Int J Oral Implantol 12 (2019), No. 2 15. May 2019
Int J Oral Implantol 12 (2019), No. 2 (15.05.2019)
Wound dehiscences following pre-implant bone augmentation with autogenous iliac crest bone grafts: A retrospective cohort study
Jager, Derk H. Jan / Maarse, Floor / Klausch, Thomas / Karagozoglu, K. Hakki / ten Bruggenkate, Christiaan M. / Sándor, George K. / Wolff, Jan / Schulten, Engelbert A.J.M.
Purpose: To evaluate possible risk factors associated with wound dehiscences following pre-implant alveolar bone augmentation with autologous anterior iliac crest bone grafts covered with resorbable collagen membranes or human demineralised bone laminae.
Materials and methods: Data of 161 patients who underwent bone augmentation prior to the insertion of dental implants were analysed. The preoperative dental status, locations of alveolar bone augmentation sites and location of wound dehiscences were recorded. Gender, age, smoking, alcohol exposure, and dental and medical histories were reviewed. Information was also collected on the surgeons, augmentation technique, application of a collagen membrane, fixation screw type and suture material. Univariate logistic regression analysis was used to evaluate pre- and perioperative variables as predictors of dehiscences.
Results: A total of 42 (26.1%) of the 161 augmented patients developed a wound dehiscence following surgery. Most commonly affected sites were the anterior maxilla, followed by the anterior mandible. Males developed wound dehiscences with higher probability than females (odds ratio female = 0.444; P = 0.025; 95% CI: 0.214 to 0.903). Furthermore, marginal associations (P < 0.10) are found for smoking and an anterior location of the augmentation. Smokers were found to have higher probability of a wound dehiscence (odds ratio 2.089; P = 0.064; 95% CI: 0.957 to 4.500) compared to non-smokers. A posterior location of the augmentation was associated with lower probability of a wound dehiscence (odds ratio 0.188; P = 0.076; 95% CI: 0.035 to 0.802) compared to an anterior location.
Conclusions: Based on this study population, smoking in males seems to be the most important risk factor for the development of wound dehiscences after pre-implant alveolar bone augmentation procedures.
Conflict of interest statement: The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Keywords: autologous iliac crest bone graft, bone augmentation, bone graft, dental implants, failure analysis, surgical procedure, wound dehiscence