Alveolar ridge augmentation with titanium mesh. A retrospective clinical study

Abstract

An adequate amount of bone all around the implant surface is essential in order to obtain long-term success of implant restoration. Several techniques have been described to augment alveolar bone volume in critical clinical situations, including guided bone regeneration, based on the use of barrier membranes to prevent ingrowth of the epithelial and gingival connective tissue cells. To achieve this goal, the use of barriers made of titanium micromesh has been advocated. A total of 13 patients were selected for alveolar ridge reconstruction treatment prior to implant placement. Each patient underwent a tridimensional bone augmentation by means of a Ti-mesh filled with intraoral autogenous bone mixed with deproteinized anorganic bovine bone in a 1:1 ratio. Implants were placed after a healing period of 6 months. Panoramic x-rays were performed after each surgical procedure and during the follow-up recalls. Software was used to measure the mesial and the distal peri-implant bone loss around each implant. The mean peri-implant bone loss was 1.743 mm on the mesial side and 1.913 mm on the distal side, from the top of the implant head to the first visible bone-implant contact, at a mean follow-up of 88 months. The use of Ti-mesh allows the regeneration of sufficient bone volume for ideal implant placement. The clinical advantages related to this technique include the possibility of correcting severe vertical atrophies associated with considerable reductions in width and the lack of major complications if soft-tissue dehiscence and mesh exposures do occur.

Keywords: Autogenous bone; bone augmentation; bone resorption; dental implants; guided bone regeneration; titanium me..

Fig. (1)

Pre-operative orthopantomograph.

Fig. (2)

Clinical situation before surgical procedures.

Fig. (3)

Alveolar ridge pre-surgical anatomy after the reflection of a mucoperiosteal flap.

Fig. (4)

Titanium mesh in situ, filled with a mixture of particulated autogenous bone and DBBM in a 1:1 ratio.

Fig. (5)

Post-operative orthopantomograph.

Fig. (6)

Orthopantomograph after titanium mesh removal.

Fig. (7)

Morphology of the newly formed bone in the right maxilla after a healing period of 6 months.

Fig. (8)

Implants inserted in the right maxilla thanks to the amount of the regenerated bone.

Fig. (9)

Healing abutments connection.

Fig. (10)

Buccal view of the final prosthesis in situ.

Fig. (11)

Occlusal view of the final prosthesis in situ.

Fig. (12)

Follow-up orthopantomograph.