[Clinical study of titanium mesh in conjunction with concentrate growth factors to rebuild severe bone defect of anterior maxilla].

Purpose: To evaluate the effect of overlaying titanium mesh with concentrate growth factors(CGF) for rebuilding severe buccal bone defect of anterior maxilla when used in association with dental implantation.
Methods: Twenty patients with severe buccal bone defect of maxilla were selected. A total of 25 dental implants were placed, including 5 cases in bilateral central incisor area and 15 cases in unilateral central incisor area. After implantation, the defects were treated with Bio-oss and Bio-guid in conjunction with fixation of titanium mesh and then CGF technology was used. Two-stage surgery was carried out after 6 months of submerged healing, and permanent prosthesis was used 3 months after temporary restoration. The repairs of the defect were observed at the second stage surgery. The height of margin bone around implants and the thickness of bone at implants lingual side were measured, at the time of the second stage operation, and 3, 6, 12, 18 months after permanent restoration. The differences were analyzed by SPSS 19.0 software package with multi-sample nonparametric test and Fierdman test.
Results: At the time of second operation, the bone plate at lingual side was completely reconstructed, and new bone was formed at the top of implants. Clinical measurements showed that the averaged thickness of bone at lingual side was (2.69±0.154) mm at that time. Three, 6, 12, 18 months after restoration, the values were (2.67±0.152) mm, (2.66±0.153) mm, (2.65±0.153) mm, (2.65±0.151) mm, respectively. Implant-abutment junction was used as a base line to assess vertical bone absorption, the marginal bone of implant neck at lingual side was all inferior to the base line, the distance was (0.02±0.048) mm, (0.69±0.085) mm，(0.87±0.019) mm, (0.87±0.013) mm, respectively. Statistical analysis showed the thickness of bone of labial side decreased significantly over time after permanent restoration (P<0.01). Likewise, the height of marginal bone was also decreased significantly (P<0.01). However, the difference between them at 12 months and 18 months was not statistically significant (P>0.05).
Conclusions: The results indicate that bone augmentation at maxilla can be achieved using titanium mesh in conjunction with CGF. The height and thickness of newly formed bone at the implant neck margin will be stabilized after 1 year. This method is worthy of wide clinical application.