(74) Application of a Customized Titanium Mesh for Predictable Bone Regeneration in Treatment of Advanced Alveolar Ridge Defects

Introduction: Treatment of advanced alveolar ridge defects remains a significant challenge in implant dentistry. Modern CAD/CAM technologies integrating cone-beam computed tomography (CBCT), scaffold design and metal laser-sintering 3D printing allow the production of patient-specific, customized titanium mesh to simplify surgical procedure and optimize treatment outcome.

Methods: Surface rendering of CBCT DICOM files was performed to facilitate planning and design of customized titanium mesh. Biologic and prosthetic considerations such as the amount of bone augmentation needed, anatomical restrictions and restoratively driven implant placement were incorporated into the design of the Titanium mesh.

Results: In this report, two patients with advanced alveolar ridge defects of the maxilla and mandible were presented. (Figures 1 and 2) The patients were treated with guided bone regeneration utilizing a customized 3D-printed titanium mesh framework in combination with a mix of allograft fibers/granules and xenograft. The bone graft materials were hydrated with rhPDGF-bb. The titanium mesh was further covered with a collagen barrier membrane. Backward design to guide and facilitate future implant placement was used in one of the clinical cases. (Figure1).

Conclusions: The two cases provide an example of the benefits in using customized titanium mesh to treat advanced alveolar ridge defect. This technology can improve communication and foster collaboration between the surgical and restorative specialists. Furthermore, the 3D models can aid in patient education and acceptance of the recommended therapy.

Lead Author's Contributions to the Research Project. : The Lead Author was responsible for the data collection, and the composition of the abstract.