Clinical Management of Titanium Mesh Exposure Following Guided Bone Regeneration (GBR): A Case Report

Tooth loss resulting from infections, trauma or disease may lead to a progressive reduction in both the quantity and quality of the alveolar bone. In this context, Guided Bone Regeneration (GBR) has become a highly effective technique for restoring bone volume in atrophic areas, enabling more predictable and stable long-term implant-based rehabilitation. Recently, classifications such as the one proposed by Vroom have provided useful tools for the clinical management of membrane exposures, establishing treatment protocols according to severity from passive observation to surgical intervention. Clinical Case: A 44-year-old female patient, systemically healthy, presented with mobility in tooth #11, increased probing depth and a surrounding periapical radiolucent lesion. Based on these findings, tooth extraction was indicated, aiming for future dental implant rehabilitation. After extraction and over the following months, alveolar ridge collapse was evident and a Class III edentulous ridge was diagnosed according to the Seibert classification. Due to the observed collapse, Guided Bone Regeneration (GBR) was performed in the area of tooth #11 using a titanium mesh as a containment device. Following the surgical procedure, membrane exposure occurred; however, after six months, radiographic evaluation showed adequate bone fill and satisfactory volume gain. Notably, the titanium mesh showed no clinical signs of infection throughout the follow-up period. Conclusion: Guided Bone Regeneration (GBR) remains a fundamental therapeutic strategy for rehabilitating patients with severe bone defects, enabling predictable and successful dental implant placement. Premature or late exposure of titanium mesh constitutes a significant clinical complication that may jeopardize treatment outcomes. Nevertheless, proper soft tissue management can significantly reduce the incidence of such exposures. Additionally, the use of topical antiseptics such as chlorhexidine has proven effective in prolonging the viability of exposed mesh by reducing bacterial load and promoting bone regeneration. This article describes the clinical management and six-month follow-up of a titanium mesh exposure, highlighting the strategies that preserved regenerative outcomes.