Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft.

This study demonstrates the effectiveness of using a custom-designed titanium mesh fitted onto a 3D model of the patient’s jaw, along with a horse bone graft, for guided bone regeneration in dental implant procedures. This approach reduced intraoperative time and maintained bone stability and implant functionality over a two-year period.

Procedure

• The research involves a dental surgical procedure known as horizontal ridge augmentation where the jawbone is built up to provide a solid base for dental implants.
• The subject of the study was a 54-year-old patient who was missing three teeth at particular points in her lower jaw.
• A 3D model of the patient’s jaw was constructed from CT scans. This model was then used to pre-shape a titanium mesh that act as a long-lasting barrier covering the bone graft site. This helps to protect the graft from invading soft tissues.

Incorporating Titanium Mesh and Equine Bone Graft

• The researchers mixed a patient’s autogenous bone (her own bone material) with a horse bone substitute. This mixture was then used to augment or build up the patient’s atrophic ridge, the section of the jawbone missing teeth.
• The designed titanium mesh was used as a shield for the graft site to prevent intrusion of surrounding soft tissues.
• Two conical implants were inserted simultaneously at specific points of the patient’s lower jaw, where the teeth were missing. The titanium mesh barrier was then placed over the augmented ridge to protect it.

Post-Operative Findings & Analyses

• Four months after the procedure, the titanium mesh was removed and a bone sample was analyzed histologically (microscopically examination of tissue) and histomorphometrically (studying structure and form).
• Subsequent provisional and definitive prosthesis were placed and periodic controls or checks were done for an extended period of 24 months.
• The study reports that the operation time was reduced significantly due to the pre-shaping of the titanium mesh against the model.

Results & Implications

• Two years post-surgery, the dental implants proved to be fully functional and the bone width, observable through radiographic controls, remained stable over time.
• The histologic analysis showed excellent biocompatibility of the heterologous (from a different species – in this case, horse) bone graft, showing signs of advanced remodeling and replacement by new bone.
• Pre-shaping the titanium mesh served as a good practice to decrease the operative time and the post surgical analyses indicates its effectiveness to maintain the dental implants over time.