for prosthetic rehabilitation of atrophic posterior maxillae. However, late complications are often nonspecific, with an incompletely understood aetiology. We evaluated patients with atypical late complications post-MSFA with bovine xenohybrid bone substitute NaturesQue SemOss B (BEGO GmbH, Bremen, Germany), describing their presentation, management, and outcomes. Methods: This retrospective, complication-selected clinical case series examined 47 patients who underwent lateral window MSFA with this graft from September 2020 to March 2023 in a single university department. Twelve complication cases were identified during the study period. Atypical late complications were defined as graft-associated clinical and\/or radiological adverse outcomes, excluding peri-implantitis, that first manifested &gt; 6 mo postoperatively. Baseline characteristics, perioperative findings, conservative and surgical management (including graft removal and reaugmentation), histology, and follow-up were assessed. Results: Twelve complication cases were identified among 47 patients treated during the study period. Seven experienced implant loss; seven, partial or complete lack of graft osseointegration; six, pain; and seven, signs of sinus infection. Histological analysis (6\/12) revealed lymphocytes, plasma cells, and fibroblastic changes without detectable macrophages. No intraoperative complications were observed. Conclusions: Atypical late complications affected 25.5% of the patients. Despite comprehensive clinical, radiological, and histological assessments, the aetiology remained unclear, and the findings did not indicate a peri-implantitis-type infection; we hypothesised impaired early phase wound healing These patients were amenable to repeat augmentation post-non-osseointegrated graft removal, although larger studies are required.<\/jats:p>","DOI":"10.3390\/diagnostics16193098","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:16:28Z","timestamp":1790244988000},"page":"3098","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Complications After Maxillary Sinus Floor Augmentation with a Bovine Xenohybrid Bone Graft: A Retrospective Clinical Case Series"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-6563","authenticated-orcid":false,"given":"Patrick","family":"Bandura","sequence":"first","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Philipp","family":"Schnell","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claas Willem","family":"Molsen","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sophia","family":"Bandura","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-0409","authenticated-orcid":false,"given":"Pascal","family":"Gr\u00fcn","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1410-6543","authenticated-orcid":false,"given":"Marius","family":"Meier","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Dental Practice, 9490 Vaduz, Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0606-4541","authenticated-orcid":false,"given":"Maximilian","family":"Jung","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2217-446X","authenticated-orcid":false,"given":"Flora","family":"Turhani","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6454-7820","authenticated-orcid":false,"given":"Sebastian","family":"Fitzek","sequence":"additional","affiliation":[{"name":"Medical Image Analysis & Artificial Intelligence (MIAAI) Group, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, 3500 Krems An Der Donau, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7311-3191","authenticated-orcid":false,"given":"Dritan","family":"Turhani","sequence":"additional","affiliation":[{"name":"Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"},{"name":"Clinical Application of Artificial Intelligence in Dentistry (CAAID) Group, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstrasse 124, A-3500 Krems-Stein, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Acerra, A., Caggiano, M., Aliberti, A., Langone, M., and Giordano, F. 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