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.

BACKGROUND: To our acknowledgment, there were limited clinical studies about the guided bone regeneration (GBR) for both vertical and horizontal augmentation at the same time using titanium mesh (Ti-mesh) with simultaneous implant placement in the esthetic zone. Meanwhile, studies that specially evaluate resorption and long-term stability of the augmented labial bone after loading were also rare. Therefore, this study introduced a newly designed L-shaped Ti-mesh used for GBR with simultaneous implant placement and evaluated the bone augmentation effectiveness, resorption, and long-term stability of peri-implant bone with this newly designed L-shaped Ti-mesh.

MATERIALS AND METHODS: Twelve patients (16 implants) who had underwent a GBR procedure using L-shaped Ti-mesh with simultaneous implants placement were reviewed in this study. Complications, implant success, and survival rate were recorded and calculated. Furthermore, the bone gain values, labial bone resorption, and remaining labial bone volume were measured by cone beam CT (CBCT) during 13-41 months follow-up.

RESULTS: After GBR using L-shaped Ti-mesh, the average bone gain values were 3.61 ± 1.50 mm vertically and 3.10 ± 2.06 mm horizontally. The implant success and surviving rate were 93.75% and 100%, respectively during the longest 41 months follow-up. The vertical labial bone resorption was -0.81 ± 1.00 mm, horizontal labial bone resorption was -0.13 ± 1.19 mm at the top of the implants. The remaining labial bone thickness was 2.24 ± 1.29 mm at the top of the implants and 2.86 ± 1.08 mm at the 2 mm apically from the implant tops after loading. There was still 1.13 ± 1.18 mm vertical labial bone remaining above the top of implants for approximately 87.5% sites.

CONCLUSIONS: GBR using L-shaped Ti-mesh with simultaneous implant placement (one-step surgery) in the esthetic zone could achieve predictable results for vertical and horizontal bone augmentation at the same time. Meanwhile, L-shaped Ti-mesh could preferably reconstruct and reduce the labial bone resorption to achieve long-term esthetics. This newly designed L-shaped Ti-mesh may offer predictable and excellent outcomes for the implant restoration in the esthetic zone.