Patients’ appreciation of pre-implant augmentation of the severely resorbed maxilla with calvarial or anterior iliac crest bone:a randomized controlled trial

Abstract

Background Little is known about the impact of bone graft harvesting for pre-implant augmentation of the maxilla from a patient’s perspective. To assess patient-reported outcome measures (PROMs) related to augmentation of the extremely resorbed edentulous maxilla with calvarial or anterior iliac crest bone. Materials and methods For this randomised controlled trial, 20 consecutive edentulous patients needing extensive pre-implant surgery of the maxilla were randomly assigned to either calvarial (n = 10) or anterior iliac crest (n = 10) bone harvesting. Patient reports on procedure-related satisfaction, questionnaires on oral functionality (denture satisfaction, chewing ability) and oral health-related quality of life (OHIP-49NL) and subjective donor site-related outcomes (e.g. of post-operative pain, scar formation, physical mobility) were assessed. Results Irrespective of the harvesting site, patients were generally satisfied (median VAS score 93 (86–99) mm, p = 0.400) with the procedure and its final results. Post-operative pain was mild (median 40 (20–40) mm) and decreased to no pain (4 (0–16) mm) within 14 days. Early post-operative pain was significantly higher following anterior iliac crest harvesting (p < 0.00). Impact on physical mobility, daily functioning and satisfaction with the scar formation were similar in both groups. Conclusions The assessed PROMs confirmed that bone graft harvesting from the calvarium or anterior iliac crest is an appropriate procedure, reflected by high levels of satisfaction, minor long-term sequela and improvement of perceived oral health. For clinical decision-making, decisions can be based on individual features and preferences. Trial registration NTR, NTR3968, registered 1 July 2013.

Patient’s perception of recovery after maxillary sinus floor augmentation with autogenous bone graft compared with composite grafts: a single-blinded randomized controlled trial

“…MSFA with autogenous bone graft used alone or in combination with different ratios of bone substitutes generates more newly formed bone, higher bone-toimplant contact, and earlier bone formation compared with the use of a bone substitute alone [13,[29][30][31]. However, harvesting of extraoral and intraoral autogenous bone graft negatively influences postsurgical OHRQoL due to increased pain, impaired eating and speaking ability, sleep impairment, limitation in daily routine, and sick leave [12,[32][33][34]. Patient's perception of recovery is therefore strongly associated with the surgical procedure, absence of pain, rapidly recovery of oral function and return to normal lifestyle.…”

Calvarial bone grafts to augment the alveolar process in partially dentate patients: a prospective case series

“…Calvarial bone can be harvested safely and has been shown to be accompanied by minor morbidity with low direct postoperative pain levels. The patient-reported outcome measures confirmed that bone graft harvesting from the calvarium is an appropriate procedure, reflected by high levels of satisfaction, minor long-term sequela and improvement of perceived oral health [5]. A limitation of calvarial bone harvesting may be visible scarring in the bald patient, and possible contour deficits afterwards [5].…”

“…Calvarial bone grafts can serve as an alternative to anterior iliac crest bone grafts. Major advantages of harvesting calvarial bone is the lower early donor site morbidity [4,5] and less resorption of the bone graft during follow-up [6]. A limitation is possible scar visibility in bald patients or palpable contour deficits [5].…”

Harvesting anterior iliac crest or calvarial bone grafts to augment severely resorbed edentulous jaws: a systematic review and meta-analysis of patient-reported outcomes

“…The full texts of the remaining 76 reports were screened and subsequently 43 reports were included. Among these, three articles included data from studies described in other articles as well 17,18,30,31,34,35 ; thus the data from both reports were combined. Finally, 40 studies were included for data collection and quality assessment (Fig.…”

“…The techniques used for calvarial harvesting were similar to that described by Tessier, 59 Kellman, 60 and Schortinghuis. 5,10,[16][17][18] The information on the prevention of intracranial perforations and filling of the contour defect varied. The calvarial defects were repaired by means of synthetic bone substitutes, such as polymethyl methacrylate (PMMA) 17,19,43 or titanium mesh or calcium phosphate cement.…”