VERTICAL COMPUTERGUIDED BONE REGENERATION OF SEVERELY RESORBED RIDGES WITH CUSTOMIZED TITANIUM GRID – ONE-YEAR FOLLOW-UP AFTER DEFINITIVE PROSTHESES DELIVERY: A RETROSPECTIVE CASE SERIES
PURPOSE. The purpose of this report was to provide outcome data from a retrospective case series of vertical bone augmentation using 3D-customized titanium grids one year after fitting of definitive prostheses.
MATERIALS AND METHODS. Patients with severe vertical bone defects in the mandible or maxilla regenerated using titanium grids, previously customized via CBCT scan and pre-surgical virtual wax up, filled outside the mouth with 50% autologous bone and 50% deproteinized bovine bone were analysed. Eight to 9 months after regeneration, a second CBCT scan was performed to evaluate the regenerated bone, and implants were planned and placed.
Patients were monitored for one year after fitting of the definitive prostheses. Primary outcome measures were implant and prosthesis survival rates and complications. Secondary outcome measures were vertical dimensional changes, and peri-implant marginal bone loss.
RESULTS. Seven patients and eight procedures involving the insertion of a total of 22 implants were assessed. One-year after definitive prosthesis fitting, no patient had dropped out. No implant or prosthesis failed during follow-up. Three grid exposures were detected; one grid was removed two months after placement, while the other two were minimally exposed, which did not affect the outcome of the guided bone-regeneration (GBR) procedure, and were therefore not removed until implant placement. No other complication was recorded during the entire follow-up.
At implant placement, the mean maximum vertical augmentation was 7.38± 2.60 mm (95% CI: 5.578 to 9.182). One year after definitive prosthesis fitting, the mean marginal peri-implant bone loss at patient level was 0.98± 0.27 mm; 95% (CI: 0.78 to 1.18).
CONCLUSIONS. Within the limitations of this case series, the results recorded one year after definitive prosthesis fitting seem to validate the use of customized titanium grids for augmentation of major vertical bone defects.