Biomaterial-based bone regeneration and soft tissue management of the individualized 3D-titanium mesh: an alternative concept to autologous transplantation and flap mobilization

Publication date: Available online 19 July 2019Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Shahram Ghanaati, Sarah Al-Maawi, Torsten Conrad, Jonas Lorenz, Ralf Rössler, Robert SaderSummaryThree-dimensional augmentation in severely atrophic bone and after cancer resection is a challenging clinical indication that is mostly solved using autologous bone transplantation. The development of the digital technique along with the additive manufacturing and three-dimensional (3D) printing opened new avenues for reconstructive oral and maxillofacial surgery. Therefore, patient-specific titanium mesh is a novel means of stabilizing the augmentation region using particulate bone substitute materials (BSMs) combined with autologous bone as a minimally invasive concept. However, dehiscence is a frequently reported complication in this field. Therefore, the aim of the present case series was to introduce a biomaterial-based regenerative concept in terms of exposed open healing to overcome the dehiscence related to 3D-titanium meshes. Additionally, this case series presents a novel protocol using a combination of xenogeneic BSMs with an autologous blood concentrate system (platelet-rich fibrin [PRF]) and collagen matrices without any autologous transplantation. Seven patients with alveolar ridge atrophy with different etiologies (cancer resection, severe atrophy after tooth loss, aplasia, trauma, implant infections) were treated using the open-healing concept. Therefore, after...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research