Effect of Exposure Rates With Customized Versus Conventional Titanium Mesh on Guided Bone Regeneration: Systematic Review and Meta-Analysis

Titanium mesh exposure is the main complication of bone regeneration. In this study, a meta-analysis was performed to clarify the effect of customized titanium mesh versus conventional titanium mesh complications and the time of mesh exposure on edentulous alveolar ridge guided bone regeneration (GBR). Databases, including PubMed, EMBASE, Web of Science, and Cochrane Central Register Controlled Trials, were searched by 2 independent reviewers to retrieve articles published from January 2010 to March 2020, regarding the incidence of complications after GBR surgery, with language limited to English articles. A total of 705 articles were found, and 9 articles were quantitatively analyzed. A funnel plot was made for 10 comprehensive data sets. The combined value of the total exposure rate of titanium mesh was 0.44 (44%, 95% CI = 0.30∼0.58). The results of subgroup analysis showed that the combined value of the customized titanium mesh exposure rate was 0.31 (31%, 95% CI = 0.15∼0.51), and the combined value of the conventional titanium mesh exposure rate was 0.51 (51%, 95% CI = 0.33∼0.69). Based on the findings of the present study, the exposure rate of customized titanium mesh is lower than that of conventional titanium mesh. The design of three-dimensional printing customized titanium mesh avoids nerves and blood vessels, which is of great significance to improve the accurate reconstruction of GBR and provides enough space for implantation and reducing the exposure rate. Soft tissue management (ie, technical sensitivity) is also an important factor to avoid soft tissue fractures.