Managing Titanium Mesh Exposure With Partial Removal of the Exposed Site: A Case Series Study

Al-Ardah, Aladdin J.; AlHelal, Abdulaziz; Proussaefs, Periklis; AlBader, Bader; humaidan, Abdulakareem A. Al; Lozada, Jaime

doi:10.1563/aaid-joi-d-17-00169

Cited by 16 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mechanical smoothing of mesh edges with carbide or diamond burs for late exposure helps to create secondary healing of the wound [71,72].…”

Section: Early and Late Complication Managementmentioning

confidence: 99%

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

Scribante,

Ghizzoni,

Pellegrini

et al. 2023

Prosthesis

View full text Add to dashboard Cite

Meshes, especially titanium ones, are being widely applied in oral surgery. In guided bone regeneration (GBR) procedures, their use is often paired with membranes, being resorbable or non-resorbable. However, they present some limitations, such as difficulty in the treatment of severe bone defects, alongside frequent mesh exposure. Customized meshes, produced by a full-digital process, have been recently introduced in GBR procedures. Therefore, the focus of the present review is to describe the main findings in recent years of clinical trials regarding patient-specific mesh produced by CAD/CAM and 3D printing workflow, made in titanium or even PEEK, applied to GBR surgeries. The purpose is to analyze their clinical management, advantages, and complications. This scoping review considered randomized clinical trials, observational studies, cohort studies, and case series/case reports studies. Studies that did not meet inclusion criteria were excluded. The preferred reporting items for scoping reviews (PRISMA-ScR) consensus was followed. A total of 15 studies were selected for this review. Based on the studies included, the literature suggests that meshes produced by a digital process are used to restore complex and severe bone defects. Moreover, they give satisfactory aesthetic results and fit the defects, counteracting grid exposure. However, more clinical trials should be conducted to evaluate long-term results, the rate of complications, and new materials for mesh manufacturing.

show abstract

“…Mechanical smoothing of mesh edges with carbide or diamond burs for late exposure helps to create secondary healing of the wound [71,72].…”

Section: Early and Late Complication Managementmentioning

confidence: 99%

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

Scribante,

Ghizzoni,

Pellegrini

et al. 2023

Prosthesis

View full text Add to dashboard Cite

show abstract

“…Currently, almost all titanium meshes are fixed with titanium screws 19–24 . Although titanium screw fixation is a powerful method, it may affect the efficiency of the surgery and increase the risk of complications and trauma 25,26 . Among these problems, increasing trauma is undoubtedly a major problem in titanium screw fixation.…”

Section: Introductionmentioning

confidence: 99%

“…[19][20][21][22][23][24] Although titanium screw fixation is a powerful method, it may affect the efficiency of the surgery and increase the risk of complications and trauma. 25,26 Among these problems, increasing trauma is undoubtedly a major problem in titanium screw fixation. Some patients with single tooth loss are unable to undergo simultaneous implant placement and bone augmentation surgery due to the presence of titanium screws; titanium screws that are fixed labially/buccally need to be removed with an extensive flap during the second-stage surgery, which increases trauma for patients.…”

Section: Introductionmentioning

confidence: 99%

A minimally invasive method for titanium mesh fixation with resorbable sutures in guided bone regeneration: A retrospective study

Zhao

Tian

et al. 2022

Clin Implant Dent Rel Res

View full text Add to dashboard Cite

Objectives: Titanium mesh has become a mainstream choice for guided bone regeneration (GBR) owing to its excellent space maintenance. However, the traditional fixation method using titanium screws impacts surgery efficiency and increases patient trauma. We report a novel method of fixing a titanium mesh using resorbable sutures.We assessed the feasibility of resorbable sutures for fixing a titanium mesh and whether it can serve as a stable, universal, and minimally invasive fixation method for a broader application of titanium meshes.Methods: Patients undergoing GBR with a digital titanium mesh fixed using titanium screws (TS group) and resorbable sutures (RS group) were observed at different time points. The stability of the fixation methods was evaluated on parameters such as titanium mesh spatial displacement, bone augmentation, and bone resorption.Results: A total of 36 patients were included in this study. The exposure rate of the titanium mesh in the TS group was 16.67%, while no exposure was noted in the RS group. There was no significant difference in the parameters of titanium mesh spatial displacement, bone augmentation, and bone resorption between the two groups (p > 0.05). Conclusion:The use of resorbable sutures for fixing a titanium mesh can achieve similar results to traditional fixation using titanium screws. Although this new fixation method can improve the efficiency of the surgery and reduce the risk of complications, the long-term clinical effects require further follow-up investigation.

show abstract

“…The literature lacks resolutive techniques that present efficacy and predictability, being restricted to palliative care and follow-up. Approaches such as the debridement of the exposed tissue, 24 removal of the entire mesh or just a part of it, 24 chlorhexidine gel, and mouthwash use, 25,26 have been suggested for treatment after exposure and their effectiveness remains uncertain. In recent literature searches, studies reviewing this topic were scarce.…”

Section: Introductionmentioning

confidence: 99%

Titanium Mesh Exposure After Bone Grafting: Treatment Approaches—A Systematic Review

Cunha

Carvalho

Quirino

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

Study Design: A systematic review according to PRISMA statement has been designed to answer the preliminary question: “ In titanium mesh exposures, is there a treatment alternative which leads to an increased graft maintenance?” and fill the PICO assessment out. Objective: To review studies published in the past 20 years (1999-2019) in which mesh exposure has occurred, detecting the suitable approaches to treat exposure allowing the graft maintenance. Methods: Initial search on PUBMED, SCOPUS, and COCHRANE databases resulted in 777 articles, and hand-searching identified 6 articles. After removing duplicates and unrelated articles, eligibility criteria were applied, and 31 studies were selected (randomized clinical trials, retrospective/prospective clinical trials, and case series). Results: A total of 677 surgical sites and 225 cases of mesh exposure were identified. Eleven treatments have been identified. Chlorhexidine was the primary approach in 46% of cases, followed by oral hygiene instructions and follow-up with 22.5% of occurrences. In 21% of clinical situations, titanium mesh removal was the treatment of choice, associated with other measures (i.e., antibiotic prescription). There seems to be a consensus in cases of infection. When this complication was associated with tissue dehiscence, the primary treatment was mesh removal. The same does not occur when the site needs to be cleaned for long-term periods. Conclusion: In 2 decades of use of titanium meshes, the available treatments do not seem to have evolved, and there is not enough data to establish a guideline.

show abstract

Managing Titanium Mesh Exposure With Partial Removal of the Exposed Site: A Case Series Study

Cited by 16 publications

References 33 publications

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

A minimally invasive method for titanium mesh fixation with resorbable sutures in guided bone regeneration: A retrospective study

Titanium Mesh Exposure After Bone Grafting: Treatment Approaches—A Systematic Review

Contact Info

Product

Resources

About