[Morbidity of autologous bone harvesting in implantology: Literature review from 1990 to 2015]

Abstract

Introduction: Autogenous bone is commonly used in pre-implant bone reconstructions. Five harvesting sites are frequently used: mandibular symphysis and ramus, iliac crest, calvaria and tibia. One of the deciding criterions among these sites is the donor site morbidity. The purpose of our work was to analyze the intra- and postoperative complications that may occur on the different donor sites.

Material and methods: An automatic and manual search on Medline covering the period 1990-2015 was made. Human studies, in English or French language, detailing the complications linked to bone harvest done for pre-implant surgery were included.

Results: Eighty-three clinical trials or case reports were analyzed. Iliac crest, mandibular symphysis and ramus donor sites were afflicted with the highest pain scores and sensory disturbances. Iliac and tibial bone harvests were complicated by walk disturbances in the first weeks. Some rare neurological complications have been reported after calvarial bone harvest.

Discussion: Although commonly used, iliac crest bone harvest is responsible for significant morbidity. Calvarial harvest is related to the lowest morbidity. It has to be performed by an experienced team in order to reduce the risk of neurologic injury. Regarding intraoral donor sites, mandibular symphysis becomes less popular. Mandibular ramus harvest has the lowest complication rate and is well accepted by patients.

Keywords: Alveolar ridge augmentation; Bone transplantation; Donor site; Morbidity; Morbidité; Reconstruction de crête alvéolaire; Site donneur; Transplantation osseuse.