Comparison of morbidity‐related parameters between autologous and allogeneic bone grafts for alveolar ridge augmentation from patients' perspective—A questionnaire‐based cohort study

Abstract

IntroductionAlveolar ridge augmentation is often required before dental implant placement. In this context, autologous bone grafts are considered the biological gold standard. Still, bone block harvesting is accompanied by some serious potential disadvantages and possible complications, such as pain, bleeding, and nerve irritation. Several studies aimed to compare autologous to allogeneic bone grafts concerning bone quality and implant survival rates; this is the first prospective study analyzing and comparing morbidity‐related parameters after alveolar ridge augmentation using autogenous and allogeneic bone blocks from patients' perspective.MethodsUsing a questionnaire, 36 patients were asked to evaluate the surgery as well as the post‐operative period concerning pain, stress, sensibility deficits, satisfaction with, and consequences from the surgery as well as the preferred procedure for future alveolar ridge augmentations.ResultsNo significant differences were shown regarding stress and pain during and after surgery, whereas the rate of nerve irritations was twice as high in the autologous group. The swelling was significantly higher in patients with autologous bone blocks (p = 0.001). Nevertheless, the overall satisfaction of patients of both groups was very high, with over 8/10 points.ConclusionsThe swelling was the main reason for patients' discomfort in both groups and was significantly higher after autologous bone augmentation. Since this side effect seems to be a highly relevant factor for patients' comfort and satisfaction, it needs to be discussed during preoperative consultation to allow shared decision‐making considering the anticipated morbidity.

Bone reconstruction of extensive maxillomandibular defects in adults

“…17 Nevertheless, block harvesting is associated with relevant donor site morbidity. 13 Although intra-oral onlay grafts from the chin were used earlier in 1965, 157 later on, at the end of the 20th century, ramus grafts became more common. 158,159 This is because of the more extensive harvesting morbidity of chin grafts with common sensitivity disturbances, 160 a problem that seemed to be overestimated according to recent comparative data.…”

“…10,11 A comprehensive overview of bony maxillary and mandibular reconstructions followed in the first half of the 20th century, published by Hjørting-Hansen. 12 In 1950, Converse in the USA 13 and Clementschitsch in Austria 14 started to successfully transplant nonvascularized autologous grafts from the iliac crest onto the maxillofacial area. The availability of antibiotic prophylaxis led to further development in this field.…”

Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions

“…The precise incidence of nerve injuries remains elusive due to the likely significant number of unreported cases. The prevalence of (temporary) nerve injuries varies across specific dental procedures, with reported rates of 0.15% for surgeries like cystectomies or block anesthesia of the inferior alveolar nerve [ 6 ], 8–12% for wisdom tooth removal [ 7 – 9 ], exceeding 30% in dental implantology [ 10 , 11 ], and reaching up to 60% in orthognathic surgery [ 12 , 13 ]. Nevertheless, permanent nerve injuries occur with considerably less frequency.…”

Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates

“…When using autogenous bone blocks, most patients reported their preference for the retromolar region as the donor site [ 4 ], which has been shown to have a low donor site morbidity [ 5 ]. However, some patients experienced postoperative pain during chewing, swelling episodes, and bleeding [ 6 – 8 ]; a particular risk of infection, mucosal dehiscences, and primarily temporary neurosensory disturbances is described [ 9 , 10 ]. Allogeneic bone is a promising alternative to autogenous material for dental augmentation with clinically similar results but is readily available without any donor site morbidity [ 11 – 14 ].…”

“…In the literature, a further advantage of allogeneic bone shells compared to autogenous bone obtained from the mandibular ramus is the shorter time of surgery and a subsequent decrease in infection risks as well as general donor site morbidity [ 10 , 27 ]. To our knowledge, clinical trials have yet to prove this.…”