Clinical and Radiographic Outcomes of Customized Titanium Mesh vs. Screw Tent-Pole Grafting: A Retrospective Study

Area of Science:

• Dental Implantology
• Bone Regeneration
• Biomaterials

Background:

• Guided bone regeneration (GBR) is crucial for alveolar ridge deficiencies before implant placement.
• Resorbable collagen membranes with tenting screws are common but may struggle with space maintenance in non-contained defects.
• Customized CAD/CAM titanium meshes offer potential for improved graft stability and surgical efficiency, yet require more clinical validation.

Purpose of the Study:

• To compare customized CAD/CAM titanium meshes against resorbable collagen membranes with tenting screws for alveolar ridge augmentation.
• Evaluate clinical, radiographic, procedural, and peri-implant outcomes.
• Assess efficacy in horizontal and/or vertical bone augmentation.

Main Methods:

• Retrospective study of 40 patients with severe alveolar ridge defects.
• Two groups (n=20 each): particulate bone grafts with tenting screws/collagen membrane vs. patient-specific CAD/CAM titanium mesh.
• CBCT scans (baseline, 6 months) for bone gain; assessment of operative time, complications, implant survival, and marginal bone levels (loading, 5-year follow-up).

Main Results:

• Comparable bone height and width gain at 6 months between groups (p>0.05).
• Stable and limited peri-implant marginal bone loss from loading to 5-year follow-up.
• Significantly shorter operative time for the customized titanium mesh group (62.4 min vs. 72.7 min).
• 100% implant survival rate with no additional grafting needed.

Conclusions:

• Both GBR techniques achieve comparable bone regeneration and long-term peri-implant stability.
• Customized CAD/CAM titanium meshes offer a procedural advantage by reducing operative time.
• Both methods are effective for severe alveolar ridge augmentation prior to implant placement.