Tooth-Supported 3D-Printed Surgical Guide for Titanium Mesh Placement in Bone Augmentation of the Esthetic Zone.

Abstract

<h4>Objective</h4>To describe a tooth-supported, 3D-printed surgical guide designed to enable accurate intraoperative placement of titanium mesh for bone augmentation in the esthetic zone, in accordance with the preoperative design.<h4>Clinical consideration</h4>Titanium mesh supported guided bone regeneration (GBR) is a widely accepted technique for bone augmentation due to its strong spatial support and predictable osteogenesis. However, intraoperative deviations in titanium mesh placement may affect the final outcome of bone augmentation. This case series presents a tooth-supported titanium mesh positioning guide, fabricated through personalized 3D printing, which allows in situ fixation of the mesh during the augmentation procedure.<h4>Conclusion</h4>The guide enabled precise intraoperative positioning of the titanium mesh in accordance with the preoperative design. The maximum intraoperative titanium mesh displacement was 1.59 mm, with an average deviation of 0.42 mm. The average overall bone augmentation volume deviation was 0.057 ± 0.031 cm³(SD), 95% CI: (0.025 cm³, 0.089cm³), corresponding to a bone augmentation accuracy of 91.67%.<h4>Clinical significance</h4>This tooth-supported positioning guide accurately transfers the preoperative design to titanium mesh-supported guided bone regeneration surgery, thereby improving the accuracy of titanium mesh placement. It facilitates a standardized and controlled workflow for bone augmentation, enhancing the predictability of outcomes in the esthetic zone.