[Pre-implantation iliac graft in the sinus. Retrospective study of the complications encountered in 100 cases].
METHODS
This series included 60 patients operated on between 1996 and 1998. Preoperative work-up included a x-ray study bone quality, preparation of the buccal cavity and assessment of the rhinosinus. We used the surgical technique described by Boynes and Tatum with modifications. The bone graft, mean 16 cm2 was fixed with a stud and clamp assemble or a long screw through the gingival crest, or with a microscrew on the lateral wall of the maxillary sinus. Minimal follow-up was two years.


RESULTS
Mean age was 54 years (range 20-80). There were only two minor (hematoma) donor site problems. At the receiver site, there were 30 perforations of the mucosa that had no effect on the graft vitality. During the postoperative period, there were 2 hematomas that resolved spontaneously and 20 cases of dysesthesia in the V2 territory. Mid-term outcome (15 days to 6 months postoperatively) showed: 4 graft infections requiring removal in 3 cases and 6 partial resorptions requiring a new parietal bone graft in 3 cases.


CONCLUSIONS
The iliac bone graft provided abundant cancellous tissue. The mid-term outcome was satisfactory although the postoperative problems resolved more slowly and were more painful than when harvesting a parietal graft. Mucosal perforations were frequent but reparable and did not increase postoperative morbidity. Infection was the most severe complication. Our incidence (3%) was slightly higher than reported in the literature. A possible explanation would be the mean height of the graft (18-20 mm) and the severity of the atrophies treated.
Service de Chirurgie Maxillo-Faciale et Stomatologie, CHU Trousseau, 37044 Tours.
D
D
Goga
G
G
Romieux
B
B
Bonin
A
A
Picard
A
A
Saffarzadeh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001862:Bone Resorption / Q000209:etiology; D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007085:Ilium / Q000601:surgery; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000293:injuries; D013516:Oral Surgical Procedures, Preprosthetic / Q000009:adverse effects* / Q000295:instrumentation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology