Utilizing Individualized Titanium Frames for Protected Alveolar Bone Augmentation: A Feasibility Case Series

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Engineering

Background:

• Guided bone regeneration (GBR) faces challenges in maintaining space and vascularization for large bone defects.
• Existing GBR techniques require effective solutions for predictable horizontal and vertical bone augmentation.

Purpose of the Study:

• To introduce and evaluate an original, customized titanium frame (TF) design for enhanced GBR in significant horizontal bone defects.
• To assess the feasibility and outcomes of using TFs combined with bone grafts and collagen membranes for bone augmentation.

Main Methods:

• A feasibility case series involving three patients with significant horizontal defects treated with customized titanium frames.
• Placement of a 50/50 autograft and bovine xenograft mixture, covered with a collagen membrane.
• Evaluation of bone gain at 8 months via reentry surgery and histomorphometric analysis of bone core biopsies.

Main Results:

• Achieved an average horizontal bone gain of 8.0 ± 1.0 mm and vertical bone gain of 3.0 ± 0.0 mm.
• Histomorphometric analysis showed 42.8% new vital bone, 18.8% residual graft particles, and 38.4% bone marrow-like structures.
• Successful implant placement and restoration were achieved in all cases.

Conclusions:

• GBR utilizing titanium frames, with or without collagen membranes, appears suitable for horizontal and vertical bone augmentation.
• The customized TF design shows potential for enhancing space maintenance and predictability in GBR.
• Results from this small case series require careful interpretation and further investigation.