Application of an anatomically contoured patient-specific titanium mesh in three-dimensional reconstruction of the mandibular alveolar ridge: a clinical case report

Relevance. Oral rehabilitation of edentulous patients with dental implants is a well-established treatment modality. However, in the absence of adequate bone volume and favorable anatomical conditions, implant placement is not feasible, necessitating reconstructive bone augmentation procedures. Such procedures, although effective, are associated with a risk of iatrogenic complications. Therefore, the use of patient-specific reconstructive techniques based on fundamental anatomical principles and supported by advances in three-dimensional (3D) virtual planning technologies in dental surgery is of particular clinical relevance.

Clinical case description. This report illustrates the use of preoperative virtual planning and the technical aspects of three-dimensional reconstruction of the mandibular alveolar ridge using a patient-specific, anatomically contoured titanium mesh. The patient presented with partial edentulism in the region of teeth 35, 36, and 37 due to trauma, extraction, or localized periodontitis. Treatment comprised three stages: preoperative virtual planning with fabrication of a custom-made titanium mesh, the reconstructive surgical procedure, and removal of the mesh eight months postoperatively. Both the early and late postoperative periods were uneventful, with no signs of inflammation or exposure of the titanium mesh. Follow-up cone-beam computed tomography (CBCT), together with clinical examination and probing, confirmed the formation of a stable, homogeneous augmented bone volume that improved the conditions for subsequent dental implant placement.

Conclusion. Patient-specific titanium meshes for mandibular oral reconstructive surgery should be designed with careful consideration of mandibular anatomy to minimize the risk of iatrogenic injury to neurovascular structures. The technique described in this case is characterized by technical simplicity, high clinical efficacy, anatomical precision, and applicability across a wide range of clinical situations.

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