Clinical effect of porous titanium mesh with cross-linked collagen membrane for guided bone regeneration

Abstract

Titanium mesh, a barrier membrane, has excellent mechanical properties and space maintaining ability. However, one of its disadvantages is that soft tissue over the membrane could be interposed through the pore of the mesh. Conversely, the cross-linked collagen membrane has good soft tissue reaction and reduces the migration of epithelial cells to the guided bone regeneration site. Therefore, we performed guided bone regeneration using a combination of collagen membrane and titanium mesh and analyzed the clinical results. The patients were divided into two groups. Only titanium mesh was used for guided bone regeneration in group A, and a combination of titanium mesh and collagen membrane was used in group B. The degree of soft tissue interposition over the titanium mesh was evaluated after titanium mesh removal, and the surface bone quality was observed. The obtained bone height was measured in the panoramas based on the adjacent tooth cemento-enamel junction, and the bone density was measured using the Hounsfield scale on cone beam computed tomography before titanium mesh removal. In group A, the average soft tissue interposition was 31.50%, and the bone quality was poor when the interposed soft tissue was removed. Therefore, additional bone grafting was performed during implant placement in one case. In group B, there was almost no soft tissue interposition between the titanium mesh pores, and no additional bone graft was performed during implant placement. The combination of two membranes provides a favorable vertically obtained bone height and excellent surface bone quality without soft tissue interposition.

Cell recognitive bioadhesive‐based osteogenic barrier coating with localized delivery of bone morphogenetic protein‐2 for accelerated guided bone regeneration

“…As one of the most commonly used GBR membranes, titanium mesh (Ti‐mesh) provides excellent performance, particularly in enabling space support for osteogenesis and in adapting to various bone defects through bending and shaping due to its superior mechanical properties, and has good biocompatibility 5 . However, the Ti‐mesh membrane is often susceptible to soft tissue intervention through the pores of the mesh 6 . In addition, inadequate or sometimes delayed bone regeneration still occurs, mainly due to the limited bioactivity of inert titanium substrates 7,8 .…”

“… 5 However, the Ti‐mesh membrane is often susceptible to soft tissue intervention through the pores of the mesh. 6 In addition, inadequate or sometimes delayed bone regeneration still occurs, mainly due to the limited bioactivity of inert titanium substrates. 7 , 8 Therefore, an advanced design of bioactive barrier membranes with regenerative ability is required to accomplish reliable clinical outcomes using the GBR approach.…”

Guided bone regeneration in peri-implant defects using a 1:1 mixture of cancellous and cortical freeze-dried bone allograft: A randomized controlled trial

“…The use of the barrier membrane in the GBR technique can increase the amount of regenerated bone [5]. After installation of the dental implant, the use of non-resorbable barrier membrane in the GBR procedure at the dehiscence type defect increases the chances of bone regeneration [6].…”