Alveolar Ridge Reconstruction with Titanium Mesh and Autogenous Particulate Bone Graft: Computed Tomography-Based Evaluations of Augmented Bone Quality and Quantity

Purpose: The purpose of this study was to evaluate the quality and quantity of augmented bone following alveolar ridge reconstruction with titanium mesh and autogenous particulate bone graft for implant placement in terms of the preoperative bone defect. Materials and Methods: Forty-one patients (50 sites) rehabilitated between September 2000 andMay 2009 with autogenous particulate intraoral bone or iliac cancellous bone marrow grafts and micro-titanium meshes were enrolled. We classified the bone defects by means of shape as complex horizontal-vertical (HV), horizontal (H), and socket (S) types, and the augmented bone was evaluated based on preoperative computed tomographic data. The postsurgical complications were assessed during the healing period and after implant superstructure placement. Results: The bone defects were successfully augmented using the titanium mesh technique. The HV-type defect was the most difficult to augment (mean horizontal gain, 3.7 +/- 2.0 [SD] mm; mean vertical gain, 5.4 +/- 3.4 [SD] mm). The mean horizontal gain with the H-type defect was 3.9 +/- 1.9 mm. The S-type defect achieved the most efficient bone augmentation (mean horizontal gain, 5.7 +/- 1.4 [SD] mm; mean vertical gain, 12.4 +/- 3.1 [SD] mm). The major postsurgical complications were mesh exposure, infection, total or partial bone resorption, and temporary neurological disturbances. Implant failure was observed in one case. The HV-type defect showed significantly higher bone resorption (p <.05) than the other defect types. Conclusions: Autogenous bone grafting with titanium mesh allows adequate vertical and horizontal alveolar bone reconstruction both quantitatively and qualitatively for implant placement. However, the clinical outcome of augmentation depends on the type of preoperative bone defect.