An important finding in this study is that a majority of patients were very satisfied after iliac crest-derived alveolar bone grafting and implant therapy. Although 90% of the patients in our study had successful bone grafting, only 70.1% reported implant survival together with prosthetic rehabilitation after 1 year. These figures are lower than those reported in previous studies [2, 3, 9]. A review by Chiapasco et al. showed that the mean graft failure in 16 studies was 1.6% and partial loss of graft of 3.3% [45]. The same review showed that the overall survival rate of dental implants in transplanted bone was 87%. However, it must be kept in mind that the patients in our study were orally compromised and very challenging to reconstruct. Moreover, the patients in our study did not report on the number of implants lost, and we do not have reliable records of the exact number of implants each patient had got installed. This could indicate differences in survival on implant or patient levels—a variable of clinical importance as the number of lost implants may be higher.

Another important finding is that patients reported to tolerate the augmentation procedure well; 85% of patients were satisfied with the hip operation (performed under general anesthesia), comparable to a previous report [46]. However, 40% of the patients reported pain for 18 ± 16 days after augmentation, which is in accordance with other studies [37, 46] and which should be considered during the treatment planning of patients scheduled to received iliac crest-derived bone grafts [33]. Two patients reported infection at the donor site. All operations were performed by a strict sterile regime and protocol at the university hospital.

The level of OHRQoL reported by the patients was favorable with an OHIP-14 value of 8.4. In a previous study, Dahl et al. reported an OHIP-14 score of 4.1 in the Norwegian adult population (2441 patients), with 35% of the sample reporting “no oral health problems” [32]. If the study sample in the study of Dahl et al. is considered to be representative of the general population, patients in our study reported poorer OHRQoL than the general population. Thus, even though the participants in this study report good oral health and better than before operation on the single questions, they still report having problems related to their oral condition. This is to be expected as the patients in our study were orally compromised before augmentation with almost no alveolar ridge to retain or support a prosthetic construction. Since the patients had extensive alveolar bone loss rendering them orally handicapped, any improvement in function would be likely to have a positive impact on satisfacation and OHRQoL. However, it is difficult to relate their reported level of OHRQoL to the augmentation and implant installation per se, as this was performed up to 12 years prior to completing the questionnaire (mean 7 years and 10 months). So, patients’ present oral situation with fixed teeth could/may alter the “reference” for the patients regarding OHRQoL. However, we cannot reliably ascribe the level of OHRQoL to the treatment performed years ago, since we have no such data either before or soon after the prosthetic rehabilitation, and therefore, cannot estimate the influence the effect of response shift on the study outcomes. Previous reports show a significant influence of implant-retained prosthetic treatment on OHRQoL, but these reports are based on before-and-after registrations [47].