The effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium mesh

Abstract

Objective Additively manufactured (3D-printed) titanium meshes have been adopted in the dental field as non-resorbable membranes for guided bone regeneration (GBR) surgery. However, according to previous studies, inaccuracies between planned and created bone volume and contour are common, and many reasons have been speculated to affect its accuracy. The size of the alveolar bone defect can significantly increase patient-specific titanium mesh design and surgical difficulty. Therefore, this study aimed to analyze and investigate the effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium meshes. Methods Twenty 3D-printed patient-specific titanium mesh GBR surgery cases were enrolled, in which 10 cases were minor bone defect/augmentation (the planned bone augmentation surface area is less than or equal to 150 mm2 or one tooth missing or two adjacent front-teeth/premolars missing) and another 10 cases were significant bone defect/augmentation (the planned bone augmentation surface area is greater than 150 mm2 or missing adjacent teeth are more than two (i.e. ≥ three teeth) or missing adjacent molars are ≥ two teeth). 3D digital reconstruction/superposition technology was employed to investigate the bone augmentation accuracy of 3D-printed patient-specific titanium meshes. Results There was no significant difference in the 3D deviation distance of bone augmentation between the minor bone defect/augmentation group and the major one. The contour lines of planned-CAD models in two groups were basically consistent with the contour lines after GBR surgery, and both covered the preoperative contour lines. Moreover, the exposure rate of titanium mesh in the minor bone defect/augmentation group was slightly lower than the major one. Conclusion It can be concluded that the size of the bone defect has no significant effect on the 3D accuracy of alveolar bone augmentation performed with the additively manufactured patient-specific titanium mesh.

Bone reconstruction of extensive maxillomandibular defects in adults

“…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 .…”

“…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][128][129][130][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 In "large" defects (mean reconstructed bone volume 1004 mm 3 ), Lizio et al 228 summarized a failure rate of 5/19 sites.…”

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

“…The studies were from four categories: c before-after (Pre-Post) studies with no control g [46][47][48][49][50][51], and case series/case report studies [52-57…”

“…The Cochrane Collaboration tool was applied included in this review (Table 1), using the judgin S4 (Supplementary Materials). A moderate risk of Chiapasco 2021 [49] Prosthesis 2023, 5, FOR PEER REVIEW Table S3 (Supplementary M the reasons for exclusion The studies were from before-after (Pre-Post) studies [46][47][48][49][50][51], and case series/case re…”

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

“…However, our previous retrospective study showed that although the created bone volume increases roughly as the planned, the final created bone contour differed from the planned contour in the alveolar bone defect reconstruction sites. 14,15 It had been proposed that the placement accuracy of customized mesh, connective tissue layer beneath the customized mesh, gingival cracking, exposure of customized mesh, and other clinical complications affect final created bone recovery and contour. 16 For obvious reason, the surgical placement of customized mesh should be considered as the most fundamental and critical factor.…”