Kuik, K. (Karel) (2015) Differences in donor site morbidity between the anterior iliac crest and the calvarium: a case-control study. thesis, Medicine.
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Abstract
Background: Due to bone resorption in patients with edentulous jaws, these patients often have problems wearing a denture. A solution is to fix the denture on dental implants, but most of the times there is an insufficient amount of bone left. Often, these patients require the har-vest of autologous bone which is then transplanted to the maxilla or mandible before dental implants can be placed. When a substantial amount of bone is needed, extra-orally harvested bone is required. Autologous bone harvesting is associated with the occurrence of donor site morbidity. The anterior iliac crest is currently in the Netherlands the mostly used location used for pre-prosthetic augmentation. For this location, the occurrence of morbidity includes nerve damage or short-term post-operative pain. Another harvesting site is the calvarium. Here morbidity includes dural exposures. The reported post-operative pain seems minimal. Up to this date, the morbidity of these two donor sites it is not investigated in a comparative study. Therefore it was decided to assess morbidity (complications, post-operative pain, pa-tient satisfaction, and implant survival) of the anterior iliac crest and the calvarium. Methods: In this case-control retrospective study, 27 edentulous patients, who had undergone a calvarial harvesting procedure, were matched with 27 edentulous patients, who had under-gone an iliac crest harvesting procedure during the same period. Patients were matched ac-cording to follow-up, age, and sex. Donor site morbidity was assessed by medical record as-sessment, patient questionnaires including pain and end result satisfaction scores, and physi-cal examination. To assess the success of the procedures, implant survival has been reported. Possible differences between harvesting groups were statistically tested. Results: The per-operative and post-operative complications did not differ significantly be-tween the two donor sites. Per-operative complications were present in 11.1% in the calvarial group, and in 3.7% of the iliac crest group. In two patients of the calvarial group, a re-operation at the donor site was necessary, whereas none of the patients in the iliac group were re-operated. The post-operative pain (VAS) scores directly after harvesting, on recall, was significantly higher in the iliac crest group (Median: 4.7) than in the calvarial group (Median: 0.5) (p<0.001). The current pain scores was zero in both groups (Mean folow up: 2 years). End result satisfaction levels did not differ between both groups, iliac crest group (Mean: 89.5), calvarial group (Mean: 93.6). Implant survival, in the iliac group (94.4%), in the calvar-ial group (91.8%), did not differ significantly. Conclusion: Low donor site morbidity, high patient satisfaction, and high implant survival were associated with both harvesting procedures. However, patients reported a higher pain level directly after iliac crest harvesting, than after calvarial harvesting.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Raghoebar, Prof. Dr. G.M. and Afdeling: Mondziekten, Kaak- en Aangezichtschirurgie UMCG |
| Supervisor name: | Extern begeleider: and Schortinghuis, Dr. J. and Scheper ziekenhuis |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2447 |
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