Hard Tissue Volume Stability Effect beyond the Bony Envelope of a Three-Dimensional Preformed Titanium Mesh with Two Different Collagen Barrier Membranes on Peri-Implant Dehiscence Defects in the Anterior Maxilla: A Randomized Clinical Trial

Abstract

This single-blinded, randomized, controlled study aimed to clinically and radiographically evaluate hard tissue volume stability beyond the bony envelope using three-dimensional preformed titanium mesh (3D-PFTM) for peri-implant dehiscence defects in the anterior maxilla. A total of 28 patients who wished to undergo implant surgery combined with guided bone regeneration (GBR) after extraction of a single maxillary anterior tooth were randomly assigned to two groups depending on the type of collagen membrane used, additionally with the 3D-PFTM—test (n = 14, cross-linked collagen membrane; CCM) and control (n = 14, non-cross-linked collagen membrane; NCCM) groups. Each implant was evaluated radiographically using CBCT at baseline, immediately after surgery, and at 6 months postoperatively. The relative position and distances from the bony envelope to the outlines of the augmented ridge were further determined immediately after GBR and 6 months after healing. At the platform level, the mean horizontal hard tissue gain (HG) at all the sites was 2.35 ± 0.68 mm at 6 months postoperatively. The mean HG rate was 84.25% ± 14.19% in the CCM group and 82.56% ± 13.04% in the NCCM group, but the difference was not significant between the groups. In all cases, HG was maintained beyond the bony envelope even after 6 months of GBR. This study suggests that 3D-PFTM should be considered a valuable option for GBR for peri-implant dehiscence defects in the anterior maxilla. In addition, 3D-PFTM may confer predictable hard tissue volume stability even after the healing period of hard tissue augmented outside the bony envelope by GBR.

Immediate Implant Placement in the Maxillary Aesthetic Zone: A Cone Beam Computed Tomography Study

“…The alveolar bone of the anterior maxilla is usually proclined in an anterior-inferior direction, forming a concavity right above the apical region of the teeth, and the labial bone is this region is usually thin [4]. Therefore, it is expected that the frequency of bone dehiscence and esthetic problems would be higher in this region in comparison to the posterior regions of the jaw [5], as the alveolar ridge is followed by a great reduction of its dimensions after the extraction of a tooth [6]. The issue is especially important if the implants planned to be placed immediately after extraction are positioned in the same position as the tooth that previously occupied the socket [7], the so-called prosthetically-driven position, as it is advocated that the implant should be anchored by a minimum amount of bone apical to the socket in order to achieve primary stability [8,9].…”

Digital planning and bone regenerative technologies: A narrative review

“…Fifty-six articles are focused on a digital workflow applied to advanced implant dentistry (relevant alveolar ridge defects and sinus expansion), including digitally guided implant placement in the regenerated areas (Atef et al, 2020;Bahaa et al, 2023;Cecchetti et al, 2021;Chiapasco et al, 2021;Ciocca et al, 2011Ciocca et al, , 2015Cucchi et al, 2017Cucchi et al, , 2020Cucchi et al, , 2022Cucchi et al, , 2023Cucchi, Vignudelli, Franceschi, et al, 2021;Cucchi, Vignudelli, Sartori, et al, 2021;de Almeida Malzoni et al, 2022;De Angelis et al, 2023;De Santis et al, 2022;De Stavola et al, 2015Felice et al, 2022;Figliuzzi et al, 2013;Garagiola et al, 2016;Goodacre et al, 2018;Lee et al, 2021;Liu et al, 2023;Li, Wang, et al, 2021;Li, Zhao, et al, 2021;Lizio et al, 2022;Mandelaris & Rosenfeld, 2008;Mangano et al, 2013;Mounir et al, 2017Mounir et al, , 2019Osman et al, Scribante al., 2023;Seiler et al, 2018;Seoung-Won et al, 2020;Shi et al, 2022;Stanley & Kurtzman, 2017;Strbac et al, 2020;Sumida et al, 2015;Tallarico et al, 2020;Tarce ...…”

“…This can be followed by infection and partial or total loss of the initial bone gain (Briguglio et al, 2019;Carini et al, 2014;Her et al, 2012;Miyamoto et al, 2012;Rasia-dal Polo et al, 2014;Roccuzzo et al, 2007). On the contrary, a digital workflow makes it possible not only to precisely plan all the pre-operative phases (as described above-see Figure 2), but also to produce customized titanium meshes with a CAD-CAM technology (Atef et al, 2020;Bahaa et al, 2023;Chiapasco et al, 2021;Ciocca et al, 2011Ciocca et al, , 2015Cucchi et al, 2017Cucchi et al, , 2020Cucchi et al, , 2023Cucchi, Vignudelli, Franceschi, et al, 2021;Cucchi, Vignudelli, Sartori, et al, 2021;De Angelis et al, 2023;De Santis et al, 2022;Felice et al, 2022;Lee et al, 2021;Li, Wang, et al, 2021;Li, Zhao, et al, 2021;Lizio et al, 2022;Mounir et al, 2017Mounir et al, , 2019Sagheb et al, 2017;Scribante et al, 2023;Seiler et al, 2018;Shi et al, 2022;Sumida et al, 2015;Tallarico et al, 2020;Xie et al, 2020;Yang et al, 2022), mainly by means of laser sintering. Most of them are designed as "open structures" to favor the re-vascularization of the underlying grafting material.…”

“…The majority of these articles are focused on CAD-CAM technologies (Montero et al, 2021) applied to design and production of titanium meshes (Atef et al, 2020;Bahaa et al, 2023;Chiapasco et al, 2021;Ciocca et al, 2011Ciocca et al, , 2015Cucchi et al, 2017Cucchi et al, , 2020Cucchi et al, , 2023Cucchi, Vignudelli, Franceschi, et al, 2021;Cucchi, Vignudelli, Sartori, et al, 2021;De Angelis et al, 2023;De Santis et al, 2022;Felice et al, 2022;Lee et al, 2021;Li, Wang, et al, 2021;Li, Zhao, et al, 2021;Lizio et al, 2022;Mounir et al, 2017Mounir et al, , 2019Sagheb et al, 2017;Scribante et al, 2023;Seiler et al, 2018;Shi et al, 2022;Sumida et al, 2015;Tallarico et al, 2020;Xie et al, 2020;Yang et al, 2022) or blocks (allograft or xenograft) created with a CAD-CAM procedure (Jacotti, 2006;Garagiola et al, 2016;Mangano et al, 2015;Venet et al, 2017).…”

How to Enhance Dental Implant Therapies and Definitive Restoration Outcomes to Reduce Complications and Improve Patient Well-Being

“…On the other hand, similar results have been found when comparing two different presentations of β-TCPs, indicating that the variation in the presentation of β-TCPs had minimal incidence in the final results regarding sinus floor elevation. Contrarily, when considering bone reconstruction in a less favorable scenario, such as a procedure concerning an area beyond the bony envelope, the use of a three-dimensional preformed titanium mesh (3D-PFTM) for peri-implant dehiscence defects situated in the anterior maxilla may achieve predictable hard tissue volume stability independently of the simultaneous use of a cross- or non-cross-linked collagen membrane [ 7 ]. Nevertheless, it is important to emphasize that the authors highlight the need to conduct more studies involving long-term results following functional loading before recommending this technique for routine clinical use.…”