# Clinical and Radiographic Outcomes of Customized Titanium Mesh vs. Screw Tent‐Pole Grafting: A Retrospective Study

## TL;DR

A study compared two bone grafting techniques for jaw reconstruction and found that a customized titanium mesh saved time without compromising results.

## Contribution

The study provides empirical evidence comparing customized titanium meshes and traditional tent-pole grafting for alveolar ridge augmentation.

## Key findings

- Both techniques achieved similar bone height and width gains with no significant differences.
- Customized titanium meshes reduced operative time by about 10 minutes compared to tent-pole grafting.
- All implants survived with stable peri-implant bone levels over a 5-year follow-up.

## Abstract

Guided bone regeneration (GBR) is a predictable approach for managing severe alveolar ridge deficiencies prior to implant placement. Resorbable collagen membranes supported by tenting screws are widely used, although space maintenance in non‐contained defects may be challenging. Customized CAD/CAM titanium meshes have been introduced to enhance graft stability and surgical workflow, but comparative clinical evidence remains limited.

To compare clinical, radiographic, procedural, and peri‐implant outcomes of customized CAD/CAM titanium meshes versus resorbable collagen membranes supported by tenting screws for horizontal and/or vertical alveolar ridge augmentation.

This retrospective study included 40 patients with severe alveolar ridge defects, allocated to two groups (n = 20 each). Both groups received particulate bone grafts stabilized either with tenting screws and a resorbable collagen membrane or with a patient‐specific CAD/CAM titanium mesh. Cone‐beam computed tomography (CBCT) scans at baseline and 6 months were used to assess vertical and horizontal bone gain. Intraoperative time, complications, pseudo‐periosteum formation, implant survival, and peri‐implant marginal bone levels at prosthetic loading and at 5‐year follow‐up were recorded.

At 6 months, mean bone height reached 8.7–8.93 mm in the maxilla and 9.25–9.35 mm in the mandible, while mean ridge width ranged from 4.7 to 5.3 mm, with no significant intergroup differences (p > 0.05). Mean peri‐implant marginal bone loss was limited and remained stable from prosthetic loading to the 5‐year follow‐up in both groups. Mean operative time was significantly shorter in the customized mesh group, 72.7 min (range: 60–85) for the Tent‐pole group and 62.4 min (range: 60–65) for the Ti‐mesh group. All 60 implants placed in 40 augmented sites survived, with no implant failures and no need for additional grafting procedures.

Both GBR techniques provided comparable bone regeneration and long‐term peri‐implant stability, while customized CAD/CAM titanium meshes were associated with reduced operative time.