Titanium Mesh Exposure in Guided Bone Regeneration Procedures: A Systematic Review and Meta-analysis.

Abstract

To investigate whether titanium mesh exposure is influenced by the type of titanium mesh, the type of bone graft material, or the associated employment of absorbable membranes. Electronic literature searches were conducted using four databases: PubMed, EMBASE, Web of Science, and Cochrane. Articles reporting titanium mesh exposure rates were included, and exposure rates in different subgroups were compared to determine whether a factor significantly influenced titanium mesh exposure. The review protocol was registered in the PROSPERO registry (CRD42020210187). Twenty and 12 articles were included in the qualitative and quantitative synthesis, respectively. The weighted exposure rates of employing conventional titanium mesh or 3D-customized titanium mesh were 19.9% and 15.2% (P = .34). When employing autogenous bone combined with anorganic bovine bone material as bone graft material, the weighted exposure rate was 21.7%, whereas when using other bone graft material, the exposure rate was 23.5% (P = .74). The weighted exposure rate of using titanium mesh associated with absorbable membranes is 23.9%, while the weighted exposure rate of using titanium mesh without absorbable membranes is 20.2% (P = .36). Meta-regression showed that when analyzing one factor, the other two confounding factors did not influence the result (P = .28). It seemed that the type of titanium mesh, the type of bone graft material, or the combined employment of absorbable membranes did not statistically significantly influence the titanium mesh exposure rate in guided bone regeneration.