Guided bone regeneration via a preformed titanium foil: clinical, histological and histomorphometric outcome of a case series.

Abstract

PURPOSE The aim of this paper was to evaluate the histological and histomorphometric outcome of Preformed Titanium Foil (PTF) to perform Guided Bone Regeneration (GBR) in posterior mandibular atrophies. MATERIALS AND METHODS 10 subjects (1 male; 9 females; mean age 58±11.37 years), with distal mandibular atrophies were selected to perform GBR by means of PTF, using a moldable allograft paste as graft material. The devices, made of a 0,2 mm thick pure titanium foil, were pre-shaped using stereolithographic models obtained from CT-scan of the patients' recipient site. In the second stage, performed at 6.7±2.33 months, 18 cylindrical two-piece implants were placed and the devices removed, at the same time bone biopsies were harvested. At 4 months, the implants were exposed and submitted to progressive prosthetic load for a span of 4 months. The cases were finalized by means of metal-ceramic cementable restorations. The post finalization follow-up was at 12 months. RESULTS Survival rate (i.e. SVR) was 100% since none fixtures were lost. At the one-year follow up the clinical appearance of the soft tissues was optimal and not pathological signs on probing were recorded. The success rate (i.e. SCR) was 88.2% and the average peri-implant bone reabsorption was 1.17±0.41 mm. The average rate of graft contraction was 19.4±10.55%. The mean percentage occupied by mineralized bone was 48.03±5.93%, while the bone marrow and graft material were 36.1±2.81% and 15.87±4.87 %, respectively. CONCLUSION The results suggest good potentialities of the method for GBR in distal mandibular atrophies, allowing to maximize the outcome and simplifying the surgical phase.