Post-surgical complications of symphyseal block graft with and without soft tissue grafting

OBJECTIVE: To determine whether soft tissue augmentation prior to block grafting will minimize post-block grafting soft tissue complications.

METHODS: This longitudinal controlled pilot study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from October 2010 to January 2013. Fourteen sites requiring block grafting were divided into 2 groups: Group A - 7 sites in 6 patients were subjected to monocortical block graft (control); and Group B - 7 sites in 6 patients were subjected to soft tissue graft through new tunnel technique, followed by monocortical block graft (test).

RESULTS: In Group A, 2 patients had wound dehiscence and graft exposure. The first that had an exposure of 3x4 mm resulted in 45% resorption of the graft. The second had an exposure of 4x5 mm followed by infection, which resulted in 75% resorption of the graft. In the other 5 cases, sites healed with no complications and minimal resorption (0-15%). In Group B - there were generalized 1-2 mm increases in the thickness of soft tissue following soft tissue graft. Recipient sites healed with no complications or infection following block grafting. Block graft resorption ranged from 0-15%.

CONCLUSION: More complications were seen in those patients who did not receive soft tissue augmentation, thus demonstrating the importance of soft tissue preparation prior to block grafting, especially in patients having thin soft tissue.