Alveolar Ridge Reconstruction with Titanium Mesh: A Three-Dimensional Evaluation of Factors Affecting Bone Augmentation

Purpose: To evaluate the three-dimensional (3D) reconstruction of atrophic alveolar ridges using titanium mesh (Ti-mesh) and its correlation with the extent and timing of mesh exposure and amount of reconstruction planned. Materials and Methods: This study retrospectively evaluated 12 patients (mean age, 49.1 years) with 15 alveolar defects treated with Ti-mesh and particulate grafts (70/30 autogenous bone/anorganic bovine bone) followed by implant placement 8 to 9 months later. For each site, computed tomography images were analyzed using software designed to measure 3D volumes. The lacking bone volume (LBV) was calculated by subtracting the reconstructed bone volume at reentry from the planned bone volume (PBV). In all cases, the meshes were modeled preoperatively on a stereolithographic model. LBV was correlated with the extent and time of mesh exposure and PBV. Results: The mean LBV (0.45 cm3) was 30.2% (range, 6% to 74%) of the mean PBV (1.49 cm3). The mean extent and timing of mesh exposure, which occurred at 80% of augmented sites (12/15), were 0.73 cm2 (range, 0.09 to 3.45 cm2) and 2.17 months (range, 1 to 8 months), respectively. LBV was significantly positively correlated with the area of mesh exposed, with 16.3% LBV for every cm2 of mesh exposed; there were positive correlations between LBV and early exposure and PBV. Conclusion: On average, there was 30.2% less bone than planned preoperatively; there was a significant negative correlation between the amount of reconstructed bone and area of mesh exposed. Palabras clave: alveolar ridge reconstruction, bone volume, computed tomography, titanium mesh exposure