Using Virtual Ridge Augmentation and 3-Dimensional Printing to Fabricate a Titanium Mesh Positioning Device: A Novel Technique Letter

Figure 1. Preoperative frontal intraoral view. Figure 2. Three-dimensional (3D) reconstruction frontal view obtained from patient's cone-beam computerized tomography scan. Figure 3. 3D virtual frontal view of defect. Figure 4. 3D virtual frontal view of virtual teeth wax patterns over defect. Figure 5. (a) Frontal view of planned 3D virtual ridge augmentation in relation to teeth wax patterns. (b) Occlusal view of planned 3D virtual ridge augmentation in relation to teeth wax patterns. Figure 6. (a) Frontal view of final planned 3D virtual ridge augmentation. (b) Occlusal view of final planned 3D virtual ridge augmentation.

Figure 7. (a) Frontal view of 3D-printed maxillary model with final planned virtual ridge augmentation. (b) Occlusal view of 3D printed maxillary model with final planned virtual ridge augmentation. Figure 8. Frontal view showing titanium mesh form and positioned with fixation screws on 3D-printed model. Figure 9. Different views of positioning thermoplastic jig fabricated on formed titanium mesh over 3D-printed model. (a) Occlusal view. (b) Frontal view. (c) Palatal view.

Figure 10. Different views of the thermoplastic positioning jig. (a) Frontal view of the positioning jig alone. (b) Palatal view of the positioning jig with titanium mesh in place. (c) Frontal view of the positioning jig with titanium mesh in place. Note how stable the titanium mesh is and how well retained by the positioning jig. Figure 11. (a) Intraoperative frontal view of bony defect. (b) Intraoperative occlusal view of bony defect.

Figure 12. (a) Frontal view of the positioning jig with the titanium mesh in place for try-in intraoperatively. (b) Bone graft being loaded onto titanium mesh. (c) Titanium mesh placed on the positioning jig to be transferred to the patient's mouth. (d) Frontal view of the positioning jig retaining the titanium mesh and bone graft on bony defect. Note that the titanium mesh was very stable and being held to place fixation screws. (e) Occlusal view following fixation of titanium mesh and positioning jig in place prior to its removal. Figure 13. (a) Platelet-rich fibrin membrane placed over titanium mesh. (b) Final suturing of operative area.