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

摘要： 不利型骨缺损常伴骨壁缺失及再生空间维持困难，对骨增量的稳定性和可预测性提出了较高要求。3D打印个性化钛网可依据骨缺损的解剖形态进行数字化设计，具有良好的空间维持能力、解剖适配性和定位精度，已成为不利型骨缺损骨增量的重要辅助装置。文章结合相关研究及临床实践经验，论述3D打印钛网的适应证，孔形、孔径、孔隙率、厚度、边缘形态等设计参数，修复导向的补偿性过增量设计，以及材料选择与增材制造工艺；重点阐述术中精准就位与稳定固位、自体骨联合骨替代材料的混合植骨、假骨膜的识别与处理、无张力创口关闭、钛网暴露的分级干预及软组织时序性管理等关键策略。现有证据表明，3D打印钛网的临床效果不仅取决于个性化数字设计，还依赖于骨移植材料的稳定、良好的软组织血供、无张力关闭及并发症发生后的及时分级处理。未来，人工智能辅助设计、动态导航与手术机器人、生物活性表面改性及可降解屏障材料的发展，有望进一步提高钛网辅助不利型骨缺损骨增量的标准化程度、安全性和可预测性。

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