A Pilot Study in the Development of Indices for Predicting the Clinical Outcome of Oral Bone Grafts

Purpose: Bone grafting to repair osseous defects is widely used in dentistry, but little information on how to predict the clinical survival of grafted bone is currently available. As an initial step toward the establishment of formal criteria for predicting the clinical outcome of oral bone grafts, this pilot study sought to determine the relevance of adverse clinical and radiographic parameters as predictor variables for graft survival. Materials and Methods: Eighty patients presenting with a variety of clinical conditions were treated with 83 oral bone grafts. Alloplastic, allogenic, and/or autogenous materials were used with or without barrier membranes. During follow-up appointments at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years after grafting, a series of clinical and radiographic parameters were used to evaluate the degree of graft integration. The data were then analyzed to determine the prediction accuracy of each variable in relation to the results of the graft. Results: The findings of this clinical study suggest that the variables of (1) graft type, (2) inflammation, (3) infection, (4) fistula, (5) graft exposure, (6) pain, and (7) radiolucency were good indices for predicting graft survival, especially with cumulative data. Discussion: The quality of the prognostic indices appeared to be good and should be further investigated for future applications. Conclusions: The cumulative index, with a sensitivity of 88.9% and a specificity of 93.8%, was the best predictor of clinical outcome. The 1-month and 3-month indices were similar.