Evaluation of the success of anterior iliac crest harvested bone graft in reconstruction of different jaw defects: a retrospective study

Year 2024, Volume: 7 Issue: 4, 371 - 377, 30.07.2024

Yusuf Nuri Kaba , Ahmet Emin Demirbaş , Cemil Eren , Emrah Soylu , Suheyb Bilge , Alper Alkan

https://doi.org/10.32322/jhsm.1487467

Abstract

Aims: The aim of this study was to evaluate the success of bone grafts obtained from the anterior iliac crest, the recipient and donor site complications in the reconstruction of jaw defects caused by different etiologies in maxillofacial surgery.
Methods: A retrospective cohort study was conducted at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Erciyes University between 2012-2022. It included patients with iliac crest harvested bone grafts due to jaw defect with full records. The primary predictive variable was the type of jaw defect. The primary outcomes were the presence of complications at donor and recipient sites. Secondary outcomes were length of hospital stay and type of complications at donor and recipient sites. The obtained data were analyzed with Kruskal Wallis Test, Pearson’s chi-square test and Fisher’s exact test.
Results: This study included 104 (44 female, 60 male) patients. Complication rate was 21.15%. There was no statistically significant relationship between the type of jaw defect and the success of iliac bone grafts (p=0.257). The most common recipient site complication was resorption in alveolar atrophy groups, the dehiscence in alveolar cleft groups, infection in other reason groups. There was no statistically significant relationship between type of jaw defect and complication types (p=0.524).
Conclusion: The results of the study demonstrate that general success rate was 78.85% in jaw reconstruction with anterior iliac crest harvested bone grafts. The major complication rate causing total graft loss was 13.46%. There was no statistically significant relationship between the type of jaw defect and the success of iliac bone grafts.

Keywords

Jaw defects, iliac crest, reconstruction

Ethical Statement

The study was initiated with the approval of the Erciyes University Clinical Research Ethics Committee. (Date: 2023, Decision No:207)

Supporting Institution

The authors declared that this study has received no financial support.

References

• Ferraz MP. Bone grafts in dental medicine: an overview of autografts, allografts and synthetic materials. Materials (Basel). 2023;16(11). doi:10.3390/MA16114117
• Sethi A, Kaus T, Cawood JI, Plaha H, Boscoe M, Sochor P. Onlay bone grafts from iliac crest: a retrospective analysis. Int J Oral Maxillofac Surg. 2020;49(2):264-271. doi:10.1016/J.IJOM.2019.07.001
• Kessler P, Thorwarth M, Bloch-Birkholz A, Nkenke E, Neukam FW. Harvesting of bone from the iliac crest-comparison of the anterior and posterior sites. Br J Oral Maxillofac Surg. 2005;43(1): 51-56. doi:10.1016/J.BJOMS.2004.08.026
• Wortmann DE, van Minnen B, Delli K, Schortinghuis J, Raghoebar GM, Vissink A. Harvesting anterior iliac crest or calvarial bone grafts to augment severely resorbed edentulous jaws: a systematic review and meta-analysis of patient-reported outcomes. Int J Oral Maxillofac Surg. 2023;52(4):481-494. doi:10.1016/J.IJOM.2022.09.002
• Mertens C, Decker C, Seeberger R, Hoffmann J, Sander A, Freier K. Early bone resorption after vertical bone augmentation-a comparison of calvarial and iliac grafts. Clin Oral Implants Res. 2013;24(7):820-825. doi:10.1111/J.1600-0501.2012.02463.X
• Fasolis M, Boffano P, Ramieri G. Morbidity associated with anterior iliac crest bone graft. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):586-591. doi:10.1016/J.OOOO.2012.01.038
• Chiapasco M, Casentini P, Zaniboni M, Corsi E. Evaluation of peri-implant bone resorption around Straumann Bone Level© implants placed in areas reconstructed with autogenous vertical onlay bone grafts. Clin Oral Implants Res. 2012;23(9):1012-1021. doi:10.1111/J.1600-0501.2011.02262.X
• Kalk WWI, Raghoebar GM, Jansma J, Boering G. Morbidity from lilac crest bone harvesting. J Oral Maxillofac Surg. 1996; 54(12):1424-1429. doi:10.1016/S0278-2391(96)90257-8
• Tosun E, Akkocaoglu M, Tüz HH, Avag C, Göktürk T. Complications associated with anterior iliac bone grafting for the reconstruction of dentoalveolar defects. J Craniofac Surg. 2019;30(4):980-984. doi:10.1097/SCS.0000000000005331
• Hynes PJ, Earley MJ. Assessment of secondary alveolar bone grafting using a modification of the Bergland grading system. Br J Plast Surg. 2003;56(7):630-636.
• Katz MS, Ooms M, Heitzer M, et al. Postoperative morbidity and complications in elderly patients after harvesting of iliac crest bone grafts. Medicina (B Aires). 2021;57(8). doi:10.3390/MEDICINA57080759
• Rawashdeh MA, Telfah H. Secondary alveolar bone grafting: the dilemma of donor site selection and morbidity. Br J Oral Maxillofac Surg. 2008;46(8):665-670. doi:10.1016/J.BJOMS.2008. 07.184
• McLain RF, Techy F. Trephine technique for iliac crest bone graft harvest: long-term results. Spine (Phila Pa 1976). 2021;46(1):41-47. doi:10.1097/BRS.0000000000003702
• Mckenna GJ, Gjengedal H, Harkin J, Holland N, Moore C, Srinivasan M. effect of autogenous bone graft site on dental implant survival and donor site complicatıons: a systematıc review and meta-analysis. J Evid Based Dent Pract. 2022;22(3). doi:10.1016/J.JEBDP.2022.101731
• Grossman MG, Ducey SA, Nadler SS, Levy AS. Meralgia paresthetica: diagnosis and treatment. J Am Acad Orthop Surg. 2001;9(5):336-344. doi:10.5435/00124635-200109000-00007
• Nkenke E, Weisbach V, Winckler E, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic augmentation procedures: a prospective study. Int J Oral Maxillofac Surg. 2004; 33(2):157-163. doi:10.1054/IJOM.2003.0465
• Moura LB, Carvalho PH de A, Xavier CB, et al. Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review. Int J Oral Maxillofac Surg. 2016;45(11):1388-1394. doi:10.1016/J.IJOM.2016.05.004
• van Gemert JTM, van Es RJJ, Van Cann EM, Koole R. Nonvascularized bone grafts for segmental reconstruction of the mandible-a reappraisal. J Oral Maxillofac Surg. 2009;67(7):1446-1452. doi:10.1016/J.JOMS.2008.12.052
• Osborn TM, Helal D, Mehra P. Iliac crest bone grafting for mandibular reconstruction: 10-year experience outcomes. J Oral Biol Craniofac Res. 2018;8(1):25-29.
• Paganini A, Hörfelt C, Mark H. Gender differences in surgical treatment of patients with cleft lip and palate. J Plast Surg Hand Surg. 2018;52(2):106-110. doi:10.1080/2000656X.2017.1348951
• Ural Ç, Bereket C, Sener Ý, Aktan AM, Akpinar YZ. Bone height measurement of maxillary and mandibular bones in panoramic radiographs of edentulous patients. J Clin Exp Dent. 2011;3(1):5-9.
• Yu B, Wang CY. Osteoporosis and periodontal diseases-an update on their association and mechanistic links. Periodontol 2000. 2022;89(1):99-113. doi:10.1111/PRD.12422
• Tache A, Mommaerts MY. Pain management at iliac donor sites after grafting of alveolar clefts. Int J Oral Maxillofac Surg. 2022; 51(1):62-69. doi:10.1016/J.IJOM.2021.05.004
• Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg. 2014; 43(5):606-625. doi:10.1016/J.IJOM.2013.12.004
• van der Meij EH, Blankestijn J, Berns RM, et al. The combined use of two endosteal implants and iliac crest onlay grafts in the severely atrophic mandible by a modified surgical approach. Int J Oral Maxillofac Surg. 2005;34(2):152-157. doi:10.1016/j.ijom.2004.05.007
• Sbordone C, Toti P, Guidetti F, Califano L, Santoro A, Sbordone L. Volume changes of iliac crest autogenous bone grafts after vertical and horizontal alveolar ridge augmentation of atrophic maxillas and mandibles: a 6-year computerized tomographic follow-up. J Oral Maxillofac Surg. 2012;70(11):2559-2565. doi: 10.1016/J.JOMS.2012.07.040
• McGrath CJR, Schepers SHW, Blijdorp PA, Hoppenreijs TJM, Erbe M. Simultaneous placement of endosteal implants and mandibular onlay grafting for treatment of the atrophic mandible: A preliminary report. Int J Oral Maxillofac Surg. 1996; 25(3):184-188. doi:10.1016/S0901-5027(96)80026-9
• Pikos MA. Mandibular block autografts for alveolar ridge augmentation. Atlas Oral Maxillofac Surg Clin. 2005;13(2):91-107. doi:10.1016/J.CXOM.2005.05.003
• Reinert S, König S, Bremerich A, Eufinger H, Krimmel M. Stability of bone grafting and placement of implants in the severely atrophic maxilla. Br J Oral Maxillofac Surg. 2003;41(4): 249-255. doi:10.1016/S0266-4356(03)00078-0
• August M, Tompach P, Chang YC, Kaban L. Factors influencing the long-term outcome of mandibular reconstruction. J Oral Maxillofac Surg. 2000;58(7):731-737. doi:10.1053/JOMS.2000. 7255