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VOLUME 16 , ISSUE 2 ( February, 2015 ) > List of Articles

CASE REPORT

Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft

Danilo Alessio Di Stefano, Gian Battista Greco, Lorenzo Cinci, Laura Pieri

Citation Information : Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015; 16 (2):154-162.

DOI: 10.5005/jp-journals-10024-1653

Published Online: 01-02-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans.

Background

Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage.

Case description

The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagenpreserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months.

Conclusion

Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone.

Clinical significance

Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice.

How to cite this article

Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015;16(2):154-162.


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  1. Reduction of residual ridges: a major oral disease entity. J Prosthet Dent 1971;26(3):266-279.
  2. Bone loss of edentulous alveolar ridges. J Periodontol 1979;50(4 Spec No):11-21.
  3. The efficacy of horizontal and vertical bone augmentation procedures for dental implants — a cochrane systematic review. Eur J Oral Implantol 2009;2(3):167-184.
  4. Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg 1988;81(5):672-676.
  5. Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Implants Res 1990;1(1):22-32.
  6. Guided bone regeneration using resorbable and nonresorbable membranes: a comparative histologic study in humans. Int J Oral Maxillofac Implants 1996;11(6):735-742.
  7. Treatment of dehiscences and fenestrations around dental implants using resorbable and nonresorbable membranes associated with bone autografts: a comparative clinical study. Int J Oral Maxillofac Implants 1997;12(2):159-167.
  8. Bone augmentation by means of barrier membranes. Periodontol 2000 2003;33:36-53.
  9. Recent advances in the development of GTR/GBR membranes for periodontal regeneration—a materials perspective. Dent Mater Off Publ Acad Dent Mater 2012;28(7):703-721.
  10. The TIME technique: A new method for localized alveolar ridge augmentation prior to placement of dental implants. Int J Oral Maxillofac Implants 1996;11(3):387-394.
  11. Localized ridge augmentation using a micro titanium mesh: A report on 27 implants followed from 1 to 3 years after functional loading. Clin Oral Implants Res 1998;9(2):123-130.
  12. Vertical ridge augmentation using xenogenic material supported by a configured titanium mesh: Clinicohistopathologic and histochemical study. Int J Oral Maxillofac Implants 2003;18(3):440-446.
  13. Vertical alveolar ridge augmentation by means of a titanium mesh and autogenous bone grafts. Clin Oral Implants Res 2004;15(1):73-81.
  14. Histologic and histomorphometric evaluation of alveolar ridge augmentation using bone grafts and titanium micromesh in humans. J Periodontol 2007;78(8):1477-1484.
  15. Current barrier membranes: titanium mesh and other membranes for guided bone regeneration in dental applications. J Prosthodont Res 2013;57(1):3-14.
  16. Alveolar ridge augmentation with titanium mesh and a combination of autogenous bone and anorganic bovine bone: a 2-year prospective study. J Periodontol 2008;79(11):2093-2103.
  17. The use of titanium mesh in conjunction with autogenous bone graft and inorganic bovine bone mineral (Bio-Oss) for localized alveolar ridge augmentation: a human study. Int J Periodontics Restorative Dent 2003;23(2):185-195.
  18. Maxillary autogenous bone grafting. Oral Maxillofac Surg Clin North Am 2011;23(2):229-238.
  19. Autogenous bone graft: basic science and clinical implications. J Craniofac Surg 2012;23(1):323-327.
  20. Volume changes of iliac crest autogenous bone grafts after vertical and horizontal alveolar ridge augmentation of atrophic maxillas and mandibles: a 6-year computerized tomographic follow-up. J Oral Maxillofac Surg 2012;70(11):2559-2565.
  21. Volume changes of autogenous bone after sinus lifting and grafting procedures: a 6-year computerized tomographic follow-up. J Craniomaxillofac Surg 2013;41(3):235-241.
  22. Vertical ridge augmentation around dental implants using a membrane technique and autogenous bone or allografts in humans. Int J Periodontics Restorative Dent 1998; 18(1):8-23.
  23. Clinical and histologic evaluation of allogeneic bone matrix versus autogenous bone chips associated with titanium-reinforced e-PTFE membrane for vertical ridge augmentation: a prospective pilot study. Int J Oral Maxillofac Implants 2008;23(6):1003-1012.
  24. Iliac crest autogenous bone graft versus alloplastic graft and guided bone regeneration in the reconstruction of atrophic maxillae: a 5-year retrospective study on cost-effectiveness and clinical outcome. Clin Implant Dent Relat Res 2011;13(4):305-310.
  25. Human allografts of iliac cancellous bone and marrow in periodontal osseous defects. II. Clinical observations. J Periodontol 1972;43(2):67-81.
  26. A sixmonth clinical evaluation of decalcified freeze-dried bone allografts in periodontal osseous defects. J Periodontol 1982;53(12):726-730.
  27. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants 1997;12(6):844-852.
  28. Effect of GBR in combination with deproteinized bovine bone mineral and/or enamel matrix proteins on the healing of critical-size defects. Clin Oral Implants Res 2004;15(1):101-111.
  29. Fate of bone formed by guided tissue regeneration with or without grafting of Bio-Oss or Biogran: an experimental study in the rat. J Clin Periodontol 2004;31(1):30-39.
  30. Bone formation by enamel matrix proteins and xenografts: an experimental study in the rat ramus. Clin Oral Implants Res 2005;16(2):140-146.
  31. Vertical ridge augmentation around implants by e-PTFE titanium-reinforced membrane and bovine bone matrix: a 24- to 54-month study of 10 consecutive cases. Int J Oral Maxillofac Implants 2008;23(5):858-66.
  32. Alveolar ridge augmentation with Bio-Oss: a histologic study in humans. Int J Periodontics Restotorative Dent 2001;21(3):288-295.
  33. Protein-chemical analysis of Bio- Oss bone substitute and evidence on its carbonate content. Biomaterials 2001;22(9):1005-1012.
  34. Type I collagen in xenogenic bone material regulates attachment and spreading of osteoblasts over the beta1 integrin subunit. Orthopade 1998;27(2):136-142.
  35. Cell-matrix interaction in bone: type I collagen modulates signal transduction in osteoblast-like cells. Am J Physiol 1995;268(5 Pt 1):C1090-103.
  36. Type I collagen-induced osteoblastic differentiation of bone-marrow cells mediated by collagen-alpha2beta1 integrin interaction. J Cell Physiol 2000;184(2):207-213.
  37. Effect of type I collagen on the adhesion, proliferation, and osteoblastic gene expression of bone marrow-derived mesenchymal stem cells. Chin J Traumatol 2004;7(6):358-362.
  38. Evaluation of the effect of heterologous type I collagen on healing of bone defects. J Oral Maxillofac Surg 2002;60(5):541-545.
  39. The effect on osteogenesis of type I collagen applied to experimental bone defects. Dent Traumatol 2004;20(6):334-347.
  40. Type I collagen induces expression of bone morphogenetic protein receptor type II. Biochem Biophys Res Commun 2001;283(2):316-322.
  41. The size exclusion characteristics of type I collagen: implications for the role of noncollagenous bone constituents in mineralization. J Biol Chem 2007;282(31):22437-22447.
  42. Human osteoclast formation and activity on an equine spongy bone substitute. Clin Oral Impl Res 2009;20(1):17-23.
  43. Human osteoclast formation and activity on a xenogenous bone mineral. J Biomed Mater Res A 2009;90(1):238-246.
  44. Sinus lift with autologous bone alone or in addition to equine bone: an immunohistochemical study in man. Implant Dent 2011;20(5):383-388.
  45. Alveolar ridge regeneration with equine spongy bone: a clinical, histological, and immunohistochemical case series. Clin Implant Dent Relat Res 2009;11(2):90-100.
  46. The use of cortical heterologous sheets for sinus lift bone grafting: a modification of Tulasne's technique with 7-year follow-up. Int J Immunopathol Pharmacol 2013;26:549-556.
  47. Case of severe bone atrophy of the posterior maxilla rehabilitated with blocks of equine origin bone: histological results. Implant Dent 2013;22(1):8-15.
  48. Treatment of a bone defect consequent to the removal of a periapical cyst with equine bone and equine membranes: clinical and histological outcome. Minerva Stomatol 2012; 61(11-12):477-490.
  49. Managing an extreme periimplantitis. Minerva Stomatol 2013;62(9):295-305.
  50. Equine-derived bone substitutes in orthopedics and traumatology: authors’ experience. Minerva Chir 2011;66(1):63-72.
  51. Implant design and interface force transfer. A photoelastic and strain-gauge analysis. Clin Oral Implants Res 2004;15(2):249-257.
  52. Quality of dental implants. Int Dent J 2003;53(6 Suppl 2):409-443.
  53. Occurrence of vertical bone defects in dentally aware individuals. Acta Odontol Scand 2003;61(1):47-51.
  54. The use of guided tissue regeneration to facilitate ideal prosthetic placement of implants. Int J Periodontics Restorative Dent 1992;12(4):256-265.
  55. Prosthetically guided implant placement for the surgical restorative team. Dent Implantol Update 1993;4(10):82-84.
  56. Selection and ideal tridimensional implant position for soft tissue aesthetics. Pract Periodontics Aesthetic Dent 1999;11(9):1063-1072.
  57. Vertical mandibular alveolar bone distraction and dental implant placement: a case report. J Oral Implantol 2006;32(3):137-141.
  58. Vertical ridge augmentation using guided bone regeneration (GBR) in three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after loading. Int J Oral Maxillofac Implants 2009;24(3):502-510.
  59. Generation of new bone around titanium implants using a membrane technique: an experimental study in rabbits. Int J Oral Maxillofac Implants 1989;4(1):19-25.
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