Customized CAD/CAM titanium meshes for the guided bone regeneration of severe alveolar ridge defects: Preliminary results of a retrospective clinical study in humans

Abstract

Objectives: To present the results of guided bone regeneration (GBR) of atrophic edentulous ridges with customized CAD/CAM titanium meshes.

Material and methods: Forty-one patients, presenting with 53 atrophic sites, were enrolled between 2018 and 2019. GBR was obtained with titanium meshes filled with autogenous bone chips and bovine bone mineral (BBM). After a mean of 7 months (range: 5-12 months), meshes were removed and 106 implants placed. After a mean of 3.5 months (range: 2-5 months), implants were uncovered and prosthetic restorations started. The outcomes were vertical and horizontal bone augmentation changes, biological complications and implant survival.

Results: Out of 53 sites, 11 underwent mesh exposure: eight of them were followed by uneventful integration of the graft, while three by partial bone loss. The mean vertical and horizontal bone gain after reconstruction was 4.78 ± 1.88 mm (range 1.00-8.90 mm) and 6.35 ± 2.10 mm (range 2.14-11.48 mm), respectively. At the time of implant placement, mean changes of initial bone gain were -0.39 ± 0.64 mm (range -3.1 to + 0.80 mm) and -0.49 ± 0.83 mm (range -3.7 to +0.4 mm), in the vertical and horizontal dimensions, respectively. Reduction of bone volume was significantly higher (p < .001 for both dimensions) in the exposed sites. The mean follow-up of implants after loading was 10.6 ± 6.5 months (range: 2-26 months). The survival rate of implants was 100%.

Conclusion: Customized titanium meshes can represent a reliable tool for GBR of severely atrophic sites, with simplification of the surgical phases.

Keywords: CAD-CAM; alveolar bone defects; autogenous bone; custom-made; dental implants; guided bone regeneration; implant-supported prosthesis; titanium mesh.