Biological properties of 3D printed bionic titanium mesh and polyurethane coating on the effect of bone augmentation after titanium mesh exposure

doi:10.12337/zgkqzzxzz.2023.12.009

Abstract

Abstract: Objective To observe the bone augmentation effect of spiderweb-shaped customized titanium mesh after exposure, and to investigate whether polyurethane coating of titanium mesh could reduce the infection rate. Methods Six Beagle dogs were selected, and the second and third premolars on both sides of the mandibles were virtually removed to construct the bone defect models. The spiderweb-structured customized titanium meshes and osteotomy guides were designed and printed. The titanium meshes were treated with acid etching and polyurethane coating, respectively. Guided bone regeneration (GBR) was performed in the mandibles of Beagle dogs bilaterally. The titanium mesh exposure models were established by feeding bait 2 weeks after GBR. Six Beagle dogs were executed 3 months later. The effect of alveolar bone augmentation after titanium mesh exposure in each group was analyzed by gross observation, CBCT analysis and microscope observation. Results There were 3 kinds of results at 12 sites of titanium mesh exposure: ① Titanium mesh detachment with soft tissue healing;② Titanium mesh in place with persistent exposure; ③ Titanium mesh in place with soft tissue healing. Among them, 2 acid etching sites and 1 polyurethane coating site showed different degrees of infection symptoms. The results of CBCT volume ratio calculation and microscope showed that 35% ± 13% osteogenesis in the titanium mesh detachment group, and 48% ± 8% osteogenesis in the titanium mesh exposed healing group was significantly higher than the 27% ± 10% in the exposed persistence group (P<0.05). The titanium mesh exposed healing group was higher than the titanium mesh detachment group (P>0.05). Conclusion Customized titanium mesh can still form new bone after early exposure, the best osteogenesis results were achieved with post-exposure healing. The infection rate after polyurethane coating was slightly lower than that of acid etching group, and the difference between the two groups was 16.6%.

Key words: Guided bone regeneration, Customized titanium mesh, Bionic spiderweb pore structure, Titanium mesh exposure

Han Zhenjia, Wang Xinyu, Dong Meixi, Zhang Liang, Han Zekui, Su Yucheng, Zang Yixin, Duan Feng. Biological properties of 3D printed bionic titanium mesh and polyurethane coating on the effect of bone augmentation after titanium mesh exposure[J]. Chinese Journal of Oral Implantology, 2023, 28(6): 444-450.

References

[1] De Santis D, Cucchi A, Rigoni G, et al.Short implants with oxidized surface in posterior areas of atrophic jaws: 3-to 5-year results of a multicenter study[J]. Clin Implant Dent Relat Res, 2015,17(3):442-452. DOI: 10.1111/cid.12123.
[2] Cassetta M, Di Mambro A, Giansanti M, et al.A 36-month follow-up prospective cohort study on peri-implant bone loss of Morse Taper connection implants with platform switching[J]. J Oral Sci, 2016,58(1):49-57. DOI: 10.2334/josnusd.58.49.
[3] Tolstunov L, Hamrick J, Broumand V, et al.Bone augmentation techniques for horizontal and vertical alveolar ridge deficiency in oral implantology[J]. Oral Maxillofac Surg Clin North Am, 2019,31(2):163-191. DOI: 10.1016/j.coms.2019.01.005.
[4] Ciocca L, Lizio G, Baldissara P, et al.Prosthetically CAD-CAM-guided bone augmentation of atrophic jaws using customized titanium mesh: preliminary results of an open prospective study[J]. J Oral Implantol, 2018,44(2):131-137. DOI: 10.1563/aaid-joi-D-17-00125.
[5] Tarsitano A, Battaglia S, Ricotta F, et al.Accuracy of CAD/CAM mandibular reconstruction: a three-dimensional, fully virtual outcome evaluation method[J]. J Craniomaxillofac Surg, 2018,46(7):1121-1125. DOI: 10.1016/j.jcms.2018.05.010.
[6] Cucchi A, Giavatto MA, Giannatiempo J, et al.Custom-made titanium mesh for maxillary bone augmentation with immediate implants and delayed loading[J]. J Oral Implantol, 2019,45(1):59-64. DOI: 10.1563/aaid-joi-D-18-00141.
[7] Rakhmatia YD, Ayukawa Y, Furuhashi A, et al.Microcomputed tomographic and histomorphometric analyses of novel titanium mesh membranes for guided bone regeneration: a study in rat calvarial defects[J]. Int J Oral Maxillofac Implants, 2014,29(4):826-835. DOI: 10.11607/jomi.3219.
[8] Gutta R, Baker RA, Bartolucci AA, et al.Barrier membranes used for ridge augmentation: is there an optimal pore size?[J]. J Oral Maxillofac Surg, 2009,67(6):1218-1225. DOI: 10.1016/j.joms.2008.11.022.
[9] 张亮, 韩泽奎, 臧旖欣, 等. 仿生蛛网孔隙结构3D打印个性化钛网设计及三维有限元分析[J]. 中国组织工程研究,2023,27(30):4796-4801.
[10] 韩泽奎, 张亮, 谢菲, 等. SLM 3D打印钛网表面聚氨酯涂层的涂覆及表面性能的研究[J]. 中国口腔种植学杂志, 2022,27(1):16-21. DOI: 10.12337/zgkqzzxzz.2022.02.004.
[11] Al-Nawas B, Kämmerer PW, Morbach T, et al.Ten-year retrospective follow-up study of the TiOblast dental implant[J]. Clin Implant Dent Relat Res, 2012,14(1):127-134. DOI: 10.1111/j.1708-8208.2009.00237.x.
[12] Simion M, Dahlin C, Rocchietta I, et al.Vertical ridge augmentation with guided bone regeneration in association with dental implants: an experimental study in dogs[J]. Clin Oral Implants Res, 2007,18(1):86-94. DOI: 10.1111/j.1600-0501.2006.01291.x.
[13] Aghaloo TL, Moy PK.Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement?[J]. Int J Oral Maxillofac Implants, 2007,22(Suppl):S49-S70.DOI:10.1016/j.ijom.2006.09.010.
[14] Trento GS, Carvalho P, Macedo DV, et al.Titanium mesh associated with rhBMP-2 in alveolar ridge reconstruction[J]. Int J Oral Maxillofac Surg, 2019,48(4):546-553. DOI: 10.1016/j.ijom.2018.09.015.
[15] Sagheb K, Schiegnitz E, Moergel M, et al.Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh[J]. Int J Implant Dent, 2017,3(1):36. DOI: 10.1186/s40729-017-0097-z.
[16] 季平. 3D打印个性化钛网用于复杂骨缺损增量治疗的研究进展[J]. 中国口腔种植学杂志, 2022,27(6):334-339.DOI: 10.12337/zgkqzzxzz.2022.12.002.
[17] 王婷婷, 王凤, 吴轶群. 3D打印数字化个性化钛网在牙槽嵴引导骨再生中的临床应用[J]. 中国口腔种植学杂志, 2022,27(4):208-216.DOI: 10.12337/zgkqzzxzz.2022.08.003.
[18] Her S, Kang T, Fien MJ.Titanium mesh as an alternative to a membrane for ridge augmentation[J]. J Oral Maxillofac Surg, 2012,70(4):803-810. DOI: 10.1016/j.joms.2011.11.017.
[19] Rasia-dal Polo M, Poli PP, Rancitelli D, et al. Alveolar ridge reconstruction with titanium meshes: a systematic review of the literature[J]. Med Oral Patol Oral Cir Bucal, 2014,19(6):e639-e646. DOI: 10.4317/medoral.19998.
[20] Miyamoto I, Funaki K, Yamauchi K, et al.Alveolar ridge reconstruction with titanium mesh and autogenous particulate bone graft: computed tomography-based evaluations of augmented bone quality and quantity[J]. Clin Implant Dent Relat Res, 2012,14(2):304-311. DOI: 10.1111/j.1708-8208.2009.00257.x.
[21] Xie Y, Li S, Zhang T, et al.Titanium mesh for bone augmentation in oral implantology: current application and progress[J]. Int J Oral Sci, 2020,12(1):37. DOI: 10.1038/s41368-020-00107-z.