Dental News - New implant study helps improve guided bone regeneration

Dental Tribune International

Tue. 20. March 2018

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RIYADH, Saudi Arabia: With more people opting for implants, dental practitioners are seeing an increase in difficult cases of implantation, such as insufficient bone volume. For this reason, new surgical techniques have been developed, such as guided bone regeneration, in which titanium mesh may be used. While this can lead to successful alveolar ridge augmentation, the use of titanium mesh has also been known to have complications in some patients, most commonly, exposure.

In the study, researchers found that augmentation can be more effective and successful if exposed titanium mesh is removed and the remainder left while the regenerative process continues.

In a collaboration between Loma Linda University in the U.S. and King Saud University and Imam Abdulrahman Bin Faisal University in Saudi Arabia, researchers treated four patients between the ages of 27 and 50 from 2015 to 2017 with titanium mesh. Each had undergone at least two failed bone augmentation procedures previously.

In all four cases, the surgical technique used to incorporate the titanium mesh with the bone graft was the same; however, each patient received a different type of membrane to cover the titanium mesh. Additionally, each patient experienced mesh exposure at a different rate, ranging from one to six weeks postoperatively. The exposed mesh was removed between four and ten weeks after exposure and the remaining titanium mesh was removed approximately six months after insertion and one to two months prior to dental implantation.

In all four cases, the researchers found that, by removing the exposed titanium mesh and allowing the rest to remain, the bone volume reached a level that was adequate for dental implants. Another benefit of removal of exposed mesh was the creation of a more hygienic space for the implant, whereas caring for areas with exposed mesh reportedly caused difficulty and discomfort for patients, compromising the integrity of the regenerative site.

“The removal of the exposed part seemingly did not have a negative effect clinically on bone integration in the final volume of the augmented bone, and allowed for easier hygiene maintenance by the patient,” said lead author Dr Aladdin J. al-Ardah, associate professor at Loma Linda University School of Dentistry.

Although their technique was successful, helping to ensure proper bone regeneration and hygiene maintenance for dental implant surgery, the researchers acknowledged that further analysis is necessary before the technique can be applied in routine dentistry.

The study, titled “Managing titanium mesh exposure with partial removal of the exposed site: A case series study,” was published in the December 2017 issue of the Journal of Oral Implantology.

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