Autogenous bone graft alone or associated with titanium mesh for vertical alveolar ridge augmentation: a controlled clinical trial

Objectives: The aim of this controlled clinical trial is to evaluate alveolar ridge augmentation using an autogenous onlay bone graft alone or associated with a titanium mesh (Ti-Mesh). Material and methods: A group of 23 partially edentulous patients, presenting the need for vertical bone augmentation of at least 4 mm, were treated before implant placement. Surgical procedure was performed by the same operator and was identical at 12 test (bone graft + Ti-Mesh) and 12 control (bone graft alone) sites. During the first surgery, an autogenous bone graft was harvested from the mandibular ramus and secured by means of titanium screws. Particulate bone was added. In patients assigned to the test group only, a Ti-Mesh was used to stabilize and protect the graft. Results: No major complications were recorded at recipient or donor sites. After a mean interval of 4.6 (SD 0.7) months, the mean vertical augmentation obtained was 5 mm (range 4-7 mm) for the test group and 3.4 mm (range 3-6 mm) for the control. The sites with Ti-Mesh coverage underwent bone resorption of 13.5%, while the sites with no coverage showed a corresponding value of 34.5%. The differences between the two groups were statistically significant. Implants were placed at all grafted sites. Conclusion: The results of this study suggest that an onlay osseous graft protected by a Ti-Mesh demonstrated significantly less bone resorption when compared with an onlay bone graft alone. This benefit was reduced in case of short-term mesh exposure, with limited drawbacks.