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

Tröltzsch, Matthias ; Caca, Johanna ; Otto, Sven und Tröltzsch, Markus (2025): Can Patient-Specific Titanium Meshes Achieve Predictable Bone Volume in Extensive Alveolar Defects? In: Journal of Oral and Maxillofacial Surgery [Forthcoming]

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 Customized Bone Regeneration ; 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 mm3).

Outcome variable

The primary outcome variable was the achieved augmentation volume (in mm3) about 3 months after mesh placement, determined by cone beam computed tomography analysis using Slicer 3D software (Brigham and Women's Hospital, Boston, MA).

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 < .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 mm3 (±949.03 mm3) and 763.23 mm3 (±510.2 mm3), respectively (P < .001; Pearson correlation coefficient 0.73). A more rigid mesh fixation significantly increased the achieved bone volume (β = 0.34; P = .006). Wound healing disturbances occurred frequently (42%) but did not reduce the achieved bone volume. During the median follow-up period of 23 months (interquartile range: 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Klinikum der LMU München > Poliklinik für Zahnerhaltung und Parodontologie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 02782391
• Sprache: Englisch