Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study

Alessandro Cucchi,Alessandro Bianchi,Paolo Calamai,Elisabetta Vignudelli,Giuseppe Corinaldesi,Francesco Mangano,Lisa Rinaldi

doi:10.1186/s12903-020-01205-4

Alessandro Cucchi, Alessandro Bianchi + Show 5 more

Open Access

https://doi.org/10.1186/s12903-020-01205-4

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Abstract

BackgroundOne of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases.MethodsTen patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated.ResultsAll augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up.ConclusionsThe results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.

Highlights

One of the most recent innovations in bone augmentation surgery is represented by computeraided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations
Many studies have confirmed the reliability of short implants to rehabilitate atrophic mandibles and maxillae [1,2,3,4], the residual bone volume is often not adequate enough to place dental implants according to criteria of the prosthetically driven implantology, as reported by the most recent guidelines [5]
In total, 10 consecutive patients, five women and five men, mean age 52 years, showing a localized bone defect in maxilla (n = 5) or mandible (n = 5) and in need of bone augmentation were consecutively treated according to the study protocol, from January 2017 to December 2018

Summary

Introduction

One of the most recent innovations in bone augmentation surgery is represented by computeraided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. With the development of computer-aided-design/computer-aided-manufacturing (CAD/CAM) technologies, accurate pre-operative planning can be established, and surgeons can plan osteotomy and reconstruction procedures, or create patient-specific implants [12]. The advantages of this technique include: restoration of geometrically complex anatomical defects, reduction of operative times, accurate fitting, and eventually performing resection and reconstruction in one step [13,14,15,16]

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