A 3D micro-CT assessment of composition and structure of bone tissue after vertical and horizontal alveolar ridge augmentation using CAD/CAM-customized titanium mesh

Clin Oral Implants Res. 2024 Dec;35(12):1546-1559. doi: 10.1111/clr.14342. Epub 2024 Aug 6.

Abstract

Objectives: To date, no studies have exploited micro-CT in humans to evaluate bone morphology and structure after bone augmentation with CAD/CAM-customized titanium mesh, in mandible and maxilla. The aim of this study was to assess the composition and microstructure of bone biopsy through micro-CT analysis.

Materials and methods: Bone augmentation at both maxillary and mandible sites was performed on 30 patients randomly treated with customized mesh, either alone (M-) or covered with resorbable membrane (M+), in both cases filled 50:50 with autogenous bone and xenograft. After 6 months, biopsies were taken and micro-CT was performed on consecutive 1-mm-thick VOIs from coronal to apical side, measuring tissue volumes, trabecular thickness, spacing, and number.

Results: In both groups, irrespective of membrane use, bone tissue (M-: 29.76% vs. M+: 30.84%) and residual graft material (M-: 14.87% vs. M+: 13.11%) values were similar. Differences were site-related (maxillary vs. mandibular) with higher percentage of bone tissue and trabecular density of low-mineralized bone and overall bone in the mandible.

Conclusions: The composition and structure of bone tissue, as assessed by micro-CT after alveolar ridge augmentation using CAD/CAM-customized titanium meshes, showed similar features regardless of whether a collagen membrane was applied.

Keywords: CAD/CAM mesh; bone biopsies; bone regeneration; micro‐CT; randomized clinical trial; resorbable membrane.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation* / methods
  • Bone Transplantation / methods
  • Computer-Aided Design*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Maxilla / diagnostic imaging
  • Maxilla / surgery
  • Middle Aged
  • Surgical Mesh*
  • Titanium*
  • X-Ray Microtomography*

Substances

  • Titanium