Vertical and Horizontal Ridge Augmentation with Titanium-Reinforced Dense PTFE and Reinforced PTFE Mesh: A Prospective Comparative Case Series

Abstract

Objectives: This study aimed to compare vertical bone gain (VBG) and horizontal bone gain (HBG) after guided bone regeneration using titanium-reinforced dense PTFE (TiR-dPTFE) versus reinforced PTFE mesh (RPM) at 9 and 12 months on three-dimensional tomographic imaging, and to perform histological assessment in selected cases. Materials and Methods: This prospective comparative case series included 14 patients (46 vertical ridge defect sites) treated with guided bone regeneration using either Ti-reinforced dPTFE membranes (TiR-dPTFE; n = 23) or resorbable porcine collagen membranes (RPM; n = 23). All sites received a 60:40 mixture of autogenous bone chips and anorganic bovine bone mineral (ABBM). After 9 months, during implant placement, a protective secondary augmentation using a 70:30 ABBM/autogenous mixture was performed and covered with a collagen membrane. Vertical and horizontal bone gain (VBG, HBG) were assessed on standardized matched CBCT cross-sections obtained at 9 and 12 months. Core biopsies were harvested at implant placement (9 months) for histological evaluation. Surgical and healing complications were recorded. Results: Both membranes produced significant VBG. TiR-dPTFE achieved greater VBG than RPM at 9 months (p = 0.045) and 12 months (p = 0.012) and remained stable from 9 to 12 months, whereas RPM showed a significant decline over time (MDa −0.48 mm; 95% CI −0.64 to −0.31; p < 0.001). HBG was similar between groups at both time points (p = 0.918 and p = 0.922). No major clinical complications occurred. Histology at 9 months confirmed vital bone formation and graft integration in both groups. Conclusions: Both TiR-dPTFE and RPM are reliable options for vertical ridge augmentation; TiR-dPTFE yielded superior and more stable vertical gains over 12 months, with comparable horizontal outcomes. Clinical Relevance: TiR-dPTFE may offer enhanced vertical augmentation, while both membranes remain suitable for implant site development.