Clinical effect of porous titanium mesh with cross-linked collagen membrane for guided bone regeneration

Abstract

Titanium mesh, a barrier membrane, has excellent mechanical properties and space maintaining ability. However, one of its disadvantages is that soft tissue over the membrane could be interposed through the pore of the mesh. Conversely, the cross-linked collagen membrane has good soft tissue reaction and reduces the migration of epithelial cells to the guided bone regeneration site. Therefore, we performed guided bone regeneration using a combination of collagen membrane and titanium mesh and analyzed the clinical results. The patients were divided into two groups. Only titanium mesh was used for guided bone regeneration in group A, and a combination of titanium mesh and collagen membrane was used in group B. The degree of soft tissue interposition over the titanium mesh was evaluated after titanium mesh removal, and the surface bone quality was observed. The obtained bone height was measured in the panoramas based on the adjacent tooth cemento-enamel junction, and the bone density was measured using the Hounsfield scale on cone beam computed tomography before titanium mesh removal. In group A, the average soft tissue interposition was 31.50%, and the bone quality was poor when the interposed soft tissue was removed. Therefore, additional bone grafting was performed during implant placement in one case. In group B, there was almost no soft tissue interposition between the titanium mesh pores, and no additional bone graft was performed during implant placement. The combination of two membranes provides a favorable vertically obtained bone height and excellent surface bone quality without soft tissue interposition.