Evaluation of alveolar ridge augmentation with titanium mesh adapted on 3D model and bone substitute graft in the mandible.

Abstract

Objective: to evaluate the alveolar ridge augmentation with titanium mesh adapted on 3D model and bone substitute graft in the mandible. Subjects and Methods: A total of 14 patients with mandibular alveolar ridge defects were selected. A preliminary CBCT scan was performed to evaluate alveolar residual bone anatomy and to created 3D model then adapted titanium mesh on the model before surgery. The deficient bone site was exposed by making a three line pyramidal flap. The recipient site was decorticated using diamond round bur. The titanium mesh fixed firstly lingual by 1.5mm diameter micro screws selfdrilling, then applied bone graft in the recipient site and adapted by condenser. Then titanium mesh fixed buccally by 1.5mm diameter micro screws. The flaps were repositioned and sutured passively with 4-0 vicryl suture. Results: Results revealed that, there was statistically a significantly higher value in bone height and width after 4 months of bone augmentation and there was statistically a significantly lower value of bone density after 4 months of bone augmentation. Conclusion: The use of titanium mesh in bone augmentation have a protective effect to the grafted bone during the healing period. The use of the titanium mesh has disadvantages, for example, the necessity of a second surgical step increases the morbidity for the patient and it has a risk of soft tissue dehiscence and membrane exposure. 3D model provide more time for adaptation of the titanium mesh during time of surgery.