In this systematic review with meta-analysis, authors included prospective human studies that reported on the survival of 2-piece micro rough surface root form dental implants placed in completely or partially edentulous jaws augmented using autogenous bone grafts. A minimum of 6 months of follow-up in studies was an inclusion requirement. They included studies that reported on the time and nature of postoperative complications. Studies in which grafts were placed in irradiated bone or in medically compromised patients were excluded. They also excluded studies in which grafts were placed in combination with platelet-rich plasma or platelet-rich fibrin. They restricted the search to studies published in the following languages: English, French, German, Norwegian, Swedish, and Danish.

Augmentation of partially edentulous or completely edentulous jaws by autogenous bone grafting is the key intervention. The study compared dental implant survial rate in bone augmented using autogenous bone harvested from intra-oral sites (such as the retro-molar area, ramus, or mental region of the mandible) versus an extra-oral site (iliac crest).

This study compared the survival of dental implants (primary outcome) placed in the alveolar ridge augmented using bone harvested from intra-oral sites versus bone harvested from the iliac crest. Implant survival was assessed during the following time points: 6, 12, 24, 36, 60 and 120 months. As a secondary outcome measure, the authors also assessed the time and nature of postoperative complications arising specifically at the donor site following the autologous bone harvesting procedures.

A total of 23 studies satisfying the inclusion criteria were included in this review. Based on the meta-analyses of 14 included studies that reported data on implant survival at different time points, the survival rate was lesser for implants placed in bone augmented using iliac crest graft (ICG), when compared to those placed in intra-oral graft (IOG) augmented sites at 6 [ICG = 95.8% IOG = 98.4%; P < .001], 12 [ICG = 97.0%, IOG = 98.4%; P < .001], 24 [ICG = 85.9%, IOG = 98.2%; P < .001], 60 [ICG = 90.0%, IOG = 91.5%; P < .001], and 120 months [ICG = 88.8%, IOG = 95.2%; P < .001]. At the 36-month follow-up, no included study reported implant survival in lilac crest augmented bone and hence a comparison could not be performed. Frequent complications in the form of pain/discomfort, gait disturbance, and sensory disturbance were associated with the iliac crest graft donor harvest site. Concerning intra-oral donor sites, grafts harvested from the mental region had the largest number of reported complications mainly in the form of paresthesia of the lower lip and mandibular anterior teeth.

Consistently higher Implant survival was observed for implants placed in intra-oral bone graft-augmented sites when compared to implants placed in iliac crest bone-augmented sites. Frequent donor site complications were reported following the harvest of bone from the iliac crest and mental region of the mandible.