Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Sep 2;13(17):3874.
doi: 10.3390/ma13173874.

Customized 3D-Printed Titanium Mesh Developed to Regenerate a Complex Bone Defect in the Aesthetic Zone: A Case Report Approached with a Fully Digital Workflow

Marco Tallarico  1 , Chang-Joo Park  2 , Aurea Immacolata Lumbau  1 , Marco Annucci  3 , Edoardo Baldoni  1 , Alba Koshovari  4 , Silvio Mario Meloni  1
Affiliations
Case Reports

Customized 3D-Printed Titanium Mesh Developed to Regenerate a Complex Bone Defect in the Aesthetic Zone: A Case Report Approached with a Fully Digital Workflow

Marco Tallarico et al. Materials (Basel). .

Abstract

Alveolar-ridge augmentation, anterior aesthetics, and digital technologies are probably the most popular topics in the dental-implant field. The aim of this report is to present a clinical case of severe atrophy of the anterior maxilla in a younger female patient, treated with a titanium membrane customized with computer-aided design/computer-aided manufacturing (CAD/CAM), simultaneous guided implant placement, and a fully digital workflow. A young female patient with a history of maxillary trauma was treated and followed-up for 1 year after implant placement. A narrow implant was inserted in a prosthetically driven position with the aid of computer-guided surgery. In the same surgical section, a customized implantable titanium mesh was applied. The scaffold was designed according to the contralateral maxillary outline in order to recreate a favorable maxillary bone volume. Finally, highly aesthetic, CAD/CAM, metal-free restorations were delivered using novel digital technologies.

Keywords: anterior maxilla; dental implants; digital workflow; guided bone regeneration; titanium mesh scaffold.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Intraoral view showing the starting position with severe bone atrophy and soft tissue deficiency.
Figure 2
Figure 2
Virtual implant planning showing the implant sites with ≤4.0 mm bone in bucco-oral dimension, as measured on cone-beam computer tomography (CBCT) cross-sectional image.
Figure 3
Figure 3
Computer-aided design (CAD) of the customized titanium mesh based on the contralateral maxillary outline and OssBuilder (Osstem Implant Co., Ltd., Seoul, Korea) features.
Figure 4
Figure 4
Computer-aided manufacturing (3D-printing technology) of the customized titanium mesh and the surgical template.
Figure 5
Figure 5
Intraoral view of the customized titanium mesh fixed using two titanium pins.
Figure 6
Figure 6
Intraoral view 3 weeks after surgery and sutural removal.
Figure 7
Figure 7
Intraoral view 4 months after uncomplicated healing.
Figure 8
Figure 8
Second-stage surgery: titanium mesh removal and soft-tissue management.
Figure 9
Figure 9
Intraoral view 3 months after second-stage surgery.
Figure 10
Figure 10
Intraoral digital impression taken using a scan body (Osstem Implant Co., Ltd., Seoul, Korea).
Figure 11
Figure 11
Intraoral digital impressions.
Figure 12
Figure 12
CAD of the definitive restorations. A Digital Lab Analog (Osstem Implant Co., Ltd., Seoul, Korea) was used at the implant position, while a removable abutment was used at the natural tooth position.
Figure 13
Figure 13
Definitive, hybrid, zirconia, screw-retained crown, cemented outside the patient’s mouth on a Ti-linked abutment (Osstem Implant Co., Ltd., Seoul, Korea). The zirconia crown was layered with feldspatic ceramic to improve the aesthetics.
Figure 14
Figure 14
Transition zone showing good soft-tissue healing.
Figure 15
Figure 15
Intraoral front 1 year after implant placement (2 months after definitive-restoration delivery).
Figure 16
Figure 16
Intra- and extraoral lateral views 1 year after implant placement (2 months after definitive-restoration delivery).
Figure 17
Figure 17
Sequence of radiographic examinations from implant placement to 1 year later.
See this image and copyright information in PMC

References

    1. Esposito M., Trullenque-Eriksson A., Tallarico M. Endodontic retreatment versus dental implants of teeth with an uncertain endodontic prognosis: 3-year results from a randomised controlled trial. Eur. J. Oral Implantol. 2018;11:423–438. - PubMed
    1. Meloni S.M., Lumbau A., Baldoni E., Pisano M., Spano G., Massarelli O., Tallarico M. Platform switching versus regular platform single implants: 5-year post-loading results from a randomised controlled trial. Int. J. Oral Implantol. (New Malden) 2020;13:43–52. - PubMed
    1. Meloni S.M., Lumbau A., Spano G., Baldoni E., Pisano M., Tullio A., Tallarico M. Sinus augmentation grafting with anorganic bovine bone versus 50% autologous bone mixed with 50% anorganic bovine bone: 5 years after loading results from a randomised controlled trial. Int. J. Oral Implantol. (New Malden) 2019;12:483–492. - PubMed
    1. Meloni S.M., Spano G., Ceruso F.M., Gargari M., Lumbau A., Baldoni E., Massarelli O., Pisano M., Tallarico M. Upper jaw implant restoration on six implants with flapless guided template surgery and immediate loading: 5 years results of a prospective case series. Oral Implantol. 2020;12:151–160. doi: 10.1111/clr.45_13508. - DOI
    1. Tallarico M., Cervino G., Scrascia R., Uccioli U., Lumbau A.I., Meloni S.M. Minimally invasive treatment of edentulous maxillae with overdenture fully supported by a cad/cam Titanium Bar with a low-profile attachment screwed on four or six implants: A case series. Prosthesis. 2020;2:53–64. doi: 10.3390/prosthesis2020006. - DOI

Publication types

LinkOut - more resources