Long‐term results in three‐dimensional, complex bone augmentation procedures with customized titanium meshes

Hartmann, Amely; Hildebrandt, H; Younan, Zina; Kämmerer, Peer W.

doi:10.1111/clr.14000

Cited by 7 publications

(6 citation statements)

References 83 publications

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“…Nevertheless, a recent systematic review did not find a significant difference in exposure rates between conventional and customized meshes, 125 whereas another review did see this difference 126 . For (customized) titanium meshes, most reports analyzed horizontal augmentation of a maximum of 5–7 mm vertically and 4–5 mm in horizontal height, or did not give exact data on the augmented volume 121,124,127–131 . In one case series, a vertical and horizontal gain of up to 9 mm with an exposure rate of 1/10 cases was reported 132 .…”

Section: Stabilization Of Particulated Graftsmentioning

confidence: 97%

“…121 For improved surgeons' and patients' reported outcomes, prefabricated patient-specific meshes were introduced 120 and used with promising results, including less exposure (0%-33%) and shorter operation times (Figure 5). 55,114,[122][123][124] Nevertheless, a recent systematic review did not find a significant difference in exposure rates between conventional and customized meshes, 125 whereas another review did see this difference. 126 For (customized) titanium meshes, most reports analyzed horizontal augmentation of a maximum of 5-7 mm vertically and 4-5 mm in horizontal height, or did not give exact data on the augmented volume.…”

Section: Titanium Meshesmentioning

confidence: 99%

“…In the case of such an adverse event, the site must be kept as clean as possible. Early mesh removal is not recommended if there are no signs of infection, because dental implant placement is often possible later on 121 …”

Section: Stabilization Of Particulated Graftsmentioning

confidence: 99%

“…Based on the patient's three‐dimensional Digital Imaging and Communications in Medicine data, a virtual model of the jaw, including the defect, is generated. The necessary bone volume is added using reverse engineering software, and the titanium mesh is generated 121 . For improved surgeons' and patients' reported outcomes, prefabricated patient‐specific meshes were introduced 120 and used with promising results, including less exposure (0%–33%) and shorter operation times (Figure 5).…”

Section: Stabilization Of Particulated Graftsmentioning

confidence: 99%

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Bone reconstruction of extensive maxillomandibular defects in adults

Kämmerer,

Al‐Nawas

2023

Periodontology 2000

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Reconstruction of significant maxillomandibular defects is a challenge that has been much discussed over the last few decades. Fundamental principles were developed decades ago (bone bed viability, graft immobilization). Clinical decision‐making criteria are highly relevant, including local/systemic factors and incision designs, the choice of material, grafting technique, and donor site morbidity. Stabilizing particulated grafts for defined defects—that is, via meshes or shells—might allow significant horizontal and vertical augmentation; the alternatives are onlay and inlay techniques. More significant defects might require extra orally harvested autologous bone blocks. The anterior iliac crest is often used for nonvascularized augmentation, whereas more extensive defects often require microvascular reconstruction. In those cases, the free fibula flap has become the standard of care. The development of alternatives is still ongoing (i.e., alloplastic reconstruction, zygomatic implants, obturators, distraction osteogenesis). Especially for these complex procedures, three‐dimensional planning tools enable facilitated planning and a surgical workflow.

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Section: Stabilization Of Particulated Graftsmentioning

confidence: 97%

Section: Titanium Meshesmentioning

confidence: 99%

Section: Stabilization Of Particulated Graftsmentioning

confidence: 99%

Section: Stabilization Of Particulated Graftsmentioning

confidence: 99%

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Bone reconstruction of extensive maxillomandibular defects in adults

Kämmerer,

Al‐Nawas

2023

Periodontology 2000

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“…There were shorter operative times and reduced risk of postoperative infections among these serial cases. Cucchi and colleagues [10][11][12] reported a series of clinical studies stating that sufficient augmentation volume and satisfactory clinical outcome could be obtained using customized mesh. Li and colleagues 13 reported that coupling customized mesh with GBR surgery increases the augmentation of alveolar bone by providing osteogenic conditions for the healing stage.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of surgical placement accuracy of customized CAD/CAM titanium mesh using screws‐position‐guided template: A retrospective comparative study

Chen

Zheng

Wang

et al. 2023

Clin Implant Dent Rel Res

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Background: Customized computer-aided-design/computer-aided-manufacturing (CAD/CAM) titanium meshes have been adopted for alveolar bone augmentation.But the inaccuracies between planned and created bone volume/contour are quite common, and the surgical placement of the customized mesh was considered as the first critical factor. However, the evaluation of surgical placement accuracy of customized mesh is currently lacking. Purpose:The aim of this study was to evaluate the accuracy of the surgical placement of customized meshes.Methods: A total of 30 cases, 20 without the screws-position-guided template and 10 with the screws-position-guided template, were included in this study. The cone beam CT (CBCT) data sets of pre-and postoperative were converted into 3D models and digitally aligned. Then the actual placement of customized mesh and retainer titanium screws was compared to the virtual one to assess the surgical placement accuracy of customized mesh. At least 6 months after surgery, a new CBCT was taken and converted into 3D models. Planned bone volume, created bone volume, vertical bone augmentation, healing complications rate, pseudo-periosteum rate, exposure rate, and infection rate were all evaluated.Results: The 3D digital reconstruction/registration analysis showed that the average difference between actual placement and planned one of customized mesh in positive and negative directions was 2.69 ± 0.70 mm and À1.41 ± 0.90 mm, respectively, without the screws-position-guided template. And the mean difference values between the actual and planned placement of the screws on the X and Y axes were 0.74 ± 0.85 mm and 0.89 ± 0.84 mm. In contrast, with the screws-position-guided template, the results were 2.38 ± 0.69 mm and À1.30 ± 1.13 mm. Accordingly, the mean difference values of screws were 0.76 ± 0.84 mm and 0.94 ± 0.72 mm. There was no statistical difference between the two groups, and the noninferiority of the control group compared to the test group was also confirmed by the comparative analysis. Conclusion:It can be concluded that there is a certain deviation between the planned surgical placement and actual one of customized mesh, and using screws-position-

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