Analysis of complications following augmentation with cancellous block allografts.
BACKGROUND
Bone grafting may be associated with soft and hard tissue complications. Recipient site complications encountered using cancellous block allografts for ridge augmentation are analyzed.


METHODS
A total of 101 consecutive patients (62 females and 39 males; mean age 44 ± 17 years) were treated with implant-supported restoration of 137 severe atrophic alveolar ridges augmented with cancellous bone-block allografts. Alveolar ridge deficiency locations were classified as anterior maxilla (n = 58); posterior maxilla (n = 32 sinuses); posterior mandible (n = 32); and anterior mandible (n = 15). A total of 271 rough-surface implants were placed. Recipient site complications associated with block grafting (infection, membrane exposure, incision line opening, perforation of mucosa over the grafted bone, partial graft failure, total graft failure, and implant failure) were recorded.


RESULTS
Partial and total bone-block graft failure occurred in 10 (7%) and 11 (8%) of 137 augmented sites, respectively. Implant failure rate was 12 (4.4%) of 271. Soft tissue complications included membrane exposure (42 [30.7%] of 137); incision line opening (41 [30%] of 137); and perforation of the mucosa over the grafted bone (19 [14%] of 137). Infection of the grafted site occurred in 18 (13%) of 137 bone blocks. Alveolar ridge deficiency location had a statistically significant effect on the outcome of recipient site complications. More complications were noted in the mandible compared to the maxilla. Age and gender had no statistically significant effect.


CONCLUSIONS
Failures caused by complications were rarely noted in association with cancellous block grafting. The incidence of complications in the mandible was significantly higher. Soft tissue complications do not necessarily result in total loss of cancellous block allograft.
Chaushu
Gavriel
G
Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. gabi.chaushu@gmail.com
Mardinger
Ofer
O
Peleg
Michael
M
Ghelfan
Oded
O
Nissan
Joseph
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects*; D016025:Bone Transplantation / Q000009:adverse effects*; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008439:Maxillary Diseases / Q000601:surgery; D008443:Maxillary Sinus / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D009059:Mouth Diseases / Q000209:etiology; D009061:Mouth Mucosa / Q000473:pathology; D011183:Postoperative Complications; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D015921:Dental Implants; D008567:Membranes, Artificial