Simultaneous TSIII implant placement with guided bone regeneration using titanium mesh (Ossbuilder ) in the narrow ridge region : case series
By: Heon-Young Kim, Jung-HyunPark, Jin-woo Kim, Sun-Jong Kim
Bone augmentation should be performed prior to and/or simultaneously with implant placement when the preoperative examination shows a lack of alveolar bone volume at the implant placement site. Despite many advantages of GBR, it is difficult to maintain suitable space for ideal bone regeneration because unless there is a hard structure to support the space, soft tissue collapses into it.
Titanium mesh has been widely used for oral and maxillofacial defect reconstruction. It is biocompatible and rigid enough to maintain the grafted space.
However, one complication related to titanium mesh is the high risk of exposure following repeated mucosal irritation. Before its application, titanium mesh should be cut, bent, and trimmed.
Recently, preformed titanium mesh with round and blunt edges were developed to prevent mucosal irritation.
We used a customized, three-dimensional, preformed titanium mesh (OSSBUILDER ) to reconstruct the peri-implant defects occurring immediately after implant placement. The objective of this study was to evaluate the preformed titanium mesh’s efficacy as a barrier membrane in localized alveolar bone regeneration.
Materials & Methods
- Patient selection :
- 7 patients (3 male and 4 female, aged 37-65) participated in this study between 2016 and 2018 at the OMFS Department, Ewha Womans University Medical Center.
- Methods :
- In all cases, the implant threads were partially exposed and the GBR procedure was performed within these peri-implant defects.
FDBA was mixed with xenograft (A-oss ) material. A mixture of the graft materials was placed on the dehiscence or fenestration defect and covered with the preformed titanium mesh.
After approximately four months of the healing period, re-entry surgery was performed and the preformed titanium mesh was removed.
Panoramic radiographs and CBCT were taken immediately after and 6months after surgery to evaluate changes in width of the implantation site.
- Clinical results: They showed good healing without specific complications such as infection
- In all cases, there is no need for additional bone graft since no bone dehiscence or marginal loss at the time of
- Radiographic results: As a result of evaluation of the width change of the alveolar crest using CBCT, the new
bone formation was successful and could cover dehiscence or fenestration defect.
- The customized, three-dimensional, and preformed titanium mesh induced successful bone regeneration in
peri-implant defects occurring after implant placement.
- Preformed titanium mesh supports the grafted space for new bone formation, makes application and
removal convenient, and minimizes the risk of mesh exposure in the reconstruction of peri-implant alveolar
- Even in the cases of titanium mesh exposure, this preformed titanium mesh produced reliable outcomes as
a barrier membrane.