Sir, the paper in BDJ 2004, 196: 167–71 prompted us to analyse retrospectively the influence of operator seniority on morbidity of secondary alveolar bone grafting procedures in our unit.

We analysed 77 cases randomly over a 10 year period, 55 of whom were treated by SHOs and 22 by registrars. Overall donor site morbidity was low with no major complications reported. Twenty two minor complications occurred including immediate post-operative pain (9), bleeding (8), wound infection (3) and delayed mobilisation (1).

There was no statistically significant difference in outcomes between those treated by SHOs and registrars. In conclusion, we propose that alveolar bone grafting from the ilium under supervision may be an appropriate procedure for trainee maxillofacial surgeons, particularly senior house officers, to enhance their surgical skills.