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3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
Published on: August 4, 2020
Individualized 3D-Printed Titanium Mesh-Assisted Alveolar Reconstruction and Implant Rehabilitation Following MRONJ
The Journal of Oral Implantology
|August 4, 2026
Summary
This study shows customized 3D-printed titanium mesh aids bone regeneration and implant success in patients with medication-related osteonecrosis of the jaw (MRONJ). Careful planning and multidisciplinary care are crucial for successful outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomaterials Engineering
- Dental Implantology
Background:
- Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of antiresorptive therapy, often requiring complex reconstructive surgery.
- Mandibular defects from MRONJ pose significant challenges for prosthetic rehabilitation and implant placement.
Purpose of the Study:
- To describe the use of a customized 3D-printed titanium mesh for alveolar bone augmentation and implant-supported rehabilitation in a patient with extensive MRONJ.
- To evaluate the efficacy of this approach in achieving stable bone regeneration and functional prosthetic restoration.
Main Methods:
- A patient with stage-3 MRONJ underwent mandibulectomy and iliac crest grafting. Nine months post-surgery, a 3D-printed titanium mesh was used for alveolar augmentation.
- Cone beam computed tomography (CBCT) assessed bone regeneration. Implants were placed after mesh removal, followed by prosthetic rehabilitation.
- Resonance frequency analysis (RFA) and clinical follow-up evaluated implant stability and peri-implant tissue health.
Main Results:
- Successful mineralization and regeneration within the titanium mesh were confirmed by CBCT.
- Achieved 9.5 mm vertical and 11 mm horizontal alveolar augmentation, enabling placement of 4 implants with high primary stability (≥ 40 N cm).
- Stable implant integration (RFA 75-84) and satisfactory function were maintained at 12 months of loading, with normal peri-implant tissues and stable bone levels.
Conclusions:
- Customized 3D-printed titanium mesh combined with guided implant placement facilitates stable bone regeneration and prosthetic rehabilitation in MRONJ patients.
- Treatment outcomes are influenced by medication history, therapy timing, and unresolved drug-related factors, necessitating a multidisciplinary approach.
- Individualized treatment planning and proactive management of complications are essential for optimizing results in MRONJ cases.
