Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.02024
Revista de Odontologia da UNESP
Artigo Original

Tomographic assessment of bone volume changes following regeneration with titanium Mesh in the maxillary anterior region. A retrospective clinical study

Avaliação tomográfica das alterações ósseas volumétricas após regeneração com malha de titânio na região anterior da maxila. Estudo clínico retrospectivo

Carolina Pinheiro da ROCHA; Ana Daisy ZACHARIAS; Elcio MARCANTONIO JR; Flávia Noemy Gasparini KIATAKE FONTÃO; Rafael Scaf de MOLON; Rubens Moreno de FREITAS

http://dx.doi.org/10.1590/1807-2577.02024 Rev. odontol. UNESP, vol.53, e20240020, 2024
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Abstract

Introduction: For a successful implant-supported rehabilitation and long-term maintenance in the anterior maxilla, it is imperative that the patient possesses adequate bone quality and quantity.

Objective: The aim of this study was to assess bone gain and stability following reconstruction with titanium mesh in the anterior region of the maxilla, irrespective of the biomaterial used for bone augmentation.

Material and method: Patient follow-up data were obtained from the Faculty's follow-up database. The focus was on individuals who had undergone rehabilitation in the anterior maxilla, previously augmented with bone grafts and growth factors in conjunction with titanium mesh. This retrospective cohort study involved at least 10 patients who met the inclusion criteria. Following an initial review of medical records, the eligible patients were invited for evaluation appointments.

Result: Out of 39 patients who had undergone guided bone regeneration surgery using titanium mesh, 12 met the inclusion criteria. As such, 17 sites suitable for the study were obtained, from which total of 276 tomographic measurements were then taken. There was a noticeable increase in thickness at all assessment levels relative to the bone crest apex, both immediately (T1) and six months post-surgery (T2), compared to baseline measurements (T0). Moreover, bone thickness tended to increase with the proximity to the apical level.

Conclusion: The use of titanium mesh combined with various biomaterials has yielded favorable outcomes in terms of augmenting bone volume.

Keywords

Bone regeneration; dental implants; biocompatible materials

Resumo

Introdução: Para o sucesso da reabilitação com implantes suportados e da manutenção dos resultados a longo prazo na região anterior da maxila, é imperativo que o paciente possua qualidade e quantidade óssea adequadas.

Objetivo: O objetivo deste estudo foi avaliar o ganho e a estabilidade óssea após a reconstrução com malha de titânio na região anterior da maxila, independentemente do biomaterial utilizado para o aumento ósseo.

Material e método: Utilizamos dados de pacientes oriundos do banco de dados da Faculdade, focando em indivíduos que haviam passado por reabilitação na maxila anterior previamente aumentada com enxertos ósseos e fatores de crescimento em conjunto com malha de titânio. Este estudo de coorte retrospectivo envolveu pelo menos 10 pacientes que atenderam aos critérios de inclusão.

Resultado: De um total de 39 registros no banco de dados de pacientes que passaram por cirurgia de regeneração óssea guiada utilizando malha de titânio, doze atenderam aos critérios de inclusão, enquanto os demais foram excluídos. Assim, foram obtidos 17 sítios adequados para o estudo, envolvendo 12 pacientes e um total de 276 medições tomográficas. Houve um aumento notável na espessura óssea em todos os níveis de avaliação em relação ao ápice da crista óssea, tanto imediatamente (T1) quanto seis meses após a cirurgia (T2), em comparação com as medições iniciais (T0). Além disso, a espessura óssea tende a aumentar com a proximidade do nível apical.

Conclusão: A utilização da malha de titânio combinada com vários biomateriais resultou em resultados favoráveis em termos de aumento do volume ósseo.

Palavras-chave

Regeneração óssea; implantes dentais; biomateriais

Referências

1 Costa NMDF, Melo BR, Brito RT, Fernandes GVO, Bernardo VG, Fonseca EC, et al. Quality and intensity of the tissue response to two synthetic granular hydroxyapatite implanted in critical defects of rat calvaria. Mater Res. 2009 Jun;12(2):245-51. http://doi.org/10.1590/S1516-14392009000200022.

2 Jones AC, Arns CH, Hutmacher DW, Milthorpe BK, Sheppard AP, Knackstedt MA. The correlation of pore morphology, interconnectivity and physical properties of 3D ceramic scaffolds with bone ingrowth. Biomaterials. 2009 Mar;30(7):1440-51. http://doi.org/10.1016/j.biomaterials.2008.10.056. PMid:19091398.

3 Park JW, Jang JH, Bae SR, An CH, Suh JY. Bone formation with various bone graft substitutes in critical-sized rat calvarial defect. Clin Oral Implants Res. 2009 Apr;20(4):372-8. http://doi.org/10.1111/j.1600-0501.2008.01602.x. PMid:19309771.

4 Tadic D, Beckmann F, Schwarz K, Epple M. A novel method to produce hydroxyapatite objects with interconnecting porosity that avoids sintering. Biomaterials. 2004 Jul;25(16):3335-40. http://doi.org/10.1016/j.biomaterials.2003.10.007. PMid:14980428.

5 Buser D, Dula K, Hess D, Hirt HP, Belser UC. Localized ridge augmentation with autografts and barrier membranes. Periodontol 2000. 1999 Feb;19(1):151-63. http://doi.org/10.1111/j.1600-0757.1999.tb00153.x. PMid:10321222.

6 Rocchietta I, Fontana F, Simion M. Clinical outcomes of vertical bone augmentation to enable dental implant placement: a systematic review. J Clin Periodontol. 2008 Sep;35(8 Suppl):203-15. http://doi.org/10.1111/j.1600-051X.2008.01271.x. PMid:18724851.

7 Omara M, Abdelwahed N, Ahmed M, Hindy M. Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant. Int J Oral Maxillofac Surg. 2016 Apr;45(4):535-44. http://doi.org/10.1016/j.ijom.2015.11.001. PMid:26644216.

8 Sakou T. Bone morphogenetic proteins: from basic studies to clinical approaches. Bone. 1998 Jun;22(6):591-603. http://doi.org/10.1016/S8756-3282(98)00053-2. PMid:9626397.

9 Lim KO, Kim MS, Yang KI, Lee WP, Kim BO, Yu SJ. Sinus floor augmentation using mineralized freeze-dried bone allograft combined with recombinant human bone morphogenetic protein-2 (rhBMP-2): A long-term retrospective study. J Dent Sci. 2024 Apr;19(2):804-12. http://doi.org/10.1016/j.jds.2023.09.022. PMid:38618071.

10 Lee JH, Seo H, Cho YC, Sung IY, Son JH. Addition of recombinant human bone morphogenic protein-2 to the graft materials improves the clinical outcomes of implants placed in grafted maxillary sinus. J Dent Sci. 2024 Apr;19(2):865-70. http://doi.org/10.1016/j.jds.2023.08.020. PMid:38618057.

11 Galarraga-Vinueza ME, Barootchi S, Nevins ML, Nevins M, Miron RJ, Tavelli L. Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration. Periodontol 2000. 2024 Feb;94(1):483-509. http://doi.org/10.1111/prd.12522. PMid:37681552.

12 Kelly MP, Vaughn OL, Anderson PA. Systematic review and meta-analysis of recombinant human bone morphogenetic protein-2 in localized alveolar ridge and maxillary sinus augmentation. J Oral Maxillofac Surg. 2016 May;74(5):928-39. http://doi.org/10.1016/j.joms.2015.11.027. PMid:26707429.

13 Fontana F, Grossi GB, Fimanò M, Maiorana C. Osseointegrated implants in vertical ridge augmentation with a nonresorbable membrane: a retrospective study of 75 implants with 1 to 6 years of follow-up. Int J Periodontics Restorative Dent. 2015 Jan-Feb;35(1):29-39. http://doi.org/10.11607/prd.2136. PMid:25734704.

14 Misch CM, Jensen OT, Pikos MA, Malmquist JP. Vertical bone augmentation using recombinant bone morphogenetic protein, mineralized bone allograft, and titanium mesh: a retrospective cone beam computed tomography study. Int J Oral Maxillofac Implants. 2015 Jan-Feb;30(1):202-7. http://doi.org/10.11607/jomi.3977. PMid:25615925.

15 de Freitas RM, Susin C, Spin-Neto R, Marcantonio C, Wikesjö UM, Pereira LA, et al. Horizontal ridge augmentation of the atrophic anterior maxilla using rhBMP-2/ACS or autogenous bone grafts: a proof-of-concept randomized clinical trial. J Clin Periodontol. 2013 Oct;40(10):968-75. http://doi.org/10.1111/jcpe.12148. PMid:23998375.

16 Ricci L, Perrotti V, Ravera L, Scarano A, Piattelli A, Iezzi G. Rehabilitation of deficient alveolar ridges using titanium grids before and simultaneously with implant placement: a systematic review. J Periodontol. 2013 Sep;84(9):1234-42. http://doi.org/10.1902/jop.2012.120314. PMid:23205918.

17 Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975 Dec;25(4):229-35. PMid:1058834.

18 Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):237-59. PMid:19885448.

19 Nevins M, Mellonig JT, Clem DS 3rd, Reiser GM, Buser DA. Implants in regenerated bone: long-term survival. Int J Periodontics Restorative Dent. 1998 Feb;18(1):34-45. PMid:9558555.

20 Kuchler U, von Arx T. Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):14-24. http://doi.org/10.11607/jomi.2014suppl.g1.1. PMid:24660187.

21 Buser D, Ingimarsson S, Dula K, Lussi A, Hirt HP, Belser UC. Long-term stability of osseointegrated implants in augmented bone: a 5-year prospective study in partially edentulous patients. Int J Periodontics Restorative Dent. 2002 Apr;22(2):109-17. PMid:12019706.

22 Buser D, Dula K, Belser U, Hirt HP, Berthold H. Localized ridge augmentation using guided bone regeneration. 1. Surgical procedure in the maxilla. Int J Periodontics Restorative Dent. 1993;13(1):29-45. PMid:8330945.

23 Zitzmann NU, Naef R, Schärer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants. 1997 Nov-Dec;12(6):844-52. PMid:9425767. Erratum in: Int J Oral Maxillofac Implants 1998 Jul-Aug;13(4):576.

24 Her S, Kang T, Fien MJ. Titanium mesh as an alternative to a membrane for ridge augmentation. J Oral Maxillofac Surg. 2012 Apr;70(4):803-10. http://doi.org/10.1016/j.joms.2011.11.017. PMid:22285340.

25 Proussaefs P, Lozada J, Kleinman A, Rohrer MD, McMillan PJ. The use of titanium mesh in conjunction with autogenous bone graft and inorganic bovine bone mineral (bio-oss) for localized alveolar ridge augmentation: a human study. Int J Periodontics Restorative Dent. 2003 Apr;23(2):185-95. PMid:12710822.

26 Simion M, Baldoni M, Rossi P, Zaffe D. A comparative study of the effectiveness of e-PTFE membranes with and without early exposure during the healing period. Int J Periodontics Restorative Dent. 1994 Apr;14(2):166-80. PMid: 7928132.

Submetido em:
20/08/2024

Aceito em:
09/09/2024

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