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Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration

Identifieur interne : 005497 ( Ncbi/Merge ); précédent : 005496; suivant : 005498

Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration

Auteurs : Gyu-Un Jung [Corée du Sud] ; Jae-Yun Jeon [Corée du Sud] ; Kyung-Gyun Hwang [Corée du Sud] ; Chang-Joo Park [Corée du Sud]

Source :

RBID : PMC:4170664

Abstract

Objectives

The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration.

Materials and Methods

Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed.

Results

Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications.

Conclusion

The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.


Url:
DOI: 10.5125/jkaoms.2014.40.4.181
PubMed: 25247148
PubMed Central: 4170664

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PMC:4170664

Le document en format XML

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<title>Materials and Methods</title>
<p>Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed.</p>
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<journal-id journal-id-type="nlm-ta">J Korean Assoc Oral Maxillofac Surg</journal-id>
<journal-id journal-id-type="iso-abbrev">J Korean Assoc Oral Maxillofac Surg</journal-id>
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<article-title>Preliminary evaluation of a three-dimensional, customized, and preformed titanium mesh in peri-implant alveolar bone regeneration</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Jung</surname>
<given-names>Gyu-Un</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="author-notes" rid="FN1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jeon</surname>
<given-names>Jae-Yun</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="author-notes" rid="FN1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hwang</surname>
<given-names>Kyung-Gyun</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Park</surname>
<given-names>Chang-Joo</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Department of Periodontology, Ewha Womans University Mokdong Hospital, Seoul, Korea.</aff>
<aff id="A2">
<label>2</label>
Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine, Seoul, Korea.</aff>
<author-notes>
<corresp>Corresponding author: Chang-Joo Park. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea. TEL: +82-2-2290-8646, FAX: +82-2-2290-8673,
<email>fastchang@hanyang.ac.kr</email>
</corresp>
<fn id="FN1" fn-type="equal">
<p>
<sup>*</sup>
These authors contributed equally to this work.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<month>8</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>26</day>
<month>8</month>
<year>2014</year>
</pub-date>
<volume>40</volume>
<issue>4</issue>
<fpage>181</fpage>
<lpage>187</lpage>
<history>
<date date-type="received">
<day>15</day>
<month>5</month>
<year>2014</year>
</date>
<date date-type="rev-recd">
<day>13</day>
<month>7</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>17</day>
<month>7</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2014 The Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">
<license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Objectives</title>
<p>The purpose of this preliminary study is to evaluate the effectiveness of a customized, three-dimensional, preformed titanium mesh as a barrier membrane for peri-implant alveolar bone regeneration.</p>
</sec>
<sec>
<title>Materials and Methods</title>
<p>Ten patients were recruited for this study. At the time of implant placement, all patients had fenestration or a dehiscence defect around the implant fixture. A mixture of particulate intraoral autologous bone and freeze-dried bone allograft was applied to the defect in a 1 : 1 volume ratio and covered by the preformed titanium mesh. A core biopsy specimen was taken from the regenerated bone four months postoperatively. Patients were followed for 12 months after the definitive prosthesis was placed.</p>
</sec>
<sec>
<title>Results</title>
<p>Satisfactory bone regeneration with limited fibrous tissue was detected beneath the preformed titanium mesh. Histologic findings revealed that newly formed bones were well-incorporated into the allografts and connective tissue. New growth was composed of approximately 80% vital bone, 5% fibrous marrow tissue, and 15% remaining allograft. All implants were functional without any significant complications.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>The use of preformed titanium mesh may support bone regeneration by maintaining space for new bone growth through its macro-pores. This preliminary study presents the efficacy of a preformed titanium mesh as a ready-to-use barrier membrane around peri-implant alveolar bone defect. This preformed mesh is also convenient to apply and to remove.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Alveolar bone loss</kwd>
<kwd>Histology</kwd>
<kwd>Surgical mesh</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="F1" orientation="portrait" position="float">
<label>Fig. 1</label>
<caption>
<p>Components and types of the customized, three-dimensional, and preformed titanium mesh (SMARTbuilder; Osstem). Type I is designed for 1-wall augmentation, type II for 2-wall augmentation, and type III for 3-wall augmentation.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g001"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float">
<label>Fig. 2</label>
<caption>
<p>After implant placement on #12 missing area, labial fenestration defect was found.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g002"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float">
<label>Fig. 3</label>
<caption>
<p>After connecting the height on the implant fixture, the defect was covered with a mixture of particulated autologous bone harvested from the mandibular ramus and freeze-dried bone allograft.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g003"></graphic>
</fig>
<fig id="F4" orientation="portrait" position="float">
<label>Fig. 4</label>
<caption>
<p>A customized, 3-dimensional, and preformed titanium mesh (SMARTbuilder type II; Osstem) was connected to the height, placed over the graft material, and stabilized by the cover cap.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g004"></graphic>
</fig>
<fig id="F5" orientation="portrait" position="float">
<label>Fig. 5</label>
<caption>
<p>The preformed titanium mesh was easily removed under the minimum flap elevation at postoperatively 4-month re-entry.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g005"></graphic>
</fig>
<fig id="F6" orientation="portrait" position="float">
<label>Fig. 6</label>
<caption>
<p>Bone core biopsy was carried out on the labial regenerated bone by a trephine drill (arrow). Note that there was a superficial thin fibrous tissue layer over the regenerated bone.</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g006"></graphic>
</fig>
<fig id="F7" orientation="portrait" position="float">
<label>Fig. 7</label>
<caption>
<p>Comparison of periapical radiographs taken at the application (A) and removal (B) of the preformed titanium mesh and at 1 year after delivery of the final prosthesis (C).</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g007"></graphic>
</fig>
<fig id="F8" orientation="portrait" position="float">
<label>Fig. 8</label>
<caption>
<p>Histological findings of the core specimen obtained from patient #2. Note that the residual allograft (RA) particles were encapsulated and incorporated with vital bone (VB). Fibrous marrow (FM) tissues were also observed (H&E staining, ×40).</p>
</caption>
<graphic xlink:href="jkaoms-40-181-g008"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Overview of patients and their surgical records</p>
</caption>
<graphic xlink:href="jkaoms-40-181-i001"></graphic>
<table-wrap-foot>
<fn>
<p>(M: male, F: female, C: cover cap, H: healing abutment)</p>
<p>
<sup>1</sup>
Mesh exposure or flap dehiscence on the cover cap.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Corée du Sud</li>
</country>
<region>
<li>Région capitale de Séoul</li>
</region>
<settlement>
<li>Séoul</li>
</settlement>
</list>
<tree>
<country name="Corée du Sud">
<region name="Région capitale de Séoul">
<name sortKey="Jung, Gyu Un" sort="Jung, Gyu Un" uniqKey="Jung G" first="Gyu-Un" last="Jung">Gyu-Un Jung</name>
</region>
<name sortKey="Hwang, Kyung Gyun" sort="Hwang, Kyung Gyun" uniqKey="Hwang K" first="Kyung-Gyun" last="Hwang">Kyung-Gyun Hwang</name>
<name sortKey="Jeon, Jae Yun" sort="Jeon, Jae Yun" uniqKey="Jeon J" first="Jae-Yun" last="Jeon">Jae-Yun Jeon</name>
<name sortKey="Park, Chang Joo" sort="Park, Chang Joo" uniqKey="Park C" first="Chang-Joo" last="Park">Chang-Joo Park</name>
</country>
</tree>
</affiliations>
</record>

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