{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:32:31Z","timestamp":1787643151391,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Delta University for Science and Technology"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Computer-guided surgery has played a crucial role in planning alveolar ridge augmentation. In the last decade, various software programs have been used in computer-guided fabricated nonresorbable membranes, including zirconia membranes, for guided bone regeneration. However, most of these software programs are not free of charge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study aimed to evaluate clinically and radiographically the accuracy of an open-source digital workflow for designing custom-made zirconia membranes for maxillary guided bone regeneration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Twelve custom-made zirconia membranes were designed for 12 patients with maxillary alveolar defects via the integration of two free open-source software programs (Blue Sky Plan<jats:sup>\u00ae<\/jats:sup> and Autodesk Meshmixer<jats:sup>\u00ae<\/jats:sup>) via a preoperative cone beam computed tomography scan. All patients underwent maxillary alveolar bone augmentation via the designed membranes and particulate mixtures of 1:1 autogenous and xenogenic bone grafts. The membranes were evaluated intraoperatively and radiographically via an immediate postoperative cone beam computed tomography scan, and the collected data were statistically analysed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>All the membranes had accurate intraoperative fits, and there were no significant differences between the virtual and milled (actual) membranes in either the volumetric analysis or the linear horizontal and vertical measurements; the P values were (0.628, 0.226 and 0.239), respectively. The designing time was significantly reduced from 4\u00a0h for the first case to 22\u00a0min for the final case, while the (mean\u2009\u00b1\u2009standard deviation) milling time was 28\u00a0min\u2009\u00b1\u200911\u00a0min, and the (mean\u2009\u00b1\u2009standard deviation) time of the whole digital workflow including membrane sterilization was 5\u00a0h and 20\u00a0min\u2009\u00b1\u20091\u00a0h and 15\u00a0min.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Zirconia membranes can be designed with free open-source software with outstanding clinical fit and promising radiographic results. Further research should be performed with larger sample sizes and other rigid Guided Bone Regeneration membrane materials.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration number<\/jats:title>\n            <jats:p>NCT06227455.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial first posted date<\/jats:title>\n            <jats:p>26\/1\/2024 (Retrospectively registered).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12903-025-06592-0","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T15:44:17Z","timestamp":1752853457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early postoperative evaluation of an open-source digital workflow for designing custom-made zirconia membranes in maxillary guided bone regeneration"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0052-4044","authenticated-orcid":false,"given":"Muhammad Ibrahim","family":"Sakr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0839-9939","authenticated-orcid":false,"given":"Ahmed Sobhy","family":"Salem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3420-459X","authenticated-orcid":false,"given":"Ayman Ahmed","family":"Yaseen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7897-5535","authenticated-orcid":false,"given":"Mohamed Abdel-Monem","family":"Tawfik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5540-2443","authenticated-orcid":false,"given":"Noha Ahmed","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"issue":"6","key":"6592_CR1","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1111\/j.1600-0501.2010.01922.x","volume":"21","author":"M Retzepi","year":"2010","unstructured":"Retzepi M, Donos N. Guided bone regeneration: biological principle and therapeutic applications. Clin Oral Implants Res. 2010;21(6):567\u201376.","journal-title":"Clin Oral Implants Res"},{"issue":"1","key":"6592_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jpor.2012.12.001","volume":"57","author":"YD Rakhmatia","year":"2013","unstructured":"Rakhmatia YD, Ayukawa Y, Furuhashi A, Koyano K. Current barrier membranes: titanium mesh and other membranes for guided bone regeneration in dental applications. J Prosthodont Res. 2013;57(1):3\u201314.","journal-title":"J Prosthodont Res"},{"key":"6592_CR3","doi-asserted-by":"publisher","first-page":"9065423","DOI":"10.1155\/2019\/9065423","volume":"2019","author":"F Briguglio","year":"2019","unstructured":"Briguglio F, Falcomat\u00e0 D, Marconcini S, Fiorillo L, Briguglio R. Farronato. The use of titanium mesh in guided bone regeneration: a systematic review. Int J Dent. 2019;2019:9065423.","journal-title":"Int J Dent"},{"issue":"1","key":"6592_CR4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1034\/j.1600-0501.1999.100104.x","volume":"10","author":"T von Arx","year":"1999","unstructured":"von Arx T, Kurt B. Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants. Clin Oral Implants Res. 1999;10(1):24\u201333.","journal-title":"Clin Oral Implants Res"},{"issue":"2","key":"6592_CR5","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.joms.2007.08.022","volume":"66","author":"PJ Louis","year":"2008","unstructured":"Louis PJ, Gutta R, Said-Al-Naief N, Bartolucci AA. Reconstruction of the maxilla and mandible with particulate bone graft and titanium mesh for implant placement. J Oral Maxillofac Surg. 2008;66(2):235\u201345.","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"6592_CR6","doi-asserted-by":"publisher","first-page":"179","DOI":"10.5624\/isd.2019.49.3.179","volume":"49","author":"S Jain","year":"2019","unstructured":"Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: combining digital technologies. Imaging Sci Dent. 2019;49(3):179\u201390.","journal-title":"Imaging Sci Dent"},{"issue":"1","key":"6592_CR7","first-page":"8","volume":"24","author":"M Sheikhi","year":"2021","unstructured":"Sheikhi M, Karami M, Abbasi S, Moaddabi A, Soltani P. Applicability of cone beam computed tomography Gray values for Estimation of primary stability of dental implants. Braz Dent Sci. 2021;24(1):8. P- P.","journal-title":"Braz Dent Sci"},{"issue":"1","key":"6592_CR8","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s40902-022-00364-4","volume":"44","author":"M-J Kim","year":"2022","unstructured":"Kim M-J, Jeong JY, Ryu J, Jung S, Park H-J, Oh H-K, et al. Accuracy of digital surgical guides for dental implants. Maxillofac Plast Reconstr Surg. 2022;44(1):35.","journal-title":"Maxillofac Plast Reconstr Surg"},{"issue":"1","key":"6592_CR9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40729-024-00539-w","volume":"10","author":"X Bai","year":"2024","unstructured":"Bai X, Wu T, Zhu Y, Yang C, Cheng T, Liu Y, et al. Cone-wedge anchored surgical templates for stackable metal guide: a novel technique. Int J Implant Dent. 2024;10(1):27.","journal-title":"Int J Implant Dent"},{"issue":"10","key":"6592_CR10","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1016\/j.ijom.2016.06.005","volume":"45","author":"J Malmstr\u00f6m","year":"2016","unstructured":"Malmstr\u00f6m J, Anderud J, Abrahamsson P, W\u00e4livaara D\u00c5, Isaksson SG, Adolfsson E. Guided bone regeneration using individualized ceramic sheets. Int J Oral Maxillofac Surg. 2016;45(10):1246\u201352.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"1","key":"6592_CR11","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/prd.12180","volume":"73","author":"N Cionca","year":"2017","unstructured":"Cionca N, Hashim D, Mombelli A. Zirconia dental implants: where are we now, and where are we heading? Periodontol 2000. 2017;73(1):241\u201358.","journal-title":"Periodontol 2000"},{"issue":"1","key":"6592_CR12","first-page":"59","volume":"14","author":"LN Melek","year":"2022","unstructured":"Melek LN. Comparison of two pre-prosthetic surgical techniques for augmentation of mandibular vertical ridge defects. JJoO. 2022;14(1):59\u201363.","journal-title":"JJoO"},{"key":"6592_CR13","doi-asserted-by":"publisher","first-page":"103780","DOI":"10.1016\/j.jdent.2021.103780","volume":"114","author":"F Mandelli","year":"2021","unstructured":"Mandelli F, Traini T, Ghensi P. Customized-3D zirconia barriers for guided bone regeneration (GBR): clinical and histological findings from a proof-of-concept case series. J Dent. 2021;114:103780.","journal-title":"J Dent"},{"issue":"1","key":"6592_CR14","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/cid.12966","volume":"23","author":"L Li","year":"2021","unstructured":"Li L, Wang C, Li X, Fu G, Chen D, Huang Y. Research on the dimensional accuracy of customized bone augmentation combined with 3D-printing individualized titanium mesh: A retrospective case series study. Clin Implant Dent Relat Res. 2021;23(1):5\u201318.","journal-title":"Clin Implant Dent Relat Res"},{"issue":"5","key":"6592_CR15","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1111\/cid.12748","volume":"21","author":"M Mounir","year":"2019","unstructured":"Mounir M, Shalash M, Mounir S, Nassar Y, El Khatib O. Assessment of three dimensional bone augmentation of severely atrophied maxillary alveolar ridges using prebent titanium mesh vs customized poly-ether\u2010ether\u2010ketone (PEEK) mesh: A randomized clinical trial. Clin Implant Dent Relat Res. 2019;21(5):960\u20137.","journal-title":"Clin Implant Dent Relat Res"},{"issue":"19","key":"6592_CR16","doi-asserted-by":"publisher","first-page":"9947","DOI":"10.3390\/app12199947","volume":"12","author":"P Felice","year":"2022","unstructured":"Felice P, Lizio G, Barausse C, Roccoli L, Bonifazi L, Pistilli R, et al. Reverse guided bone regeneration (R-GBR) digital workflow for atrophic jaws rehabilitation. Appl Sci. 2022;12(19):9947.","journal-title":"Appl Sci"},{"key":"6592_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40729-020-00269-9","volume":"6","author":"CE Hofferber","year":"2020","unstructured":"Hofferber CE, Beck JC, Liacouras PC, Wessel JR, Getka TP. Volumetric changes in edentulous alveolar ridge sites utilizing guided bone regeneration and a custom titanium ridge augmentation matrix (CTRAM): a case series study. Int J Implant Dent. 2020;6:1\u20139.","journal-title":"Int J Implant Dent"},{"issue":"1","key":"6592_CR18","doi-asserted-by":"publisher","first-page":"27","DOI":"10.4103\/2231-0754.176247","volume":"8","author":"N Pandit","year":"2016","unstructured":"Pandit N, Pandit IK. Autogenous bone grafts in periodontal practice: A literature review. J Int Clin Dent Res Org. 2016;8(1):27\u201333.","journal-title":"J Int Clin Dent Res Org"},{"issue":"5","key":"6592_CR19","doi-asserted-by":"publisher","first-page":"361","DOI":"10.5125\/jkaoms.2020.46.5.361","volume":"46","author":"Y-K Kim","year":"2020","unstructured":"Kim Y-K, Ku J-K. Guided bone regeneration. J Korean Assoc Oral Maxillofac Surg. 2020;46(5):361\u20136.","journal-title":"J Korean Assoc Oral Maxillofac Surg"},{"key":"6592_CR20","unstructured":"Kim Y-K, Kim S-G, Lim S-C. The comparative study of guided bone regeneration using various of bone graft materials. J Korean Assoc Oral Maxillofac Surg. 2007:350\u20138."},{"issue":"3","key":"6592_CR21","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1111\/clr.12143","volume":"25","author":"A Mordenfeld","year":"2014","unstructured":"Mordenfeld A, Johansson CB, Albrektsson T, Hallman M. A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation. Clin Oral Implants Res. 2014;25(3):310\u201320.","journal-title":"Clin Oral Implants Res"},{"issue":"2","key":"6592_CR22","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/cid.12890","volume":"22","author":"OA El Morsy","year":"2020","unstructured":"El Morsy OA, Barakat A, Mekhemer S, Mounir M. Assessment of 3-dimensional bone augmentation of severely atrophied maxillary alveolar ridges using patient\u2010specific Poly ether\u2010ether ketone (PEEK) sheets. Clin Implant Dent Relat Res. 2020;22(2):148\u201355.","journal-title":"Clin Implant Dent Relat Res"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-06592-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-025-06592-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-025-06592-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T14:19:40Z","timestamp":1757254780000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-025-06592-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6592"],"URL":"https:\/\/doi.org\/10.1186\/s12903-025-06592-0","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"assertion":[{"value":"14 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Research Ethics Committee, Faculty of Dentistry, Mansoura University (approval number No. A02030123). All procedures performed in this study were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments. Before enrolment, all patients were asked to sign an informed written consent form to document that they understood the aims of the study (including procedures, follow-up evaluations, and any potential risks involved). Patients were allowed to ask questions about this study and were thoroughly informed of alternative treatments. Patients signed informed consent regarding publishing their data and photographs.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors state that the study adheres to CONSORT guidelines for reporting clinical trials.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Adherence to CONSORT guidelines"}},{"value":"Blue Sky Plan:.Autodesk Meshmixer:.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"URLs for downloading the software programs of the study"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1200"}}