FORAMEN dental magazine 1. Surgery english version | Page 8

Dr. Rui Coelho

Use of titanium meshes in

maxillary bone regeneration

T

he bone has the intrinsic capacity of regeneration as part of the repair process in response to injury or continuous remodeling during our lifetime.
Regeneration of bone is composed of a sequence of biological processes that
induce and lead to formation of bone, known as inflammation.

This process involves many cell types
and molecular intracellular and extracellular signaling pathways with a temporal
and spatial sequence that leads to tissue
repair. Unlike other tissues, the majority
of bone lesions heal without scarring, resulting in bone formation with the same
capabilities of the original and being indistinguishable from it.
In the last few years there has been a
tremendous advancement in techniques
and materials that lead bone cells from
adjacent tissues to regenerate areas, that
for various reasons, bone ceased to exist
where once was present.
Regeneration Techniques
The principles of guided bone regeneration are divided into use of autogenous
grafts , where the repair merely recrea-

tes anastomoses between the vascular
network of the graft and the donor site
, and guided bone regeneration where
granules from multiple sources create
scaffolds where the new vascular network, collagen and osteoblasts proliferates and undergoes calcification turning
into mature bone .
Because bone cell turnover is considerably lower than connective tissue, the use
of membranes is an important premise,
so that the scaffold is not occupied by
connective tissue cells.
To further adapt the regeneration materials they are presented in granular forms, which sometimes lead to low graft
stability, impairing the replacement of
tissues above the graft caused by movement.
Thus, the use of membranes reinforced

with titanium and titanium mesh began
to be commonly used in order to maintain the shape of the areas to regenerate.
Indications of titanium mesh
The titanium mesh is indicated to regenerate geometries where you can not
get bone support in the remaining bone
and its neighboring area Fig . 1, 2 , 3, 4
and 5. The crestal vertical growth by the
tent pole technique where support is given by a titanium mesh or osteosyntesis
screws in order to support the stability
of the bone substitute which is placed
beneath this.
FIG. 6 .
The titanium meshes can also be used
to stabilize a bone substitute for the
alveoli with dehiscence , where other
membranes have no rigidity to restore
the original socket shape , or to protect