A Titanium Mesh and Particulate Allograft for Vertical Ridge Augmentation in the Posterior Mandible: A Pilot Study

This preliminary study was designed to test the clinical efficacy of a modified Ti-mesh combined with particulate allograft for vertical ridge augmentation (VRA). Five healthy patients with vertical ridge deficiency in the posterior mandible were recruited. Preoperative width of the keratinized mucosa (KM) and mucosal thickness (MT) were measured. Cone beam computed tomography (CBCT) scans were taken preoperatively, immediately, and 5 months after VRA. The amount of vertical bone gain was measured on CBCT scans. Bone core biopsies were taken for histomorphometric examinations. The mean ± standard deviation KM on the facial and lingual sides was 3.9 ± 1.7 mm and 3.3 ± 1.3 mm, respectively. The mean thickness of the flaps, measured at the facial, lingual, and crestal sites, was 2.9 ± 0.8 mm, 1.8 ± 0.8 mm, and 3.2 ± 1.2 mm, respectively. The mean vertical gain was 3.4 ± 1.9 mm when only the sites with the greatest vertical defect in each subject were studied. Histometric analysis of the bone cores revealed that percentages of the soft tissue, residual allograft, and new bone were 42.2% ± 10.0%, 25.2% ± 13.5%, and 32.6% ± 4.9%. The use of a Ti-mesh and particulate allograft may be a viable option for vertical augmentation of sites with slight to moderate ridge deficiency.