scholarly journals Clinical and Radiographic Evaluation of Simultaneous Alveolar Ridge Augmentation by Means of Preformed Titanium Meshes at Dehiscence-Type Peri-Implant Defects: A Prospective Pilot Study

Materials ◽  
2020 ◽  
Vol 13 (10) ◽  
pp. 2389 ◽  
Author(s):  
Carlo Maiorana ◽  
Mattia Manfredini ◽  
Mario Beretta ◽  
Fabrizio Signorino ◽  
Andrea Bovio ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Radiographic Evaluation ◽  
Mesh Exposure ◽  
Titanium Mesh ◽  
Patient Centered ◽  
Intimate Contact ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Clinical Measurements ◽  
Bone Gain

Background: bone augmentation by means of manually shaped titanium mesh is an established procedure to regenerate atrophic alveolar ridges and recreate a proper contour of the peri-implant bone anatomy. Conversely, current literature on the use of preformed titanium meshes instead of traditional grids remains lacking. Therefore, the aim of the present prospective study was to evaluate the use of preformed titanium mesh to support bone regeneration simultaneously to implant placement at dehiscence-type defects from clinical, radiological, and patient-related outcomes. Methods: 8 implants showing buccal dehiscence defects were treated with preformed titanium mesh directly fixed to flat abutments screwed to the implant. Intrasurgical clinical measurements and radiographic evaluations by means of cone-beam computed tomography scans were performed to assess the horizontal bone gain after 8 months from the augmentation surgery. Biological and patient-centered outcomes were also evaluated.; Results: clinically, a mean horizontal bone gain of 4.95 ± 0.96 mm, and a mean horizontal thickness of the buccal plate of 3.25 ± 0.46 mm were found. A mean horizontal bone gain of 5.06 ± 0.88 mm associated with a mean horizontal thickness of the buccal plate of 3.45 ± 0.68 mm were observed radiographically. From a macroscopic aspect, the remodeled graft appeared well integrated with the host bone. Well vascularized newly formed bone-like tissue was observed in intimate contact with the implants. Conclusions: preformed titanium mesh may be effective in supporting simultaneous horizontal bone regeneration at dehiscence-type peri-implant defects. Titanium mesh exposure still remain an issue in this type of surgery.

scholarly journals Volumetric changes in edentulous alveolar ridge sites utilizing guided bone regeneration and a custom titanium ridge augmentation matrix (CTRAM): a case series study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Craig E. Hofferber ◽  
J. Cameron Beck ◽  
Peter C. Liacouras ◽  
Jeffrey R. Wessel ◽  
Thu P. Getka
Keyword(s):  
Case Series ◽  
Bone Allograft ◽  
Volumetric Analysis ◽  
Collagen Membrane ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Case Series Study ◽  
Freeze Dried ◽  
Clinical Measurements ◽  
Bone Gain

Abstract Background The purpose of this study was to evaluate the volumetric changes in partially edentulous alveolar ridges augmented with customized titanium ridge augmentation matrices (CTRAM), freeze-dried bone allograft, and a resorbable collagen membrane. Methods A pre-surgical cone beam computed tomography (CBCT) scan was obtained for CTRAM design/fabrication and to evaluate pre-surgical ridge dimensions. Ridge augmentation surgery using CTRAM, freeze-dried bone allograft, and a resorbable collagen membrane was performed at each deficient site. Clinical measurements of the area of augmentation were made at the time of CTRAM placement and re-entry, and a 2nd CBCT scan 7 months after graft placement was used for volumetric analysis. Locations of each CTRAM in situ were also compared to their planned positions. Re-entry surgery and implant placement was performed 8 months after CTRAM placement. Results Nine subjects were treated with CTRAM and freeze-dried bone allograft. Four out of the nine patients enrolled (44.4%) experienced premature CTRAM exposure during healing, and in two of these cases, CTRAM were removed early. Early exposure did not result in total graft failure in any case. Mean volumetric bone gain was 85.5 ± 30.9% of planned augmentation volume (61.3 ± 33.6% in subjects with premature CTRAM exposure vs. 104.9% for subjects without premature exposure, p = 0.03). Mean horizontal augmentation (measured clinically) was 3.02 mm, and vertical augmentation 2.86 mm. Mean surgical positional deviation of CTRAM from the planned location was 1.09 mm. Conclusion The use of CTRAM in conjunction with bone graft and a collagen membrane resulted in vertical and horizontal bone gain suitable for implant placement.

scholarly journals Highly Predictable Augmentation of the Alveolar Ridge: Using a Titanium Mesh in Two-Stage Implant Surgery at the Mandible. Report of Clinical Cases and Surgical Technique

2018 ◽  
Vol 2 (1) ◽  
pp. 43-50
Keyword(s):  
Mesh Exposure ◽  
Alveolar Ridge ◽  
Titanium Mesh ◽  
Alveolar Ridge Augmentation ◽  
Two Stage ◽  
Implant Surgery ◽  
Ridge Augmentation ◽  
Mesh Material ◽  
Bone Gain ◽  
Prosthetic Complications

Purpose. The aim of this prospective surgical note was to evaluate the highly predictable horizontal bone gain of the alveolar ridge augmentation in two-stage implant surgery at the mandible with titanium mesh. Material and Methods. Five patients treated with 10 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Seoul, Republic of Korea) were selected for inclusion in the present surgical note. Primary outcomes were highly predictable horizontal bone gain of the alveolar ridge augmentation, secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the cone beam computed tomography (CBCT) showed a mean horizontal bone gain of 2 mm. The most frequent complications were mild postoperative edema (40% of patients) and discomfort after surgery (60% of patients); these complications were resolved within one week. Titanium mesh exposure occurred in 0 patients. And implant survival rate of 100% (implant-based). Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results.

scholarly journals Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series

2020 ◽  
Author(s):  
Peter Windisch ◽  
Kristof Orban ◽  
Giovanni E. Salvi ◽  
Anton Sculean ◽  
Balint Molnar
Keyword(s):  
Bone Regeneration ◽  
Case Series ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Autogenous Bone ◽  
Hard Tissue ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Simultaneous Group ◽  
Flap Design

Abstract Objectives To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing. Materials and methods Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination. Results Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3. Conclusion Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction. Clinical relevance The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure.

scholarly journals Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft

2015 ◽  
Vol 16 (2) ◽  
pp. 154-162 ◽  
Author(s):  
Danilo Alessio Di Stefano ◽  
Gian Battista Greco ◽  
Lorenzo Cinci ◽  
Laura Pieri
Keyword(s):  
Bone Graft ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Bone Sample ◽  
Successful Outcome ◽  
Autogenous Bone ◽  
Titanium Mesh ◽  
Ridge Augmentation ◽  
Stereolithographic Model ◽  
Equine Bone

ABSTRACT Aim The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans. Background Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage. Case description The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagenpreserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months. Conclusion Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone. Clinical significance Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice. How to cite this article Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015;16(2):154-162.

scholarly journals 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

Materials ◽  
2020 ◽  
Vol 13 (17) ◽  
pp. 3874 ◽  
Author(s):  
Marco Tallarico ◽  
Chang-Joo Park ◽  
Aurea Immacolata Lumbau ◽  
Marco Annucci ◽  
Edoardo Baldoni ◽  
...  
Keyword(s):  
Female Patient ◽  
Computer Aided Design ◽  
Digital Technologies ◽  
Titanium Mesh ◽  
Digital Workflow ◽  
Anterior Maxilla ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Computer Aided ◽  
Cad Cam

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.

scholarly journals Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
B. Alper Gultekin ◽  
Elcin Bedeloglu ◽  
T. Emre Kose ◽  
Eitan Mijiritsky
Keyword(s):  
Bone Resorption ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Outcome Variable ◽  
Insertion Torque ◽  
Recipient Site ◽  
Implant Placement ◽  
Bone Atrophy ◽  
Augmentation Techniques ◽  
Bone Gain

Purpose. Bone atrophy after tooth loss may leave insufficient bone for implant placement. We compared volumetric changes after autogenous ramus block bone grafting (RBG) or guided bone regeneration (GBR) in horizontally deficient maxilla before implant placement. Materials and Methods. In this retrospective study, volumetric changes at RBG or GBR graft sites were evaluated using cone-beam computed tomography. The primary outcome variable was the volumetric resorption rate. Secondary outcomes were bone gain, graft success, and implant insertion torque. Results. Twenty-four patients (28 grafted sites) were included (GBR, 15; RBG, 13). One patient (RBG) suffered mucosal dehiscence at the recipient site 6 weeks after surgery, which healed spontaneously. Mean volume reduction in the GBR and RBG groups was 12.48 ± 2.67% and 7.20 ± 1.40%, respectively. GBR resulted in significantly more bone resorption than RBG (P<0.001). Mean horizontal bone gain and width after healing were significantly greater in the GBR than in the RBG group (P=0.002 and 0.005, resp.). Implant torque was similar between groups (P>0.05). Conclusions. Both RBG and GBR hard-tissue augmentation techniques provide adequate bone graft volume and stability for implant insertion. However, GBR causes greater resorption at maxillary augmented sites than RBG, which clinicians should consider during treatment planning.

scholarly journals Localized ridge augmentation in the anterior maxilla using titanium mesh, an alloplast, and a nano-bone graft: a case report

2018 ◽  
Vol 46 (5) ◽  
pp. 2001-2007 ◽  
Author(s):  
Adel S Alagl ◽  
Marwa Madi
Keyword(s):  
Bone Graft ◽  
Relevant Literature ◽  
Alveolar Ridge ◽  
Titanium Mesh ◽  
Anterior Maxilla ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Maxillary Region ◽  
Radiographic Presentation

Alveolar ridge deficiency is considered a major limitation for successful implant placement, as well as for the long-term success rate, especially in the anterior maxillary region. Various approaches have been developed to increase bone volume. Among those approaches, inlay and onlay grafts, alveolar ridge distraction, and guided bone regeneration have been suggested. The use of titanium mesh is a reliable method for ridge augmentation. We describe a patient who presented with a localized, combined, horizontal and vertical ridge defect in the anterior maxilla. The patient was treated using titanium mesh and alloplast material mixed with a nano-bone graft to treat the localized ridge deformity for future implant installation. The clinical and radiographic presentation, as well as relevant literature, are presented.

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