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

Abstract

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.