Assessment of bone grafts placed within an oral and maxillofacial training programme for implant rehabilitation


Dr Arun Chandu
Department of Oral and Maxillofacial Surgery
Royal Dental Hospital of Melbourne
720 Swanston Street
Carlton VIC 3053


Background:  This study aimed to review the survival of bone grafting procedures, performed by surgical trainees and assess factors affecting survival of these bone grafts as an adjunct to implant rehabilitation.

Methods:  Data were collected from patients between 2003 and 2009 receiving bone grafting. Graft failure was defined as any complete or partial graft loss, graft which had to be removed or regrafted, or was unable to have an implant placed. Implant survival rates were not assessed in this study.

Results:  Seventy-five patients received 86 bone grafts over a period of 7 years. Overall graft survival was 87.3% with 7 complete graft failures (8.1%) and 3 partial graft failures (4.6%). All failed grafts were of the block graft type, predominately in the anterior maxilla. The main reason for failure was secondary infection. Other complications occurred in about 27% of patients. Factors significantly increasing the risk of graft failure included use of bone block augmentation (p = 0.001), mixed autogenous/bone substitute grafts (p = 0.007) and diabetes mellitus (p = 0.006). Smoking was not found to affect graft survival.

Conclusions:  Good results were found in a series of patients treated in an oral and maxillofacial training programme. Care should be taken in regards to planning block grafts in diabetic patients.