Bone Augmentation Techniques with Customized Titanium Meshes: A Systematic Review of Randomized Clinical Trials

Background: A correct tridimensional implant placement requires a sufficient amount of bone to completely satisfy the prosthetic reconstruction. Several techniques can be used to recreate the bone quantity. Among them, titanium meshes have shown great potential in space maintenance and fewer complications in case of exposure. Recently, 3D CAD, CAM technology, and specifically SLM have been used to produce customized meshes in titanium alloy. The aim Purpose of this systematic review is to evaluate new customized meshes compared to traditional ones in terms of new volume of generated bone and the incidence of complications. Materials and Methods: A MEDLINE/PubMed literature search was performed to find relevant randomized controlled clinical trials published in English up to and including December 2022. The Cochrane Database of Systematic Reviews and SCOPUS were also searched. The main keywords used in the search were: titanium meshe(s), customized titanium meshe(s), combined with AND/OR as Boolean operators, and bone augmentation with/and/or titanium mesh. Results: The electronic search identified 1002 papers in total, and after duplicate removal, 500 articles were screened. After a manual screening of the title and abstract, 488 studies were excluded, and 12 articles' full text of 12 articles was analyzed. Further analysis was performed to make sure that the articles matched the inclusion/exclusion criteria of the present review. Six additional articles were excluded in this phase. No meta-analysis was performed due to the heterogeneity of the data. Conclusion: By using traditional or customized devices with the newly generated bone volume allowed the implant placement in all cases. Complications were mainly reported as exposure during the healing phase, but the conclusions of whether customized or conventional systems perform one better than the other are still inconclusive.