Delayed implant rehabilitation following iliac crest grafting for traumatic dentoalveolar defects: a prospective single-arm interventional clinical study

BACKGROUND: Implant rehabilitation following post-traumatic dentoalveolar defects can be challenging due to irregular bone loss and insufficient ridge volume that compromise dental implant placement and prosthetic rehabilitation. AIM OF THE STUDY: To evaluate implant rehabilitation following reconstruction of delayed post-traumatic maxillary and mandibular dentoalveolar defects using iliac crest bone grafts in terms of implant stability (primary outcome), marginal bone loss, graft success, and patient satisfaction (secondary outcomes). METHODS: This prospective interventional single-arm clinical study included 20 patients (18-65 years), both sexes presenting with post-traumatic alveolar bone defects who underwent reconstruction using anterior iliac crest grafts, followed by implant placement after 6 months and prosthetic rehabilitation. Post-operative assessments primarily evaluated implant stability and secondarily assessed marginal bone loss, graft success, and patient satisfaction. All adverse events were recorded during follow-up. RESULTS: Graft associated with improved implant stability significantly from 59.7 ±10.01 Ncm at baseline to 68.7 ±10.17 Ncm after 6 months (P < 0.001). Horizontal graft width increased from 2.1±0.5 mm preoperatively to 6.9±0.8 mm at 6 months (P<0.001), while vertical graft height improved from 7.2±1.1 mm to 10.7±1.3 mm (P<0.001). Median marginal bone loss reached 1.5 mm at 6 months (P < 0.001). A total of 30 implants were placed with an implant survival rate of 96.7% (29/30). Graft success was achieved in all cases. Most patients reported high satisfaction, with 85% being very satisfied or satisfied. A single case of donor site wound dehiscence was reported. CONCLUSIONS: Iliac crest bone grafting may represent a clinically promising approach for reconstruction of post-traumatic dentoalveolar defects, allowing favorable short-term implant stability following delayed implant rehabilitation. TRIAL REGISTRATION: The research was registered retrospectively in pactr.samrc.ac.za (PACTR202511489819034) on 11-11-2025.