CONE BEAM COMPUTED TOMOGRAPHIC ANALYSIS OF OUTCOMES IN RIDGE AUGMENTATION USING TITANIUM MESH AND TITANIUM REINFORCED PTFE MEMBRANES
Master of Science in Dentistry
Janina Golob Deeb
Objective: The primary goal of this study is to evaluate and compare the average vertical and horizontal bone gain between titanium reinforced polytetrafluoroethylene (Ti-PTFE) and titanium mesh (Ti-mesh) using superimposition of preoperative and postoperative (CBCT). The secondary goal is to evaluate and compare the surgical outcomes between the two techniques.
Methods: A retrospective chart review was completed to assess the clinical and radiographic outcomes of patients who underwent ridge augmentation therapy using either Ti-PTFE or Ti-mesh. Preoperative and postoperative CBCT scans were superimposed using InVivo 3D imaging software. Vertical component of the augmented site (L1) was assessed along a vertical bisecting line, and width (W1-6) was measured in buccolingual dimension at 3 mm intervals along the vertical line with W1 being the most coronal horizontal measurement. Paired t-tests were used to compare measurements pre- and post-operatively at each location and ANCOVA Models determined if the change in bone level differed based on the grafting method. Comparison in the percent of cases with bone gain at L1 and those deemed successes were compared with chi-squared tests. Intraclass correlation coefficient (ICC) analyzed the interrater agreement of measurements on pre and postoperative CBCT scans.
Results: Forty-three ridge augmentation cases with 61 sites were included: 20 Ti PTFE patients with 28 sites (G, N=28), and 23 Ti-mesh patients with 33 sites (G2, N=33). For G1, the average gain in length (L1) was 0.91 ± 1.9 mm which was statistically significant, while in G2 it was 0.6 ± 2.6 mm and not statistically significant. The average gain in width for G1 was 2.1 ± 2.7 mm and was significant at W1 through W4, while for G2 the average gain in width was 2.49 ± 2.9 mm and was significant at W1 through W6. After adjusting for preoperative bone levels, G1 had significantly greater gains at W1 when compared to G2. More G1 cases demonstrated a gain at L1 than G2 with an average of 1.99 mm versus 2.57 mm. Overall, 60% of the cases showed bone gain in G1 and 69% in G2 with no statistically significant difference. In terms of surgical outcomes, 75% of cases in G1 and 56% in G2 had postoperative complications with no statistically significant difference between both groups. Interrater reliability was excellent with an ICC of 0.9476.
Conclusion: Both ridge augmentation techniques resulted in vertical and horizontal bone gains. No statistically significant difference in terms of bone gain or surgical outcomes between the two techniques. The proposed method can be a useful tool to evaluate accurately the outcomes of ridge augmentation for large alveolar defects using Ti-PTFE or Ti-mesh membranes.
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