AUTOGENOUS CALVARIAL BONE GRAFTS IN MAXILLOFACIAL RECONSTRUCTION: COMPLICATIONS, RISK FACTORS, AND PREVENTIVE STRATEGIES

Abstract

Autogenous cranial vault bone grafts are widely used in complex oral and maxillofacial reconstructions due to their biocompatibility, volumetric stability, low resorption rates, and reduced donor-site morbidity. In recent decades, virtual surgical planning, three-dimensional printing, and the use of custom surgical guides have significantly enhanced the precision and predictability of reconstructive outcomes, facilitating better graft adaptation and more satisfactory functional and aesthetic results. Despite these advances, complications such as infection, osteomyelitis, dehiscence, graft exposure, and failure of bone incorporation remain significant clinical challenges. This study aimed to critically review the literature on the use of autogenous cranial vault grafts in oral and maxillofacial reconstruction, addressing indications, advantages, complications, risk factors, technological innovations, and preventive strategies. A narrative review was conducted using the PubMed/MEDLINE, Scopus, and Google Scholar databases, primarily including studies published between 2014 and 2026, alongside classic articles. The findings indicate that the cranial vault remains a safe and predictable option when combined with appropriate planning and careful patient selection. However, a significant gap was identified regarding the influence of prior head trauma and diploic alterations on donor-site safety. It is concluded that prospective studies are needed to elucidate this relationship and refine evidence-based clinical protocols.