Guided bone regeneration using titanium mesh and xenogeneic graft alone: Histologic findings and 7-year follow-up.

Abstract

Background: Guided bone regeneration is a reliable technique for treating alveolar ridge deficiencies, especially in cases of severe maxillary atrophy. This case report describes the clinical management of a partially edentulous female patient presenting horizontal bone resorption in the anterior maxilla.

Methods: Horizontal ridge augmentation was performed using a titanium mesh in combination with a xenogeneic particulate bovine bone graft and a resorbable collagen membrane, without the use of autogenous bone. After 10 months of healing, the titanium mesh was removed, and a bone sample was collected using a trephine drill for histological analysis, which confirmed new cortical bone formation with osteocytes in close contact with graft particles. Two implants were then placed, followed by soft tissue conditioning with provisional restorations and final prosthetic rehabilitation.

Results: Histological analysis confirmed new cortical bone formation with osteocytes in close contact with graft particles. At the 7-year follow-up, clinical and radiographic assessments demonstrated stable bone volume and successful implant osseointegration.

Conclusion: Within the limitations of this case report, the findings suggest that a xenogeneic particulate bone substitute used without autogenous bone, in combination with a titanium mesh and a resorbable collagen membrane, may represent a viable approach for reconstruction of severely atrophic ridges, enabling long-term esthetic and functional outcomes.

Key points: Reconstruction of a severely atrophic anterior maxillary ridge was performed using guided bone regeneration with a titanium mesh, a xenogeneic particulate bovine bone graft, and a resorbable collagen membrane, without autogenous bone harvesting. Histological analysis demonstrated new cortical bone formation in close contact with residual graft particles at the time of implant placement. Clinical and radiographic follow-up over 7 years demonstrated maintenance of peri-implant bone levels and stable esthetic and functional outcomes.

Plain language summary: Severe bone loss in the upper front jaw can make dental implant treatment challenging, particularly when both function and appearance are important. Traditional bone grafting procedures often require harvesting the patient's own bone, which may increase treatment complexity and postoperative discomfort. This case report describes the reconstruction of a severely atrophic anterior maxillary ridge using guided bone regeneration with a titanium mesh, a bovine-derived bone substitute, and a resorbable collagen membrane, without autogenous bone harvesting. After healing, two dental implants were placed to support a fixed prosthetic restoration. Histological analysis showed new bone formation around the graft particles. Clinical and radiographic evaluations over a 7-year follow-up demonstrated stable bone volume, healthy peri-implant tissues, and long-term functional and esthetic success. Although this report describes a single patient, the findings suggest that this approach may be a less invasive alternative for selected cases requiring reconstruction of severe horizontal bone defects before implant placement.