Titanium Mesh Exposure: A Case Report of Retrieved Underlying Soft Tissue and a Review of Literature Titanium Mesh Exposure
Journal of "Regeneration, Reconstruction & Restoration" (Triple R),
Vol. 9 (2024),
1 January 2024
https://doi.org/10.22037/rrr.v9.34663
Abstract
Background and objectives: In this study, we aimed to report histopathological evaluation of the underlying tissues in a case of premature Titanium mesh exposure and assess the rate of Titanium mesh (Ti-mesh) exposure in the literature and its effect on treatment outcomes when used as a barrier membrane in jaw-bone reconstruction.
Materials and methods: We reviewed articles that used Ti-mesh with/without grafting materials to reconstruct atrophic ridges both vertically and/or horizontally. Considering our inclusion criteria, 51 studies were included. All relevant RCTs, retrospective studies (cohorts and case-controls) and case-series were included but case-reports and review articles were excluded. Data regarding premature exposure rate, removal rate, associated bone loss, and implant survival rate were extracted. Later, a report of an early Ti-mesh exposure in anterior maxillary horizontal augmentation with autogenous bone graft and deproteinized bovine bone mineral in a 50-year-old female is presented with a histological study of the underlying soft tissue at the time of mesh removal.
Results: A total of 51 studies were included in the review. Among the 41 studies reporting exposure, 18 reported removal of membranes, of which 3 caused significant bone loss. In the obtained biopsy from the reported case, a connective tissue infiltrated with sporadic inflammatory cells covered with keratinized stratified squamous epithelium was observed.
Conclusion: Our results indicate the loss of outcomes (both bone loss and implant failure) may not be associated with Ti-mesh exposure, which could, along with the rate of exposure, help the clinician assess the relative risk of its application.
Keywords: Alveolar ridge augmentation, Guided bone regeneration, Bone graft, Titanium mesh, Exposure.
Keywords:
- Alveolar ridge augmentation, Guided bone regeneration, Bone graft, Titanium mesh, Exposure
How to Cite
Akhavan Azar, B., Safiaghdam, H., Gharehdaghi, N., & Khojasteh, A. (2024). Titanium Mesh Exposure: A Case Report of Retrieved Underlying Soft Tissue and a Review of Literature: Titanium Mesh Exposure. Journal of "Regeneration, Reconstruction & Restoration" (Triple R), 9. https://doi.org/10.22037/rrr.v9.34663
References
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3. Khojasteh A, Soheilifar S, Mohajerani H, Nowzari H (2013) The effectiveness of barrier membranes on bone regeneration in localized bony defects: a systematic review. INT J ORAL MAX IMPL 28 (4). https://doi.org/10.11607/jomi.2925
4. dal Polo MR, Poli PP, Rancitelli D, Beretta M, Maiorana C (2014) Alveolar ridge reconstruction with titanium meshes: a systematic review of the literature. Med Oral Patol Oral Cir Bucal 19 (6):e639.https://doi.org/ 10.4317/medoral.19998
5. Gielkens PF, Schortinghuis J, de Jong JR, Paans AM, Ruben JL, Raghoebar GM, Stegenga B, Bos RR (2008) The influence of barrier membranes on autologous bone grafts. J. Dent. Res 87 (11):1048-1052. https://doi.org/10.1177/154405910808701107
6. Kuchler, U., von Arx, T. (2014). Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: a systematic review. INT J ORAL MAX IMPL, 29 Suppl:14-24. https://doi.org/10.11607/jomi.2014suppl.g1.1
7. Ankli, V., Limeira, F., Yamauti, M., Sá, T. (2018). Gingival Veneer Used as Prosthetic Solution for Esthetic-Compromised Malpositioned Dental Implant. Contemp clin dent, 9(1), 123–127. https://doi.org/10.4103/ccd.ccd_739_17
8. Pieri, F., Nicoli Aldini, N., Marchetti, C., Corinaldesi, G. (2013). Esthetic outcome and tissue stability of maxillary anterior single-tooth implants following reconstruction with mandibular block grafts: a 5-year prospective study. INT J ORAL MAX IMPL, 28(1): 270-80. https://doi.org/10.11607/jomi.2560.
9. Özkan P, Aka PS, Genç F, Keskin A, Gürbüz A (2017) Surgical and Aesthetic Rehabilitation for Traumatic Maxilla. Clin Case Rep Rev 3: https://doi.org/10.15761/CCRR.1000341
10. Levine RA, Manji A, Faucher J, Present S. Use of titanium mesh in implant site development for restorative-driven implant placement: case report. Part 1--Restorative protocol for single-tooth esthetic zone sites. Compend Contin Educ Dent. 2014;35(4):264-273.
11. Roccuzzo, M, Grasso, G, Dalmasso, P. Keratinized mucosa around implants in partially edentulous posterior mandible: 10‐year results of a prospective comparative study. Clin. Oral Impl. Res. 27, 2016, 491– 496. https://doi.org/10.1111/clr.12563
12. Cucchi, A, Vignudelli, E, Napolitano, A, Marchetti, C, Corinaldesi, G. Evaluation of complication rates and vertical bone gain after guided bone regeneration with non‐resorbable membranes versus titanium meshes and resorbable membranes. A randomized clinical trial. Clin Implant Dent Relat Res. 2017; 19: 821– 832. https://doi.org/10.1111/cid.12520
13. Her S, Kang T, Fien MJ (2012) Titanium mesh as an alternative to a membrane for ridge augmentation. J. Oral Maxillofac. Surg. 70 (4):803-810. https://doi.org/10.1016/j.joms.2011.11.017
14. Viswanathan M, Berkman ND, Dryden DM, et al. Assessing Risk of Bias and Confounding in Observational Studies of Interventions or Exposures: Further Development of the RTI Item Bank [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Aug. https://www.ncbi.nlm.nih.gov/books/NBK154461
15. Milinkovic I, Cordaro L (2014) Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg 43 (5):606-625. https://doi.org/10.1016/j.ijom.2013.12.004
16. Ricci L, Perrotti V, Ravera L, Scarano A, Piattelli A, Iezzi G (2013) Rehabilitation of deficient alveolar ridges using titanium grids before and simultaneously with implant placement: a systematic review. J Periodontol 84 (9):1234-1242. https://doi.org/10.1902/jop.2012.120314
17. Lizio G, Corinaldesi G, Marchetti C (2014) Alveolar ridge reconstruction with titanium mesh: a three-dimensional evaluation of factors affecting bone augmentation. INT J ORAL MAX IMPL 29 (6):1354-1363.https://doi.org/ 10.11607/jomi.3417
18. Zitzmann NU, Naef R, Scharer P (1997) Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. INT J ORAL MAX IMPL 12 (6):844-852.
19. Corinaldesi G, Pieri F, Sapigni L, Marchetti C (2009) Evaluation of survival and success rates of dental implants placed at the time of or after alveolar ridge augmentation with an autogenous mandibular bone graft and titanium mesh: a 3-to 8-year retrospective study. INT J ORAL MAX IMPL 24 (6).
20. Papaspyridakos P, Chen C-J, Singh M, Weber H-P, Gallucci GO (2012) Success Criteria in Implant Dentistry:A Systematic Review. J. Dent. Res 91 (3):242-248. https://doi.org/10.1177/0022034511431252
21. von Arx T, Hardt N, Wallkamm B (1996) The TIME technique: a new method for localized alveolar ridge augmentation prior to placement of dental implants. INT J ORAL MAX IMPL 11 (3):387-394
22. Roccuzzo M, Ramieri G, Bunino M, Berrone S (2007) Autogenous bone graft alone or associated with titanium mesh for vertical alveolar ridge augmentation: a controlled clinical trial. Clin. Oral Implants Res. 18 (3):286-294. https://doi.org/10.1111/j.1600-0501.2006.01301.x
23. Adell R, Lekholm U, Rockler B, Brånemark P-I (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Maxillofacs surg 10 (6):387-416
24. El Chaar E, Urtula AB, Georgantza A, Cruz S, Fallah-Abed P, Castaño A, Abitbol T, Warner MM (2019) Treatment of Atrophic Ridges with Titanium Mesh: A Retrospective Study Using 100% Mineralized Allograft and Comparing Dental Stone Versus 3D-Printed Models.INT J PERIODONT REST 39(4). https://doi.org/10.11607/prd.3733
25. Hartmann A, Hildebrandt H, Schmohl JU, Kämmerer PW (2019) Evaluation of Risk Parameters in Bone Regeneration Using a Customized Titanium Mesh: Results of a Clinical Study.Implant Dent 28 (6):543-550. https://doi.org/10.1097/id.0000000000000933
26. Malik R, Gupta A, Bansal P, Sharma R, Sharma S (2020) Evaluation of Alveolar Ridge Height Gained by Vertical Ridge Augmentation Using Titanium Mesh and Novabone Putty in Posterior Mandible.J Oral Maxillofac 19 (1):32-39. https://doi.org/10.1007/s12663-019-01250-9
27. Ghanaati S, Al-Maawi S, Conrad T, Lorenz J, Rössler R, Sader R (2019) Biomaterial-based bone regeneration and soft tissue management of the individualized 3D-titanium mesh: An alternative concept to autologous transplantation and flap mobilization.J Craniomaxillofac Surg 47 (10):1633-1644. https://doi.org/10.1016/j.jcms.2019.07.020
28. Khojasteh A, Hosseinpour S, Rezai Rad M, Alikhasi M, Zadeh HH (2019) Buccal fat pad-derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: An exploratory prospective clinical study. Clin Implant Dent Relat Res 21 (2):292-300. https://doi.org/10.1111/cid.12729
29. Tallarico M, Ceruso FM, Muzzi L, Meloni SM, Kim Y-J, Gargari M, Martinolli M (2019) Effect of Simultaneous Immediate Implant Placement and Guided Bone Reconstruction with Ultra-Fine Titanium Mesh Membranes on Radiographic and Clinical Parameters after 18 Months of Loading. Materials 12 (10):1710. https://doi.org/10.3390/ma12101710
30. Zhang T, Zhang T, Cai X (2019) The application of a newly designed L-shaped titanium mesh for GBR with simultaneous implant placement in the esthetic zone: A retrospective case series study. Clin Implant Dent Relat Res 21 (5):862-872. https://doi.org/10.1111/cid.12726
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