Custom-Made Titanium Mesh for Maxillary Bone Augmentation With Immediate Implants and Delayed Loading

Figure 1. Frontal and occlusal view of atrophic maxilla. Figure 2. Preoperative ortopanthomography.

Figure 3. Digital implant placement planning. Because of severe horizontal bone atrophy, the previsualization showed implant fenestrations. Figure 4. Maxilla computer-aided design (CAD) rendering from computerized tomography data. Figure 5. CAD design of bone augmentation volume. Figure 6. CAD design of titanium mesh.

Digital titanium mesh (Ti-mesh) computer-aided design workflow. The space that will be occupied by biomaterial is represented in light blue, while in red is figured the Ti-mesh. The titanium grid is designed and printed to precisely adapt to bone anatomy.

Surgical implant placement phases. The previsualization of fenestrations shown in Figure 4 revealed to be true in reality (d).

Biomaterial application under titanium mesh and plasma-rich growth factor.

Second-stage surgery after 6 months. (a, b) Augmented maxilla in frontal and lateral view. (c, d) Grid exposure and removal, detaching from pseudo-periosteum. (e) Augmented bone volume. (f) Healing abutments and soft-tissue augmentation.

Orthopantomography after prosthetic loading.

Detailed computerized tomography images of implant bone, horizontal and vertical levels 1 year after loading.

Computerized tomography 1 year after loading, occlusal view. Notice the native cortical level in the inner augmented bone and the newly formed cortical bone.