PEEK or titanium mesh for the ridge? They tie once you control the graft

Patient-specific PEEK meshes are being marketed as a step up from prebent titanium for guided bone regeneration (GBR). Does the data support it? This randomized clinical trial enrolled 14 patients (28 maxillary sites) with predominantly horizontal ridge deficiencies, assigning prebent titanium mesh (n=7) or customized milled PEEK mesh (n=7), each with an autogenous bone plus xenograft mixture. Outcomes were measured by CBCT preoperatively, immediately after surgery, and at 6 months, with horizontal bone gain as the primary endpoint.

There was no statistically significant difference in horizontal bone gain (titanium 3.02 ± 0.68 mm vs PEEK 2.42 ± 0.38 mm; p=0.065) or vertical gain (1.12 vs 1.09 mm; p=0.738). The PEEK group showed a significantly higher gained bone volume (499.47 vs 370.82 mm³; p=0.004) but also greater graft loss volume (174.83 vs 127.73 mm³; p=0.040). Crucially, the PEEK group received a graft richer in autogenous bone (70:30 autograft:xenograft) than the titanium group (60:40), so the authors frame the result as a comparison of two protocols, not of two mesh materials in isolation. Complications, including mesh exposure, were minimal and managed in both arms.

The honest read: for horizontal augmentation, the custom PEEK mesh did not outperform prebent titanium on the dimensional endpoints that matter, and the volumetric differences track the graft composition rather than the mesh. With only 14 patients this is a pilot; it tempers, rather than confirms, the marketing case for PEEK.