Clinicians who practice implant dentistry are increasingly seeing more difficult cases where they must first overcome insufficient bone volume within the upper and lower jaw. These cases have led to new surgical techniques such as the use of titanium mesh to assist in guided bone regeneration.
But while this technique can lead to success, complications have emerged in some patients. An international team of researchers, then, has developed a new method for treating exposed titanium mesh. By removing it and leaving the remainder to continue the regenerative process, dental implantation can be more effective and successful, they report.
Between 2015 and 2017, four patients between the ages of 27 and 50 were treated with titanium mesh. Each had two previously failed bone regenerative procedures. Also in all four cases, the surgical technique used to incorporate the titanium mesh with the bone graft was the same. However, each patient received a different type of material or membrane to cover the titanium mesh.
Each patient experienced mesh exposure at a different rate, ranging from one to six weeks post-operation. The exposed mesh was removed between four and 10 weeks after exposure occurred. The remaining titanium mesh was removed approximately six months after insertion and one to two months prior to dental implantation.
By removing the exposed titanium mesh and allowing the rest to remain, the bone volume reached a level that was adequate for dental implants in all four cases. Also, removing the exposed mesh created a more hygienic space for the implant. Caring for areas with exposed mesh caused difficulty and discomfort for patients, compromising the integrity of the regenerative site.
“The removal of the exposed part seemingly did not have a negative effect clinically on bone integration in the final volume of the augmented bone and allowed for easier hygiene maintenance by the patient,” said researcher Aladdin J. Al-Ardah, DDS, MS, of the Advanced Education Program in Implant Dentistry at the Loma Linda University School of Dentistry.
The researchers acknowledge that their technique has been successful and helps ensure proper bone regeneration and hygiene maintenance for dental implant surgery, but further analyses are necessary. Before this technique can be carried out in routine dentistry, they say, more clinical research with a greater number of patients is needed.
The study, “Managing Titanium Mesh Exposure With Partial Removal of the Exposed Site: A Case Series Study,” was published by the Journal of Oral Implantology.
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