关键词: 3D打印钛网, 不利型骨缺损, 骨增量, 引导骨再生, 数字化设计

Abstract: Unfavorable bone defects are frequently complicated by missing bony walls and difficulty in maintaining the regenerative space，posing considerable challenges to the stability and predictability of bone augmentation. Patient-specific 3D-printed titanium meshes can be digitally designed according to the anatomical morphology of bone defects and provide reliable space maintenance，accurate anatomical adaptation，and precise positioning，making them important auxiliary devices for bone augmentation in unfavorable bone defects. This article discusses the indications for 3D-printed titanium meshes，design parameters including mesh geometry，pore size，porosity，thickness，and edge configuration，prosthetically-driven compensatory overaugmentation，material selection and additive manufacturing processes based on related researches and clinical experience in practice. Particular emphasis is placed on accurate intraoperative positioning and stable fixation，mixed grafting with autogenous bone and bone substitutes，identification and management of the pseudoperiosteum，tension-free wound closure，graded management of titanium mesh exposure，and staged soft-tissue management. Current evidence indicates that the clinical outcomes of 3D-printed titanium meshes depend not only on patient-specific digital design but also on graft stability，adequate soft-tissue vascularity，tension-free wound closure，and timely management of complications according to their severity. Future advances in artificial intelligence-assisted design，dynamic navigation and surgical robotics，bioactive surface modification，and biodegradable barrier materials are expected to further improve the standardization，safety，and predictability of titanium mesh-assisted bone augmentation for unfavorable bone defects.

Key words: 3D-printed titanium mesh, unfavorable bone defects, bone augmentation, guided bone regeneration, digital design