CAD/CAM Titanium Meshes for GBR: A Case Series with Preliminary Histologic Analysis

Area of Science:

• Biomaterials Science
• Oral and Maxillofacial Surgery
• Regenerative Medicine

Background:

• Titanium meshes have been utilized for guided bone regeneration (GBR) since the 1990s.
• Traditional mesh adaptation to bone defects presents challenges.
• Digital technologies offer solutions for precise mesh customization.

Purpose of the Study:

• To evaluate the efficacy of digitally designed titanium meshes for GBR.
• To assess bone regeneration using a combination of titanium meshes, demineralized bovine bone matrix (DBBM), and autogenous bone.
• To analyze radiographic and histologic outcomes of this regenerative approach.

Main Methods:

• A case series involving five patients undergoing 3D regenerative surgery.
• Customized titanium meshes were designed using patient CBCT data.
• Regeneration was achieved using a 1:1 mix of DBBM and autogenous bone.
• Radiographic evaluation of vertical bone gain was performed using CBCT scans.
• Histologic analysis of regenerated bone samples was conducted when available.

Main Results:

• Four out of five patients healed without significant complications.
• A mean vertical bone gain of 4.3 ± 1.5 mm was observed.
• Histologic analysis showed bone tissue percentages of 44.4% and 15.6% in the two samples.
• One mesh required removal due to early exposure.

Conclusions:

• Digitally designed titanium meshes are a viable option for GBR, offering precise adaptation to bone defects.
• The combination of these meshes with DBBM and autogenous bone promotes significant bone regeneration.
• This digital workflow enhances surgical predictability and patient outcomes in complex bone reconstructions.