Risk factors for dehiscence in alveolar ridge augmentation using patient-specific titanium mesh: a retrospective analysis

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PURPOSE: This retrospective study aimed to evaluate the incidence of dehiscence following bone augmentation with patient-specific titanium meshes and to identify factors associated with its occurrence. MATERIAL AND METHODS: Patients who underwent bone grafting with patient-specific titanium mesh between December 2014 and October 2021 were included. The primary outcome was the occurrence of dehiscence. The occurrence of dehiscences was recorded during the following time phases, enabling the determination of whether dehiscences occur early (< 2 weeks), in the mid-term (2-9 weeks), or later in the healing phase (> 9 weeks). RESULTS: A total of 78 patients undergoing 85 titanium mesh augmentations were included, with a mean follow-up period of 1.2 years. Dehiscence occurred in 33 meshes (38.8%), with 51.5% of these events arising during the early healing phase. In no case was premature removal of the titanium mesh required due to dehiscence. A statistically significant association was observed between dehiscence and both smoking behavior (p < 0.001) and the anatomical location of the maxillary defect (p = 0.029). No significant associations were found between dehiscence and gender (p = 0.160), periodontitis (p = 0.512), gingival phenotype (p = 0.495), defect type (p = 0.490), augmented bone volume (p = 0.373), or incision type (p = 0.354). Logistic regression analysis further identified smoking (odds ratio: 7.07; 95% CI: 2.19-22.80) and maxillary defect alveolar (odds ratio: 11.86; 95% CI: 0.34-4.60) as significant predictors of dehiscence. CONCLUSION: Dehiscence following customized titanium mesh augmentation was significantly associated with smoking and the location of the maxillary defect, underscoring the importance of early detection and timely intervention.

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