Retrospective Analysis of the Effect of Three-Dimensional Preformed Titanium Mesh on Peri-Implant Non-Contained Horizontal Defects in 100 Consecutive Cases

Abstract

This study aimed to clinically and radiographically evaluate the results of guided bone regeneration (GBR) using three-dimensional preformed titanium mesh (3-D-PFTM) for non-contained horizontal defects in 100 consecutive cases. This study involved 100 patients (129 implants) with peri-implant non-contained horizontal defects. The patients were divided into three groups: 3-D-PFTM alone (Group 1), 3-D-PFTM plus cross-linked collagen membrane (Group 2), and 3-D-PFTM plus non-cross-linked collagen membrane (Group 3). Each implant was evaluated radiographically using CBCT at baseline and 6 months postoperatively. At the platform level, the mean horizontal hard tissue gain of all the sites was 3.1 ± 1.3 mm at 6 months postoperatively. The mean rate of mesh exposure was 11.8% in Group 1, 4.2% in Group 2, and 5.0% in Group 3. The mean hard tissue gain rate was 71.0 ± 23.0% in group 1, 84.2 ± 21.5% in group 2, and 84.0 ± 22.9% in group 3. Groups 2 and 3 showed significantly higher hard tissue gain rates than group 1. However, there was no significant difference between the rates in groups 2 and 3. Within the limitations of this study, 3-D-PFTM should be considered as a valuable option for GBR for peri-implant non-contained horizontal defects. The use of an additional resorbable collagen membrane provides additional advantages.

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

“…A study by Lim et al [ 29 ] reported that the exposure rate was not significantly reduced even with the additional use of a resorbable collagen membrane, but Strietzel et al [ 30 ] reported that when a collagen membrane was used during GBR, the fibrous tissue grew within the collagen membrane and functioned as a barrier for space maintenance to prevent flap dehiscence. In our previous study, where only 3D-PFTM was used, an exposure rate of 11.8% was observed, whereas when CCM and NCCM were additionally used together, the exposure rate was reduced to 4.2% and 5.0%, respectively [ 15 ]. In this study, when CCM and NCCM were additionally used together with 3D-PFTM, the exposure rate was 6.67%, showing a slightly increased exposure rate compared to that reported in a previous study.…”

“…Regardless of the presence or absence of cross-linking, a horizontally stable HG of 2 mm or more was observed even after 6 months of GBR. In our previous study including the posterior region, the HGR was 71.0% for 3D-PFTM only, whereas it was 84.2% in the CCM group and 84.0% in the NCCM group, when the resorbable membrane was used together [ 15 ]. In an animal experiment by Shin et al [ 36 ], increased HGR was observed in the Ti mesh group using the resorbable collagen membrane compared to that in the group treated with Ti mesh alone.…”

“…In the measurement program (OnDemand 3-DTM, Cybermed, Seoul, Korea), cross-sectional computed tomography (CT) images across the center of the implant were used to compare the amount of bone regeneration obtained from the bony defects, and the line perpendicular to the long axis of the implant was extended from the platform level to the buccal side to measure the distance from the outermost bone on the extension line ( Figure 2 ). The amount of bone graft reduction (BR) was defined as the amount of bone augmentation (BA) measured immediately after the first surgery minus the amount of new hard tissue gain (HG) after 6 months, and hard tissue gain rate (HGR) was defined as the percentage of HG compared with BA [ 15 ]. The position of the bony envelope was determined by the line connecting the most labial alveolar bone of both residual teeth in the 3D image ( Figure 3 ), based on which the outside of the bony envelope was set as a negative value and the inside of the bony envelope as a positive value [ 14 ].…”

“…The position of the bony envelope was determined by the line connecting the most labial alveolar bone of both residual teeth in the 3D image ( Figure 3 ), based on which the outside of the bony envelope was set as a negative value and the inside of the bony envelope as a positive value [ 14 ]. The length of the implant was measured, and measurement errors were corrected based on the magnification of the image in proportion to the actual length of the implant [ 15 ]. To improve the reliability of radiographic evaluation, the ‘test-retest reliability’ method was used.…”

“…In our recent retrospective clinical study of 129 implant sites in 100 patients, when GBR was performed using a three-dimensional preformed titanium mesh (3D-PFTM) in the peri-implant non-contained defects, sufficiently predictable hard tissue gain was obtained [ 15 ].…”