Work

Can Patient-Specific Titanium Meshes Achieve Predictable Bone Volume in Extensive Alveolar Defects?

Year: 2025

Type: article

Abstract: Background Reconstructing alveolar defects with titanium meshes is challenging and prone to complications. The introduction of patient-specific titanium meshes was expected to overcome these drawbacks. Purpose The aim of this study was to evaluate the association between planned and achieved augmentation volumes using patient-specific titanium meshes (Yxoss CBR ®️; ReOss, Filderstadt, Germany) and to identify factors associated with the clinically achieved augmentation volumes. Study Design, Setting, and Sample A single-center, retrospective cohort study was performed in an outpatient clinic. Inclusion criteria were patients aged >18 who underwent jaw augmentation with custom titanium meshes and a complete follow-up (postoperative healing, implant placement, and loading) between 2018 and 2023. Exclusion criteria were objection or inability to submit informed consent, loss to follow-up, and incomplete documentation. Predictor variable The predictor was the planned augmentation volume (in mm 3 ). Outcome variable The primary outcome variable was the achieved augmentation volume (in mm 3 ) about 3 months after mesh placement, determined by cone beam computed tomography (CBCT) analysis using Slicer 3D ® software (Boston). Covariates The covariates were sex, wound healing disturbances, rigidity of mesh fixation (number of screws) and mesh exposure. Analyses Descriptive and inferential statistics were computed (p < 0.05). Results During the study interval, 82 patients were treated, and 53 (64%) were excluded due to incomplete radiological data or loss to follow-up. The sample was composed of 29 subjects with a mean age of 61.8 years (± 12.75), in whom 33 augmentation procedures were performed. Eight (27.8%) subjects were male. The mean planned and achieved augmentation volumes were 1488.73 mm 3 (± 949.03 mm 3 ) and 763.23 mm 3 (± 510.2 mm 3 ), respectively (p < 0.001; Pearson correlation coefficient 0.73). A more rigid mesh fixation significantly increased the achieved bone volume (β = 0.34, p=0.006). Wound healing disturbances occurred frequently (42%) but did not reduce the achieved bone volume. During the median follow-up period of 23 months (IQR: 14-31), none of the 60 implants placed in the augmented bone failed. Conclusion and relevance Despite a significant complication rate, adequate bone volume for implant placement can be attained with custom titanium meshes.

Source: Journal of Oral and Maxillofacial Surgery

DOI: 10.1016/j.joms.2025.07.006

Authors: Matthias Tröltzsch, Matthias Tröltzsch, Johanna Caca, Sven Otto, Markus Tröltzsch, Markus Tröltzsch

Institution: Ludwig-Maximilians-Universität München

Language: English

Topic: Dental Implant Techniques and Outcomes

Subfield: Oral Surgery

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,500