Enhancing early-stage healing responses through the modified "Poncho" technique in customized titanium mesh-mediated bone regeneration: A soft tissue management approach-case series.

Abstract

Soft tissue management is critical in bone augmentation surgery to prevent wound dehiscence. Several strategies for passive tissue primary closure have been explored. This article introduces a flap design known as the modified "Poncho" technique (MPT), integrated with customized titanium mesh-mediated bone regeneration, and investigates the healing quality during the initial stages of an incision. The cohort consisted of 5 patients undergoing customized bone regeneration procedures, concerned primarily with the successful integration and healing of the augmented bone site without complications such as wound dehiscence or infection. All patients were diagnosed with insufficient bone volume requiring augmentation to support future dental implants, necessitating the use of customized titanium mesh for guided bone regeneration. The MPT was detailed and applied during the customized bone regeneration procedures. Postoperative evaluations included recording complications and using Landry's healing index at intervals of 3, 7, 14, and 30 days post-surgery to assess the technique's performance in early wound closure. The study found that 95.7% of surgery sites experienced uneventful soft tissue healing within the observation period. Only 1 of 23 sites exhibited partial wound dehiscence at postsurgical days 14 and 30, accompanied by mild inflammation. The Landry's healing index increased from 3 ± 0.47 to a final value of 4.69 ± 1.06, indicating substantial improvement in healing over time. The MPT shows promise as an innovative approach for promoting passive and predictable primary wound closure beneath a digitally customized titanium mesh for bone regeneration, demonstrating a high rate of successful healing and minimal complications during the early postoperative phase.