Vertical Ridge Augmentation with Customized Titanium Mesh Using a 3D-Printing Model: A Prospective Study in Humans.

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Engineering

Background:

• Vertical bone defects pose challenges for dental implant placement.
• Traditional ridge augmentation techniques can be complex and may have limitations.
• Customized implants offer potential for improved fit and predictability.

Purpose of the Study:

• To assess the efficacy of customized titanium mesh (CTM) for vertical ridge augmentation.
• To evaluate clinical, radiologic, histologic, and histomorphometric outcomes of CTM-based augmentation.
• To determine the feasibility of using 3D-printed models for CTM fabrication.

Main Methods:

• Prospective study involving patients requiring vertical ridge augmentation.
• CTM was fabricated using a 3D-printed model and commercial titanium mesh.
• Grafting utilized deproteinized porcine bone mineral with an absorbable membrane.
• Computed tomography assessed bone volume changes; clinical data recorded complications.
• Histologic and histomorphometric analyses were performed on bone core samples.

Main Results:

• Mean reconstructed bone volume achieved was 1.02 cm³ (80%+ reconstruction rate).
• An overall mesh exposure rate of 30% was observed.
• Histomorphometry revealed 27.52% new bone, 7.62% residual graft, and 64.86% connective tissue.
• Distinct pseudoperiosteum layer appearances were noted based on healing stage.

Conclusions:

• CTM fabrication via 3D printing simplifies vertical ridge augmentation.
• The technique facilitates achieving target bone acquisition and potentially reduces complications.
• CTM may aid in quantitative analysis of the pseudoperiosteum layer.