Complications in bone regeneration: A dental and orthopedic surgery comparison

Objectives: Bone is a regenerative tissue, yet healing may fail after trauma, surgery, or atrophy. Regenerative methods restore bone but still pose complications. This study analyzes complication types, causes, and frequencies, emphasizing materials, membrane characteristics, and clinical indications. Methods: This narrative review synthesizes clinical studies, trials, and systematic reviews on bone regeneration. The focus lies on guided bone regeneration in oral/maxillofacial surgery and grafting techniques in orthopedic procedures. Data were categorized based on material type, indication, and complication type, referencing studies with documented patient outcomes. Results: Dental Surgery: Major complications include wound dehiscence, membrane exposure, and infection. Complication rates vary between 15% to 40%, strongly influenced by membrane type and degradation rate. Nonresorbable membranes show higher infection risks upon exposure but are preferred for large/vertical defects. Uncross-linked resorbable collagen and synthetic degradable membranes demonstrate better outcomes postexposure. Orthopedic Surgery: Key complications include infection, fracture, non-union, and graft failure. Autografts have the highest complication rates due to donor site morbidity. Allografts pose moderate risks including infection and rejection. Synthetic bone substitutes show lower complication rates, particularly in spine surgeries. Conclusion: The clinical success of bone regeneration depends largely on material selection tailored to the anatomical and pathological context. In dental surgery, membrane characteristics dictate infection risks, while in orthopedics, the graft type and surgical indication are more decisive. Synthetic membranes and bone substitutes with tailored degradation rates and biomechanical properties offer promising avenues to reduce complication rates and improve clinical outcomes.