Implant Site Development Using Titanium Mesh in the Maxilla: A Retrospective Study of 58 Mesh Procedures in 48 Patients.

This article presents a retrospective case series of implant site development using titanium mesh (Ti-mesh) in the maxilla. A total of 58 mesh procedures in combination with several different bone grafts (allograft, cellular allograft, and bovine xenograft) and biologics (including recombinant human platelet-derived growth factor, autogenous platelet-rich growth factor, and recombinant human bone morphogenetic protein-2) were performed in 48 patients. Ti-mesh guided bone regeneration procedures were performed 2 to 3 months after extraction of nonrestorable/hopeless teeth, and the implants were placed 6 to 8 months postaugmentation. The mean initial ridge width was 2.0 ± 1.0 mm, and the mean horizontal gain after Ti-mesh procedures was 4.7 ± 1.6 mm. The ridge width was first measured on the cross-sectional presurgical CBCT image and then confirmed clinically during surgical procedures. No statistical difference in the horizontal gain was found among different combinations of bone grafts and biomaterials. Ti-mesh exposure occurred 22% of the time. The middle-aged adults (odds ratio [OR] = 8.59; P = .046) and older adults (OR = 16.66; P = .02) had significantly higher chances of mesh exposure compared to young adults. While all implants were successfully placed, about 56% of the implants had < 2 mm of bone to the facial aspect of the osteotomy and received additional contour augmentation when placed in a prosthetically appropriate position for a screw-retained restoration. This study demonstrates that although Ti-mesh procedures result in significant bone regeneration in narrow alveolar ridges to predictably allow implant placement, the age-related mesh exposure rate and frequency of need for additional contour grafting should be discussed with patients.

A Prospective Clinical Study on Implant Survival at 1-Year Post-Loading of a Bone-Level Tapered Implant in Private Practice: Multicentered Study.

This non-interventional study evaluated the implant survival and success of a new bone-level tapered implant design in seven private dental practices in the United States. One hundred subjects in need of implant(s) were enrolled according to all cleared indications. After implant surgery, subjects were followed for a period of 1-year post-loading. Treatment planning, implant stability, radiographic evaluation of bone levels, soft-tissue characteristics, clinician satisfaction, and adverse events were assessed. A total of 184 implants were placed, of which 172 were evaluable at 1-year follow-up. Of the 172 evaluable implants, 169 survived and were successful at 1-year post-loading. Of 152 implants with radiographs at 1 year, 90% showed no bone remodeling or <1 mm bone loss. Overall clinician satisfaction was high across all centers. Normal soft-tissue profiles were reported around the implants with improvement in color, form, and mucosal attachment at 1 year. In a "real-world" setting this observational study demonstrated high implant survival and success, stable crestal bone levels, high clinician satisfaction, and a low incidence of adverse events.

End stage renal disease as a modifier of the periodontal microbiome.

BACKGROUND: Evidence supports high prevalence of periodontitis in patients with chronic kidney disease. Several renal factors have been proposed as possible modifiers of periodontitis pathogenesis in this population. In this cross sectional study, we investigated whether distinct microbial profiles in renal patients could explain high periodontitis prevalence. METHODS: We characterized the subgingival microbiome in 14 End Stage Renal Disease (ESRD) and 13 control individuals with chronic periodontitis with similar demographic and clinical parameters. Medical, demographic and periodontal parameters were recorded. Subgingival biofilm samples were collected from the deepest pocket in two different quadrants and characterized via 454-pyrosequencing of the 16S rRNA gene. RESULTS: We found 874 species-level operational taxonomic units (OTU) across samples. Renal and control groups did not differ in the individual proportions of periodontitis-associated taxa. However, in principal coordinate plots of distance among samples based on OTU prevalence, some renal patients clustered apart from controls, with the microbial communities of these outlier subjects showing less diversity. Univariate correlation analysis showed a significant negative correlation between dialysis vintage and community diversity. CONCLUSIONS: Within the study limitations, dialysis vintage was associated with a less diverse periodontal microbial community in ESRD suggesting the need for further research.

Use of titanium mesh in implant site development for restorative-driven implant placement: case report. Part 2: surgical protocol for single-tooth esthetic zone sites.

There are many techniques in the dental implant literature to augment bone for implant site development. The use of rigid titanium mesh was first described by Boyne in the mid-1980s to maintain regenerative space and to aid in unimpeded bone healing. Ti-mesh was used in this case report to demonstrate the predictability of this technique in creating bone augmentation in both a lateral and vertical direction prior to the placement of a single implant in site No. 5. The article describes the surgical steps for the use of ti-mesh in a single esthetic zone site with a 3-year follow-up.