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Complications in bone-grafting procedures: Classification and management
Periodontology 2000 ( IF 17.5 ) Pub Date : 2022-02-01 , DOI: 10.1111/prd.12413
Ignacio Sanz-Sánchez 1, 2 , Ignacio Sanz-Martín 1 , Alberto Ortiz-Vigón 1 , Ana Molina 1, 2 , Mariano Sanz 1, 2
Affiliation  

Bone-regenerative interventions aiming to restore deficient alveolar ridges, such as the use of block grafts or through the application of guided bone-regeneration principles, have reported positive outcomes in the published scientific literature. These interventions, however, are invasive, and hence, intraoperative and/or postoperative complications may occur. The types of complications and their severity may vary from the exposure of the biomaterial (membrane or graft) to postsurgical infections, neurosensorial disturbances, occurrence of hemorrhage, and pain, etc. The aim of the present narrative review was to search the available scientific evidence concerning the incidence of these complications, their effect on treatment outcomes, their clinical management and, finally, strategies aimed at prevention. Exposure of the barrier membrane or the block graft is the most common complication associated with oral regenerative interventions. To manage these complications, depending on the extent of the exposure and the presence or absence of concomitant infections, therapeutic measures may vary, from the topical application of antiseptics to the removal of the barrier membrane or the block graft. Regardless of their treatment, the occurrence of these complications has been associated with patient selection, with compliant patients (eg, nonsmokers) having a lower reported incidence of complications. Similarly, surgical factors such as correct flap elevation and a tensionless closure are of obvious importance. Finally, to prevent the incidence of complications, it appears prudent to utilize whenever possible less invasive surgical interventions.

中文翻译:

骨移植手术的并发症:分类和管理

旨在恢复有缺陷的牙槽嵴的骨再生干预,例如使用块状移植物或通过应用引导骨再生原则,已在已发表的科学文献中报告了积极的结果。然而,这些干预措施是侵入性的,因此可能会发生术中和/或术后并发症。并发症的类型及其严重程度可能因生物材料(膜或移植物)的暴露、术后感染、神经感觉障碍、出血的发生和疼痛等而异。本叙述性综述的目的是搜索可用的科学证据关于这些并发症的发生率、它们对治疗结果的影响、它们的临床管理以及最后旨在预防的策略。屏障膜或块状移植物的暴露是与口腔再生干预相关的最常见并发症。为了处理这些并发症,根据暴露程度和是否存在伴随感染,治疗措施可能会有所不同,从局部应用防腐剂到去除屏障膜或块状移植物。不管他们的治疗如何,这些并发症的发生都与患者的选择有关,依从性好的患者(例如,非吸烟者)报告的并发症发生率较低。同样,正确的皮瓣抬高和无张力闭合等手术因素也很重要。最后,为了防止并发症的发生,尽可能谨慎地使用侵入性较小的手术干预。
更新日期:2022-02-01
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