Complications following ridge augmentation with bone grafts

Aim of the study

This article reviews the complications following bone grafts and displaced flaps for the augmentation of resorbed ridges, prior to the placement of implants. Details are given of the prevention and the development of sequelae accompanying surgical ridge augmentation.

Materials and methods

A sample of 200 patients, followed for a period of 7 years, served as the study population. They were examined preoperatively and postoperatively, not only in connection with the level of bone and soft tissues but also for complications arising in the neighbouring tissues.

Also, it was necessary not to overlook the need to over-estimate the size of the bone graft to be used and its fixation, especially in cases involving the sinus. The treated areas can only confidently be covered with large, split thickness flaps that facilitates their displacement. The absence of tension and the preservation of the vasculature serve to prevent any disturbance of haemostasis. The surgeon must be very attentive to the most minute detachment of the sinus membrane, finding any perforation and/or other complication associated with sinus floor grafts.

Results

Three types of postoperative complication can occur. Infection, whether at the recipient or at the donor site (due to trephination) may be controlled by systemic antibiotics. Rarely (in the case of osteomyelitis) this may be administered intravenously. The absence of resorption is more important in the mandible, compared with the maxilla. Dehiscences of the soft tissues are the result of the flap being too short and/or poor vascularisation.

Conclusion

The less visible the defect, the more disappointed the patient will be if it is not corrected perfectly. It is necessary to listen to the patient and find the surgical protocol that is best suited to the case. Before any intervention, it is necessary to identify the possible risks and complications before presenting our proposed treatment plan to the patient.

Commentary

This is a courageous summary that illustrates the experience of the surgeon, O. Bahat, always pushing back the limits of surgical practice, thanks to technical innovations that are now available. All clinicians who strive to achieve comparable results will discover in this article small details that make a difference. To be read and reread…