Exposure management of a titanium‐reinforced dense polytetrafluoroethylene mesh used in a vertical ridge augmentation: A case report with 1‐year follow‐up

Abstract

Introduction: A new titanium-reinforced dense polytetrafluoroethylene mesh (TR-dPTFEM) has recently been introduced for vertical ridge augmentation (VRA). Since primary closure is required, the literature lacks information on its behavior in case of premature exposure. To the author's knowledge, this is the first report about TR-dPTFEM complication management. Case Presentation: A TR-dPTFEM was used for the VRA in the molar region of the upper right maxilla. The defect was filled with a mix of particulate autogenous bone and porcine xenograft in a 1:1 ratio. A collagen membrane covered the hole pattern of the TR-dPTFEM to prevent soft tissue growth within the grafted material during the first weeks. After a 4-month uneventful healing period, a 4-mm exposure occurred without infection. Patient was prescribed 0.2% chlorhexidine mouth rinse three times a day and manual cleansing with gauze soaked in 3% hydrogen peroxide, and was recalled for weekly follow-up. One month later, the clinical situation was unchanged and the site was re-entered. After TR-dPTFEM removal, the regenerated tissue appeared to be covered with a thin layer of connective tissue. The favorable bone quality made it possible to obtain the primary stability of two implants. At implant uncovering, a gingival graft augmented the keratinized mucosa width. Two screw-retained crowns were delivered 4 months after implant insertion and the 1-year follow-up showed perfectly maintained hard and soft tissues. Conclusion:A late TR-dPTFEM exposure, managed under strict hygiene control, did not affect this VRA. The augmented bone remained stable 1 year after prosthetic loading. K E Y W O R D SBiocompatible materials, bone regeneration, bone substitutes, guided tissue regeneration 84

Customized Barrier Membrane (Titanium Alloy, Poly Ether-Ether Ketone and Unsintered Hydroxyapatite/Poly-l-Lactide) for Guided Bone Regeneration

“…For wound dehiscence prevention, Masayuki Takano et al reported a minimally invasive subperiosteal tunneling flap technique involving long labial incision, cervical palatal incision, and peritoneal-releasing incision ( Takano et al, 2019 ). Although some studies showed that the premature (within 4–6 weeks) or delayed (after 6 weeks) exposure of Ti mesh has no effect on bone augmentation in the presence of a pseudo-periosteum ( Ciocca et al, 2018 ), infection does compromise bone augmentation, and timely measures are still needed when exposure occurs, such as gentle cleaning and daily rinsing with 0.12% chlorhexidine or removing prematurely exposed meshes ( Hartmann et al, 2019 ; Belleggia, 2021 ).…”