Can Patient-Specific Titanium Meshes Achieve Predictable Bone Volume in Extensive Alveolar Defects?

BACKGROUND: Reconstructing alveolar defects with titanium meshes is challenging and prone to complications. The introduction of patient-specific titanium meshes was expected to overcome these drawbacks. PURPOSE: The aim of this study was to evaluate the association between planned and achieved augmentation volumes using patient-specific titanium meshes (Yxoss Customized Bone Regeneration ; ReOss, Filderstadt, Germany) and to identify factors associated with the clinically achieved augmentation volumes. STUDY DESIGN, SETTING, AND SAMPLE: A single-center, retrospective cohort study was performed in an outpatient clinic. Inclusion criteria were patients aged >18 who underwent jaw augmentation with custom titanium meshes and a complete follow-up (postoperative healing, implant placement, and loading) between 2018 and 2023. Exclusion criteria were objection or inability to submit informed consent, loss to follow-up, and incomplete documentation. PREDICTOR VARIABLE: ). OUTCOME VARIABLE: ) about 3 months after mesh placement, determined by cone beam computed tomography analysis using Slicer 3D software (Brigham and Women's Hospital, Boston, MA). COVARIATES: The covariates were sex, wound healing disturbances, rigidity of mesh fixation (number of screws), and mesh exposure. ANALYSES: Descriptive and inferential statistics were computed (P < .05). RESULTS: ), respectively (P < .001; Pearson correlation coefficient 0.73). A more rigid mesh fixation significantly increased the achieved bone volume (β = 0.34; P = .006). Wound healing disturbances occurred frequently (42%) but did not reduce the achieved bone volume. During the median follow-up period of 23 months (interquartile range: 14-31), none of the 60 implants placed in the augmented bone failed. CONCLUSION AND RELEVANCE: Despite a significant complication rate, adequate bone volume for implant placement can be attained with custom titanium meshes.