Outcomes Of Autogenous Bone Grafting Versus Alloplastic Materials In Maxillofacial Reconstruction: Systemic Review

Abstract

Background: Maxillofacial reconstruction often requires bone grafting to restore form and function following trauma, congenital defects, or tumor resection. The choice of graft material—autogenous bone, alloplastic materials, allogeneic bone, or xenogeneic bone—significantly impacts clinical outcomes. This systematic review and network meta-analysis aimed to compare the efficacy and safety of these different grafting materials in maxillofacial reconstruction. Methods: A comprehensive literature search was conducted across PubMed, Cochrane Library, MEDLINE, and Embase to identify relevant randomized controlled trials (RCTs). Studies were selected based on predefined inclusion criteria, including human subjects undergoing maxillofacial reconstruction with various bone graft materials. Data were extracted from the included studies, and a network meta-analysis was performed to compare the clinical outcomes, including success rates, complication rates, functional recovery, and aesthetic outcomes. Results: The review included 10 RCTs involving 496 patients. Autogenous bone grafting demonstrated the highest overall success rate and was considered the gold standard due to its osteogenic, osteoinductive, and osteoconductive properties. However, it was associated with donor site morbidity. Alloplastic materials showed satisfactory outcomes but had a higher rate of material-related complications. Allogeneic and xenogeneic bone grafts were less effective than autogenous grafts, with lower success rates and higher complication rates. Conclusions: Autogenous bone grafts remain the preferred choice for maxillofacial reconstruction due to their superior biological properties and clinical outcomes. However, alloplastic, allogeneic, and xenogeneic materials can be viable alternatives in specific clinical contexts, particularly where autogenous grafts are contraindicated or donor site morbidity is a concern.