A novel polycaprolactone mesh for buccal bone augmentation with simultaneous implant placement: A feasibility report of three cases.

Abstract

Background: Polycaprolactone (PCL) is a synthetic, biocompatible, and biodegradable thermoplastic polyester. Three-dimensionally (3D) printed PCL meshes have demonstrated the ability to conform to the defect morphology, providing stable space maintenance and promoting angiogenesis during hard tissue healing. While PCL has shown promise across various medical applications, clinical studies evaluating its effectiveness for hard tissue augmentation in implant dentistry remain limited.

Methods: This case study included three patients with four implants placed simultaneously with lateral bone augmentation using thermally shaped and trimmed PCL mesh and autogenous bone graft. Cone-beam computed tomography scans were obtained preoperatively, immediately post-augmentation, and at 1-year follow-up. Voxel-based registration was used to standardize measurements, evaluating bone width changes at the implant shoulder level, and 1, 3, 5, and 7 mm apical to the implant shoulder.

Results: At 1 year, all implants remained clinically stable with no adverse events or significant crestal bone loss. Bone width increased at all measured levels post-augmentation. Mean bone gain reached 2.13 mm (1.74-2.70 mm) at 1 mm apical and 1.59 mm (0.78-2.33 mm) at 3 mm apical to the implant shoulder. Final buccal bone thickness exceeded 2 mm in 62.5% of sites (5 out of 8) at the implant shoulder level and 1 mm apical to the implant shoulder.

Conclusions: PCL mesh demonstrated clinical feasibility for simultaneous bone augmentation during implant placement. However, further clinical trials with extended follow-up periods are needed to validate these findings and fully explore the potential of PCL mesh in implant dentistry.

Key points: Polycaprolactone (PCL) mesh provides a stable, resorbable scaffold for buccal bone augmentation during simultaneous implant placement, offering a minimally invasive alternative to autogenous bone block harvesting. Consistent horizontal bone gain was achieved, particularly near the implant shoulder, with 62.5% of sites exhibiting buccal bone thickness greater than 2 mm at or near the implant shoulder, supporting its clinical effectiveness.

Plain language summary: This case study looked at three patients who had areas in their jaws where the bone was too thin or missing to support dental implants. To rebuild the bone, doctors used a special medical material called polycaprolactone (PCL) mesh, a flexible, moldable plastic that can be shaped to fit the bone defect. This mesh was combined with bone graft material to help stimulate new bone growth. Each patient received 3D scans before surgery, right after the procedure, and again 1 year later to monitor progress. In all three cases, the jawbone successfully grew back within 4 months, providing enough support for stable dental implants. The results suggest that PCL mesh can create a healthy space for new bones to grow while keeping the area stable during healing. It also helped reduce surgery time and avoided some of the complications that come with traditional bone graft methods.