Abstract
Purpose The aim of the present prospective study was to evaluate the effect of titanium mesh and concentrated growth factor (CGF) membranes in reconstructing severe labial bone defects during immediate implantation of anterior maxillary tooth. Methods Patients with severe defects presenting on the anterior labial bone plate of maxillary were enrolled in this study. During immediate implantation, the titanium mesh was used to maintain the space of bone graft, collagen membrane, and xenograft bone that were used to guide bone regeneration (GBR). Cone beam computed tomography (CBCT) was used to measure the height and the labial bone thickness around the implant at the time of the second stage surgery, 6 months, 1 year, and 2 years after restoration. The pink esthetic score (PES) was used to evaluate the esthetic outcomes after restoration. Results 18 patients were enrolled in this study. The survival rate of implants was 100%, and no complication was observed, except for 1 case of titanium mesh exposure which did not affect osteogenesis. In the second stage of surgery, the labial bone was completely reconstructed, and the top of the implant was covered with a small amount of new bone. The thickness of the labial bone was 3.01 mm (±0.23), 2.96 mm (±0.21), 2.93 mm (±0.19), and 2.92 mm (±0.16) at the time of the second stage surgery, 6 months, 1 year, and 2 years after restoration, respectively. The height of the marginal bone around implants was above the top of implant at the time of the second stage surgery and then reduced 0.72 mm (±0.07), 0.91 mm (±0.08), and 0.90 mm (±0.07) at the time point of 6 months, 1 year, and 2 years after restoration, respectively. The changes of bone thickness and height were statistically significant within one year, but stable after one year. The PES values showed the same tendency. Conclusions With the limitation of the present prospective study, the combination of titanium mesh and CGF membrane could provide space maintenance for bone augmentation of alveolar bone defects and improve the bone regeneration in patients with severe labial bone defect when immediate implant of anterior maxillary.
Highlights
The first study of immediate implant placement was completed by Professor Wilfried Schulte at the German University of Tubinge in 1978 [1]
The presence of a facial bone defect may result in soft tissue recession which would worsen the aesthetic outcome in the anterior maxillary area, and even cause the implant failure [4]
They were treated with titanium mesh and immediate implantation in a period between November 2013 and November 2016 at the Implant Department of Anyang Stomatological hospital
Summary
The first study of immediate implant placement was completed by Professor Wilfried Schulte at the German University of Tubinge in 1978 [1]. After more than 40 years of basic and clinical researches, immediate implant placement has been shown to be a safe and feasible method for restoring failing teeth [2]. Immediate implant is accepted by patients and doctors because it can reduce the treatment time and restore the patients’ confidence earlier. In the implant treatment of maxillary anterior teeth, Buser believes that a fully intact facial bone wall at the extraction site is prerequisite for immediate implant placement [3]. Might often lead to BioMed Research International severe vertical and horizontal bone defects after tooth extraction. The presence of a facial bone defect may result in soft tissue recession which would worsen the aesthetic outcome in the anterior maxillary area, and even cause the implant failure [4]
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