Retrospective evaluation of the use of patient-specific digitally designed titanium mesh in guided bone regeneration

Objective: This study aimed to assess the clinical and radiographic outcomes of GBR using digitally designed patient-specific titanium meshes for vertical, horizontal, and combined alveolar ridge defects. Materials and Methods: This study included 33 patients (24 female, 9 male) with alveolar bone defects, classified as 19 Class 3 and 14 Class 4 defects. All underwent GBR using CAD/CAM-fabricated custom titanium meshes. Grafting involved a combination of inorganic bovine-derived bone mineral (IBDBM) and demineralized freeze-dried bone allograft (DFDBA). Postoperative CBCT was used to assess planned vs. achieved bone volumes, vertical bone gain, and mesh adaptation accuracy. Results: The mean planned bone volume was 889.73 mm³, and the mean achieved volume was 680.88 mm³, with an overall success rate of 78%. Average vertical bone gain was 2.47 mm, and mesh adaptation was 84.64%. Mesh exposure occurred in 21.2% of cases (7/33). Success rates were not significantly affected by defect location, jaw, or number of missing teeth. However, cases with complications, especially mesh exposure, showed significantly lower success (62% vs. 83%, p < 0.001) and reduced vertical gain (1.91 mm vs. 2.62 mm, p = 0.030). Conclusion: GBR using digitally designed patient-specific titanium meshes is a reliable and effective approach for vertical and horizontal ridge augmentation, demonstrating high clinical and radiographic success. Despite a low complication rate, mesh exposure notably reduced bone gain and overall success. Thus, meticulous surgical planning and soft tissue management are essential to optimize outcomes and minimize complications.