. 2020 Nov 30;11(3):e1. doi: 10.5037/jomr.2020.11301

Table 3.

Complications and donor site morbidity following harvesting of autogenous bone graft from the ascending mandibular ramus compared with the chin region

Study	Material and methods					Outcome measures

	Year of publication	Study design	Number of patients	Donor site	Observation period	Pain	Infection	Mucosal dehiscence	Altered sensation or vitality of tooth/teeth	Neurosensory disturbances of IAN or vestibular area				Patient-reported outcome measures

										Temporary		Permanent
Misch et al [24]	1997	CT	31	Chin	4 - 6 months	NR	6%	11%	29%	Verbal response				NR
			31	Chin			6%	11%	29%	9.6%		NR

			19	Mandibular ramus			0%	0%	0%	0%

Cordaro et al. [25]	2002	CT	13	Chin	4 - 38 months	No difference	0%	0%	Temporary: 7%; permanent: 0%	Verbal response				NR

			5	Mandibular ramus					0%	0%		0%

Clavero et al. [26]	2003	CT	29	Chin	18 months	Higher pain	0%	NR	NR	Self-administrated questionnaire				Met pretreatment expectations: 91% Undergo same treatment again: 94%
			29	Chin		Higher pain				76%		52%

			24	Mandibular ramus		Less pain				21%		4%

Silva et al. [27]	2006	CT	50	Chin	120 days	NR	0%	0%	NR	Review of medical records				NR
			50	Chin						16%

			36	Mandibular ramus						8%

Raghoebar et al. [28]	2007	CT	15	Chin	12 months	33%	0%	NR	Temporary: 13%; permanent: 0%	Self-administrated questionnaire				Acceptance of the surgical procedure was significantly higher after harvesting of mandibular ramus bone and third molar removal^a
			15	Chin		33%			Temporary: 13%; permanent: 0%	40%		20%
									Temporary: 0%; permanent: 0%			0%
			15	Mandibular ramus		20%				7%

			15	Mandibular ramus and third molar		20%				7%

Andersson et al. [29]	2008	CT	16	Chin	3 - 5 years	Higher pain	NR	NR	Sensitivity to cold: 12.5%	Interview				Significant lower discomfortc and higher satisfaction after harvesting of mandibular ramus^d
			16	Chin		Higher pain			Sensitivity to cold: 12.5%	NR		33%

			12	Mandibular ramus		Less pain^b			Sensitivity to cold: 0%			0%

Cordaro et al. [30]	2011	CT	37	Chin	18 - 42 months	Less pain	NR	NR	Negative pulp sensitivity: 13%; root canal treatment: 0.7%	PBT	TPDT	Verbal response		Patient´s perception of morbidity did not differ between chin and mandibular ramus^j
			37	Chin		Less pain			Negative pulp sensitivity: 13%; root canal treatment: 0.7%	Mucosa: 16.2%; skin: 16.2%	43.2%	40%	13.5%

			43	Mandibular ramus		Higher pain^e			Negative pulp sensitivity: 3%^f; root canal treatment: 0%^g	Mucosa: 0%; skin: 11.6%	41.9%	16%^h	2.3%ⁱ

Altiparmak et al. [31]	2015	CT	44	Chin	6 months	VAS:	NR	NR	Negative pulp sensitivity: 13.8%; root canal treatment: 1.4%	PBT	TPDT	PBT	TPDT	NR
			44	Chin		1.5 (0 - 5.8)				Mucosa: 43.2%; skin: 13.6%	Mucosa: 34.1%; skin: 13.6%	Mucosa: 0%; skin: 0%

			31	Mandibular ramus		1.3 (0 - 4)^k			Negative pulp sensitivity: 13.3%^l; root canal treatment: 0%^m	Mucosa: 9.7%ⁿ; skin: 12.9%	Mucosa: 16.1%; skin: 0%

Ersanli et al. [32]	2016	CT	18	Chin	12 months	NR	13%	13%	13%	NR		NR		NR

			14	Mandibular ramus			9%	18%	0%

Pereira et al. [33]	2019	CT	29	Chin	12 months	5.6%	NR	NR	1.9%	Self-administered questionnaire				Satisfied with treatment: 91%; recommend the procedure: 91%
			29	Chin						62.1%		13.8%^o

			28	Mandibular ramus						35.7%		3.5%^p

^aStatistically significant at level P < 0.05 (Student t-test); ^bstatistically significant at level P = 0.002 (Mann-Whitney test); ^cstatistically significant at level P = 0.006 (Mann-Whitney test); ^dstatistically significant at level P = 0.027 (Mann-Whitney test); ^estatistically significant at level P = 0.003 (Mann-Whitney test); ^f,gstatistically significant at level P < 0.001 (Mann-Whitney test); ^hstatistically significant at level P = 0.03 (Chi-squared test); ⁱstatistically non-significant at level P > 0.05 (Mann-Whitney Test); ^jstatistically significant at level P = 0.004 (Chi-squared test); ^kstatistically non-significant at level P = 0.862 (Mann-Whitney test); ^lstatistically non-significant at level P = 1 (Fisher´s exact test); ^mstatistically non-significant at level P = 1 (continuity corrected Chi-squared test); ⁿstatistically significant at P = 0.004 (Mann-Whitney test); ^ostatistically significant at level P < 0.05 (Mann-Whitney test); ^pstatistically significant at level P < 0.05 (Mann-Whitney test).

CT = controlled trial; IAN = inferior alveolar nerve; NR = not reported; PBT = pointed-blunt test; RS = retrospective study; SD = standard deviation; TPDT = two-point discrimination test (threshold values of 7 mm and 11 mm); VAS = visual analogue scale.