Evaluating the Comparative Outcomes of Bone Grafts in Maxillofacial Reconstructions based Healthcare Settings
DOI:
https://doi.org/10.36283/ziun-pjmd15-2/015Abstract
Background: In maxillofacial reconstruction, bone grafting is necessary to restore function and facial structure. Autogenous grafts, being the standard, are superior in terms of integration, but they suffer from donor site complications. Alloplastic grafts have lessened these complications, but their effectiveness is not well defined. This study compared the clinical and radiographic outcomes of the two types of grafts.
Methods: The prospective comparative study (February-July 2025) included 60 patients undergoing of bone grafting for reconstruction (n = 30 in each group). Autogenous grafts (from intraoral and extraoral donor sites) and alloplastic grafts (hydroxyapatite/tricalcium phosphate-based materials) were randomly allocated to the study participants. Primary outcomes measured at 6 months included graft volume retention (based on CBCT), graft incorporation, donor site morbidity, postoperative infection, and patient satisfaction (based on Visual Analogue Scale 0-10). Statistical analysis was done using SPSS version 27.0 with independent samples t-test and Chi-square test. The p-value < 0.05 was statistically significant.
Results: Autogenous grafts showed better integration (93.6% vs. 78.2%, p = 0.014) and volume retention (88.5 ± 7.4% vs. 74.2 ± 9.1%, p = 0.009). Donor site morbidity was significantly higher in autogenous group (30.0% vs. 3.3%, p < 0.001) whereas patient satisfaction was higher in alloplastic groups (8.7 ± 1.1 vs. 7.4 ± 1.5, p = 0.002). No significant difference in the infection rates was observed (p = 0.187)
Conclusion: In conclusion, autogenous grafts are better in terms of retention of volume and biological integration, whereas alloplastic grafts reduce donor site morbidity while increasing patient satisfaction. The choice between different alternatives should be based on a careful consideration of the biological benefits and the needs and preferences of the individual patient.
References
1.Simko K, Czako L, Sovis M, Vidova I, Sufliarsky B, Odnoga P, et al. Advantages of virtual planning in reconstructive surgery of bone defects in the maxillofacial region. Bratisl Lek Listy. 2023;124(10):759-763. doi: 10.4149/BLL_2023_116.
2.Moussa NT, Dym H. Maxillofacial Bone Grafting Materials. Dent Clin North Am. 2020 Apr;64(2):473-490. doi: 10.1016/j.cden.2019.12.011.
3.Wickramasinghe ML, Dias GJ, Premadasa KMGP. A novel classification of bone graft materials. J Biomed Mater Res B Appl Biomater. 2022 Jul;110(7):1724-1749. doi: 10.1002/jbm.b.35029.
4.Janjua OS, Qureshi SM, Shaikh MS, Alnazzawi A, Rodriguez-Lozano FJ, Pecci-Lloret MP, et al. Autogenous Tooth Bone Grafts for Repair and Regeneration of Maxillofacial Defects: A Narrative Review. Int J Environ Res Public Health. 2022 Mar 20;19(6):3690. doi: 10.3390/ijerph19063690.
5.McKenna GJ, Gjengedal H, Harkin J, Holland N, Moore C, Srinivasan M. EFFECT OF AUTOGENOUS BONE GRAFT SITE ON DENTAL IMPLANT SURVIVAL AND DONOR SITE COMPLICATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract. 2022 Sep;22(3):101731. doi: 10.1016/j.jebdp.2022.101731.
6.Mittal N, Goyal M, Sardana D. Autogenous grafts for reconstruction arthroplasty in temporomandibular joint ankylosis: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2022 Nov;60(9):1151-1158. doi: 10.1016/j.bjoms.2022.05.012.
7.Abdulaziz MKB, Kamal M, Kolaityte V, Aziz H. Complications of alloplastic facial skeletal implants in aesthetic surgery: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2025 Aug;107:5-18. doi: 10.1016/j.bjps.2025.04.042.
8.Hsieh TY, Dhir K, Binder WJ, Hilger PA. Alloplastic Facial Implants. Facial Plast Surg. 2021 Dec;37(6):741-750. doi: 10.1055/s-0041-1725088.
9.Khattak YR, Baig MA, Din SZU, Ahmad I. Autogenous, alloplastic, or hybrid for total mandibular reconstruction; is here an optimal path? Oral Maxillofac Surg. 2024 Jun;28(2):557-568. doi: 10.1007/s10006-024-01224-3.
10.Zhang S, Zhang X, Li Y, Mao X, Liu R, Qi Y, et al. Clinical Reference Strategy for the Selection of Treatment Materials for Maxillofacial Bone Transplantation: A Systematic Review and Network Meta-Analysis. Tissue Eng Regen Med. 2022 Jun;19(3):437-450. doi: 10.1007/s13770-022-00445-5.
11.Bhardwaj R, Agrawal U, Vashist P, Manna S. Determination of sample size for various study designs in medical research: A practical primer. J Family Med Prim Care. 2024 Jul;13(7):2555-2561. doi: 10.4103/jfmpc.jfmpc_1675_23
12.Sun H, Yin X, Yang C, Kuang H, Luo W. Advances in autogenous dentin matrix graft as a promising biomaterial for guided bone regeneration in maxillofacial region: A review. Medicine (Baltimore). 2024 Aug 23;103(34):e39422. doi: 10.1097/MD.0000000000039422.
13.Marschall JS, Davis SS, Rysavy O, Kushner GM. Reconstruction of Maxillary Bone Defects With Cellular Bone Matrix Allografts. Craniomaxillofac Trauma Reconstr. 2024 Dec;17(4):NP263-NP270. doi: 10.1177/19433875241288138.
14.Lee KC, Neal TW, Tung R, Coelho PG, Markiewicz MR, Melville JC. History of Maxillary Reconstruction. Atlas Oral Maxillofac Surg Clin North Am. 2024 Sep;32(2):65-71. doi: 10.1016/j.cxom.2023.12.001.
15.Ashfaq R, Kovács A, Berkó S, Budai-Szűcs M. Developments in Alloplastic Bone Grafts and Barrier Membrane Biomaterials for Periodontal Guided Tissue and Bone Regeneration Therapy. Int J Mol Sci. 2024 Jul 15;25(14):7746. doi: 10.3390/ijms25147746.
16.Chan TJ, Long C, Wang E, Prisman E. The state of virtual surgical planning in maxillary Reconstruction: A systematic review. Oral Oncol. 2022 Oct;133:106058. doi: 10.1016/j.oraloncology.2022.106058.
17.Ramezanzade S, Aeinehvand M, Ziaei H, Khurshid Z, Keyhan SO, Fallahi HR, et al. Reconstruction of Critical Sized Maxillofacial Defects Using Composite Allogeneic Tissue Engineering: Systematic Review of Current Literature. Biomimetics (Basel). 2023 Mar 30;8(2):142. doi: 10.3390/biomimetics8020142.
18.Subash P, Nerurkar SA, Krishnadas A, Vinay V, Iyer S, Manju V. Patient Specific Alloplastic Implant Reconstruction of Mandibular Defects-Safe Practice Recommendations and Guidelines. J Maxillofac Oral Surg. 2023 Mar;22(Suppl 1):28-36. doi: 10.1007/s12663-023-01881-z.
19.Zeng C, Gao SG, Li H, Yang T, Luo W, Li YS, et al. Autograft Versus Allograft in Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Randomized Controlled Trials and Systematic Review of Overlapping Systematic Reviews. Arthroscopy. 2016 Jan;32(1):153-63.e18. doi: 10.1016/j.arthro.2015.07.027.
20.Simon D, Capitán L, Coon D, Gutiérrez-Santamaría J, Bailón C, Bellinga RJ, et al. Secondary Facial Gender Surgery: Causes of Poor Outcomes and Strategies for Avoidance and Correction. Plast Reconstr Surg. 2023 Aug 1;152(2):347e-357e. doi: 10.1097/PRS.0000000000010324.
21.Hölzle F, Wolff KD, Mohr C. Reconstructive oral and maxillofacial surgery. Dtsch Arztebl Int. 2008 Nov;105(47):815-22. doi: 10.3238/arztebl.2008.0815.
22.Lim HK, Choi YJ, Choi WC, Song IS, Lee UL. Reconstruction of maxillofacial bone defects using patient-specific long-lasting titanium implants. Sci Rep. 2022 May 9;12(1):7538. doi: 10.1038/s41598-022-11200-0.
23.Ismail T, Haumer A, Lunger A, Osinga R, Kaempfen A, Saxer F, et al. Case Report: Reconstruction of a Large Maxillary Defect With an Engineered, Vascularized, Prefabricated Bone Graft. Front Oncol. 2021 Dec 6;11:775136. doi: 10.3389/fonc.2021.775136.
24.Ciszyński M, Dominiak S, Dominiak M, Gedrange T, Hadzik J. Allogenic Bone Graft in Dentistry: A Review of Current Trends and Developments. Int J Mol Sci. 2023 Nov 22;24(23):16598. doi: 10.3390/ijms242316598.
25.Łuczak JW, Palusińska M, Matak D, Pietrzak D, Nakielski P, Lewicki S, et al. The Future of Bone Repair: Emerging Technologies and Biomaterials in Bone Regeneration. Int J Mol Sci. 2024 Nov 27;25(23):12766. doi: 10.3390/ijms252312766.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Pakistan Journal of Medicine and Dentistry

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the CreativeCommons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/