[논문]Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration

Jung, Gyu-Un; Jeon, Jae-Yun; Hwang, Kyung-Gyun; Park, Chang-Joo

doi:10.5125/jkaoms.2014.40.4.181

Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration 원문보기

Journal of the Korean Association of Oral and Maxillofacial Surgeons, v.40 no.4, 2014년, pp.181 - 187

Jung, Gyu-Un (Department of Periodontology, Ewha Womans University Mokdong Hospital) , Jeon, Jae-Yun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine) , Hwang, Kyung-Gyun (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine) , Park, Chang-Joo (Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine)

Abstract ▼ AI-Helper

Objectives: The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration. Materials and Methods: Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed. Results: Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications. Conclusion: The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.

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문제 정의

Actually, the most important ability of GBR is its ability to maintain space under the membrane. This preliminary study focused on a titanium mesh, which is one of the most reliable barrier membranes in ridge augmentation. The titanium mesh was first proposed for alveolar ridge reconstruction in 1969 by Boyne⁷.

가설 설정

(Fig. 4) Primary flap closure was accomplished without tension. Antibiotics and analgesics were administered three times daily for ten days in addition to 0.

제안 방법

After approximately four months of the healing period, reentry surgery was performed to uncover the implant under the minimum flap reflection. The preformed titanium mesh was removed and the regenerated bone was examined carefully.

대상 데이터

A total of 10 patients (5 male and 5 female, aged 17-87 years) who were partially edentulous participated in this study between August 2012 and June 2014 at Hanyang University Hospital. Preoperative clinical and radiologic evaluations indicated that the GBR procedure should be performed simultaneously with the implant placement in all patients.
Implant were placed under local anesthesia using a trapezoidal full-thickness flap with two vertical releasing incisions. A total of 12 implants (TS III CA; Osstem) in 10 patients were inserted by the standard procedure. In all cases, the implant threads were partially exposed and the GBR procedure was performed for these peri-implant defects.
¹⁴ reported 52% exposure of the maxilla and mandible with a range of 43%-55%. Three of the 10 patients (30%) in this study experienced titanium mesh exposure during the healing period (with one in the maxilla and two in the mandible). However, even in cases of membrane exposure, there was satisfactory bone regeneration and successful implant survival.

참고문헌 (21)

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6 Rakhmatia YD Ayukawa Y Furuhashi A Koyano K Current barrier membranes: titanium mesh and other membranes for guided bone regeneration in dental applications J Prosthodont Res 2013 57 3 14 23347794

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7 Boyne PJ Restoration of osseous defects in maxillofacial casualities J Am Dent Assoc 1969 78 767 776 4975262
8 Corinaldesi G Pieri F Sapigni L Marchetti C Evaluation of survival and success rates of dental implants placed at the time of or after alveolar ridge augmentation with an autogenous mandibular bone graft and titanium mesh: a 3- to 8-year retrospective study Int J Oral Maxillofac Implants 2009 24 1119 1128 20162118
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10 Ciocca L Fantini M De Crescenzio F Corinaldesi G Scotti R Direct metal laser sintering (DMLS) of a customized titanium mesh for prosthetically guided bone regeneration of atrophic maxillary arches Med Biol Eng Comput 2011 49 1347 1352 21779902

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14 Louis PJ Gutta R Said-Al-Naief N Bartolucci AA Reconstruction of the maxilla and mandible with particulate bone graft and titanium mesh for implant placement J Oral Maxillofac Surg 2008 66 235 245 18201602

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15 von Arx T Hardt N Wallkamm B The TIME technique: a new method for localized alveolar ridge augmentation prior to placement of dental implants Int J Oral Maxillofac Implants 1996 11 387 394 8752560

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16 Boyne PJ Cole MD Stringer D Shafqat JP A technique for osseous restoration of deficient edentulous maxillary ridges J Oral Maxillofac Surg 1985 43 87 91 3881576

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17 Adeyemo WL Reuther T Bloch W Korkmaz Y Fischer JH Zöller JE Healing of onlay mandibular bone grafts covered with collagen membrane or bovine bone substitutes: a microscopical and immunohistochemical study in the sheep Int J Oral Maxillofac Surg 2008 37 651 659 18378427

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19 Proussaefs P Lozada J Use of titanium mesh for staged localized alveolar ridge augmentation: clinical and histologic-histomorphometric evaluation J Oral Implantol 2006 32 237 247 17069168

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21 Wang HL Tsao YP Histologic evaluation of socket augmentation with mineralized human allograft Int J Periodontics Restorative Dent 2008 28 231 237 18605598

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Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration 원문보기

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Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration 원문보기

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