GBR with Ultra-Thin Titanium Mesh and Coral-Derived Hydroxyapatite.

Objective: The purpose of this pilot study is to test the regenerative potential of new ultra-thin (<0,2mm) titanium membranes used in combination with a coral-derived hydroxyapatite grafting material (T-barrier, B&B Dental Implant Company S.r.l., Bologna, Italy); we also would like to validate a surgical protocol suitable for this technique that allows us to undertake a prospective study, excluding the initial learning curve. Method: 10 suitable patients were selected (intrabony defects >3mm, insufficient bone height/thickness for >4x6mm implants). After full-mouth disinfection, it was raised a full-thickness flap, the bone surface has been regularised, inserted the graft material of coral-derived hydroxyapatite and placed the ultra-thin titanium membrane fixed at the implant using a surgical screw and finally the flap sutured with non-absorbable 4.0 silk sutures. Patients were left healing for 4 months before prosthetic phase. 12 implants have been inserted. Periapical radiographs were taken immediately after implant placement, at the prosthetic phase, and at 1-year follow-up. Result: In 10 cases carried out, followed for at least 12 months clinically and radiographically, there were no rejection of titanium mesh and no implant failures. Average supracrestal new bone formation amounted to 1.52±1.04 mm. In only one case, the flap showed a dehiscence, probably due to a poor oral hygiene of the patient, with titanium mesh exposure (90% overall success). Conclusion: From this preliminary pilot study the ultra-thin titanium mesh used in combination with a coral-derived hydroxyapatite grafting material seems to be reliable and easy to use.