Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 13 Mar 2025

Efficacy of Bioresorbable Mesh Sheets Made of 85:15 Poly(lactic-co-glycolic acid) in the Anterior Maxilla for Alveolar Bone Augmentation

DDS, PhD,
DDS, PhD,
DDS,
DDS, PhD, and
DDS, PhD
Page Range: 60 – 66
DOI: 10.1563/aaid-joi-D-24-00102
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This study evaluated the efficacy of poly(lactic-co-glycolic acid) (PLGA) mesh sheets for alveolar bone reconstruction in the anterior maxilla with significant bone defects. This prospective case series included 4 male patients (mean age, 34.5 years; range, 20–49 years) with anterior maxillary bone defects. Bone augmentation was performed using a staged guided bone regeneration technique with PLGA mesh sheets as barrier membranes and a 1:1 mixture of autogenous and xenogeneic bone as grafting material. The effectiveness of bone augmentation was evaluated using preoperative and postoperative computerized tomography data at 1 and 6 months. Secondary outcomes included complications such as wound infection and dehiscence. The treatment of the 4 patients required 7 PLGA mesh sheets and particulate bone, followed by 9 implant placements. Wound healing was uneventful except for 1, wherein wound dehiscence and graft loss were observed. One patient had an exposed PLGA mesh sheet during healing, necessitating its removal. The mean vertical bone gain was 2.3 ± 0.5 mm, and the mean horizontal gain was 3.7 ± 1.3 mm at 1 month postoperatively. Sites without wound dehiscence exhibited a bone decrease rate of 6.5%–21.1%, whereas successful bone height and width increases were observed across treated sites. Bone augmentation using PLGA mesh sheets proved effective in reconstructing horizontal and vertical alveolar bone dimensions. This technique provides adequate support for implant placement, demonstrating its potential utility in cases of substantial alveolar bone deficiency.

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<sc>igure 1.</sc>
F igure 1.

Surgical procedures. (a) The templates were manually molded to align with the planned bone shapes at the treatment site. (b) PLGA mesh sheets were formed using a precontoured bending template as a guide in a hot water bath. (c) Particulated bone graft material was placed on the residual bone. (d) Bone graft material was covered with a PLGA mesh sheet and fixed to the residual bone.


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<sc>igure 2.</sc>
F igure 2.

The postoperative models were superimposed onto the preoperative model, which consisted of a composite of computerized tomography reconstruction and imported dental cast models with waxed-up crowns for implant prosthodontics. This was achieved through surface-based matching with respect to the anterior cranial base. T0: before surgery, T1: 1 week after surgery, T2: 6 months after surgery.


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<sc>igure 3.</sc>
F igure 3.

Measurements of alveolar bone width and height changes at the mesiodistal midpoint of the planned implant placement site with alignment performed parallel to the occlusal plane.


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<sc>igure 4.</sc>
F igure 4.

PLGA mesh sheet exposure 2 months after surgery.


Contributor Notes

Corresponding author, e-mail: kounosur@tmd.ac.jp
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