1
|
Araújo CRG, Araújo RCD, Araújo CG, Carvalho AP, Cota LOM, Martins-Júnior PA, Pelegrine AA. Bone Regeneration in the Anterior Maxilla With Titanium Mesh and Advanced-Platelet-Rich Fibrin: A Case Report With 2-Year Follow-up. J ORAL IMPLANTOL 2024; 50:514-518. [PMID: 39158854 DOI: 10.1563/aaid-joi-d-23-00154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Guided bone regeneration involving the use of titanium mesh and platelet-rich fibrin could be a feasible approach in cases of severely atrophic ridges. The purpose of this case report was to present an esthetic and functional rehabilitation in the anterior maxilla with the installation of dental implants in conjunction with guided bone regeneration using titanium mesh and advanced platelet-rich fibrin (A-PRF). A 60-year-old patient presented bone atrophy and partial edentulism in the anterior maxilla. After clinical and cone beam computed tomography assessment, guided bone regeneration was planned using a titanium mesh and A-PRF with xenograft bone. After 8 months of healing, the dental implants were placed with the aid of a surgical guide to obtain accurate 3-dimensional positioning. Prosthetic rehabilitation was carried out with individualized crowns. After 2 years of follow-up, radiographic analysis demonstrated a good quality and density of the bone tissue adjacent to the dental implants. No radiolucent areas were observed, and there were no clinical signs of failure. In cases of severe atrophy, using a titanium mesh and A-PRF proved to be a feasible alternative for bone reconstruction prior to dental implant placement. This approach can aid dental professionals in achieving an ideal implant positioning for rehabilitation with individualized crowns.
Collapse
Affiliation(s)
- Carlos Roberto Garcia Araújo
- Department of Implant Dentistry, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
- IMPLA, Belo Horizonte, Brazil
| | - Roberto Carlos de Araújo
- IMPLA, Belo Horizonte, Brazil
- Department of Dental Prosthesis, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
| | - Cristiano Garcia Araújo
- IMPLA, Belo Horizonte, Brazil
- Department of Dental Prosthesis, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
| | - Ana Paula Carvalho
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas, Brazil
| | | | - André Antonio Pelegrine
- Department of Implant Dentistry, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, Campinas, Brazil
| |
Collapse
|
2
|
Tommasato G, Piano S, Casentini P, De Stavola L, Chiapasco M. Digital planning and bone regenerative technologies: A narrative review. Clin Oral Implants Res 2024; 35:906-921. [PMID: 38591734 DOI: 10.1111/clr.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES The aim of this narrative review was to explore the application of digital technologies (DT) for the simplification and improvement of bone augmentation procedures in advanced implant dentistry. MATERIAL AND METHODS A search on electronic databases was performed to identify systematic reviews, meta-analyses, randomized and non-randomized controlled trials, prospective/retrospective case series, and case reports related to the application of DT in advanced implant dentistry. RESULTS Seventy-nine articles were included. Potential fields of application of DT are the following: 1) the use of intra-oral scanners for the definition of soft tissue profile and the residual dentition; 2) the use of dental lab CAD (computer-aided design) software to create a digital wax-up replicating the ideal ridge and tooth morphology; 3) the matching of STL (Standard Triangulation Language) files with DICOM (DIgital COmmunication in Medicine) files from CBCTs with a dedicated software; 4) the production of stereolithographic 3D models reproducing the jaws and the bone defects; 5) the creation of surgical templates to guide implant placement and augmentation procedures; 6) the production of customized meshes for bone regeneration; and 7) the use of static or dynamic computer-aided implant placement. CONCLUSIONS Results from this narrative review seem to demonstrate that the use of a partially or fully digital workflow can be successfully used also in advanced implant dentistry. However, the number of studies (in particular RCTs) focused on the use of a fully digital workflow in advanced implant dentistry is still limited and more studies are needed to properly evaluate the potentials of DT.
Collapse
Affiliation(s)
- Grazia Tommasato
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
| | | | | | - Luca De Stavola
- Unit of Periodontology, Dental Clinic, Department of Neurosciences, University of Padova, Padova, Italy
| | - Matteo Chiapasco
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, University of Milano, Milan, Italy
| |
Collapse
|
3
|
Kouhi M, de Souza Araújo IJ, Asa'ad F, Zeenat L, Bojedla SSR, Pati F, Zolfagharian A, Watts DC, Bottino MC, Bodaghi M. Recent advances in additive manufacturing of patient-specific devices for dental and maxillofacial rehabilitation. Dent Mater 2024; 40:700-715. [PMID: 38401992 DOI: 10.1016/j.dental.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Customization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties. METHODS This paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018-2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages. RESULTS The recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported. SIGNIFICANCE Additive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry.
Collapse
Affiliation(s)
- Monireh Kouhi
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Isaac J de Souza Araújo
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, MI, United States
| | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lubna Zeenat
- School of Engineering, Deakin University, Geelong 3216, Australia; Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Sri Sai Ramya Bojedla
- Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Falguni Pati
- Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Ali Zolfagharian
- School of Engineering, Deakin University, Geelong 3216, Australia
| | - David C Watts
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, MI, United States; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Mahdi Bodaghi
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK.
| |
Collapse
|
4
|
Kyser AJ, Fotouh B, Mahmoud MY, Frieboes HB. Rising role of 3D-printing in delivery of therapeutics for infectious disease. J Control Release 2024; 366:349-365. [PMID: 38182058 PMCID: PMC10923108 DOI: 10.1016/j.jconrel.2023.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
Modern drug delivery to tackle infectious disease has drawn close to personalizing medicine for specific patient populations. Challenges include antibiotic-resistant infections, healthcare associated infections, and customizing treatments for local patient populations. Recently, 3D-printing has become a facilitator for the development of personalized pharmaceutic drug delivery systems. With a variety of manufacturing techniques, 3D-printing offers advantages in drug delivery development for controlled, fine-tuned release and platforms for different routes of administration. This review summarizes 3D-printing techniques in pharmaceutics and drug delivery focusing on treating infectious diseases, and discusses the influence of 3D-printing design considerations on drug delivery platforms targeting these diseases. Additionally, applications of 3D-printing in infectious diseases are summarized, with the goal to provide insight into how future delivery innovations may benefit from 3D-printing to address the global challenges in infectious disease.
Collapse
Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Bassam Fotouh
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
| |
Collapse
|
5
|
Boroojeni HSH, Mohaghegh S, Khojasteh A. Application of CAD-CAM Technologies for Maxillofacial Bone Regeneration: A Narrative Review of the Clinical Studies. Curr Stem Cell Res Ther 2024; 19:461-472. [PMID: 36372914 DOI: 10.2174/1574888x18666221111154057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
The application of regenerative methods in treating maxillofacial defects can be categorized as functional bone regeneration in which scaffolds without protection are used and in-situ bone regeneration in which a protected healing space is created to induce bone formation. It has been shown that functional bone regeneration can reduce surgical time and obviate the necessity of autogenous bone grafting. However, studies mainly focused on applying this method to reconstruct minor bone effects, and more investigation concerning the large defects is required. In terms of in situ maxillofacial bone regeneration with the help of CAD-CAM technologies, the present data have suggested feasible mesh rigidity, perseverance of the underlying space, and apt augmentative results with CAD-CAM-based individualized Ti meshes. However, complications, including dehiscence and mesh exposure, coupled with consequent graft loss, infection and impeded regenerative rates have also been reported.
Collapse
Affiliation(s)
- Helia Sadat Haeri Boroojeni
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
6
|
Wang L, Wang F, Ayisen S, Ren T, Luo X, Wang P. Enhancing the mechanical properties and surface morphology of individualized Ti-mesh fabricated through additive manufacturing for the treatment of alveolar bone defects. Front Bioeng Biotechnol 2023; 11:1284359. [PMID: 38026903 PMCID: PMC10657841 DOI: 10.3389/fbioe.2023.1284359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Titanium meshes are widely utilized in alveolar bone augmentation, and this study aims to enhance the properties of titanium meshes through heat treatment (HT) and the synergistic finishing technology of electric field and flow field (EFSF). Our findings illustrate that the titanium mesh exhibits improved mechanical properties following HT treatment. The innovative EFSF technique, in combination with HT, has a substantial impact on improving the surface properties of titanium meshes. HT initiates grain fusion and reduces surface pores, resulting in enhanced tensile and elongation properties. EFSF further enhances these improvements by significantly reducing surface roughness and eliminating adhered titanium powder, a byproduct of selective laser melting printing. Increased hydrophilicity and surface-free energy are achieved after EFSF treatment. Notably, the EFSF-treated titanium mesh exhibits reduced bacterial adhesion and is non-toxic to osteoblast proliferation. These advancements increase its suitability for clinical alveolar bone augmentation.
Collapse
Affiliation(s)
- Lingxu Wang
- School of Stomatology, Xuzhou Medical University, Xuzhou, China
| | - Fangfang Wang
- School of Stomatology, Nanjing University, Nanjing, China
| | - Saimi Ayisen
- School of Stomatology, Nanjing University, Nanjing, China
| | - Tianshui Ren
- School of Stomatology, Xuzhou Medical University, Xuzhou, China
| | - Xiaoping Luo
- School of Stomatology, Nanjing University, Nanjing, China
| | - Penglai Wang
- School of Stomatology, Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
7
|
Sonika S, Esther Nalini H, Renuka Devi R. Quintessential commence of three-dimensional printing in periodontal regeneration-A review. Saudi Dent J 2023; 35:876-882. [PMID: 38025599 PMCID: PMC10658379 DOI: 10.1016/j.sdentj.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 12/01/2023] Open
Abstract
The prime focus of regenerative periodontal therapy is to reconstruct or regenerate the lost periodontium, including both hard and soft tissues. Over the years, periodontics has witnessed different regenerative modalities, such as bone grafts, guided tissue membranes, growth factors, stem cell technology, 3D printing, etc. 3D printing is a newly emerging manufacturing technology that finds applications in diverse fields, including aerospace, defense, art and design, medical and dental field. Originally developed for non-biological applications, 3D printing has undergone modifications to print biocompatible materials and living cells to minimize any potential compromise on cell viability. Thus, the utilisation of 3D printing in the regeneration of lost periodontal tissues represents a novel approach that facilitates optimal cell interactions and promotes the successful regeneration of biological tissues.
Collapse
Affiliation(s)
- S Sonika
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India
| | - H Esther Nalini
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India
| | - R Renuka Devi
- Department of Periodontology, KSR Institute of Dental Science and Research, Tiruchengode, Tamilnadu, India
| |
Collapse
|
8
|
Takahashi A, Inoue K, Imagawa-Fujimura N, Matsumoto K, Yamada K, Sawai Y, Nakajima Y, Mano T, Kato-Kogoe N, Ueno T. Clinical Study of 14 Cases of Bone Augmentation with Selective Laser Melting Titanium Mesh Plates. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6842. [PMID: 37959439 PMCID: PMC10648651 DOI: 10.3390/ma16216842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/22/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
Additive manufacturing techniques are being used in the medical field. Orthopedic hip prostheses and denture bases are designed and fabricated based on the patient's computer-aided design (CAD) data. We attempted to incorporate this technique into dental implant bone augmentation. Surgical simulation was performed using patient data. Fourteen patients underwent bone augmentation using a selective laser melting (SLM) titanium mesh plate. The results showed no evidence of infection in any of the 14 patients. In 12 patients, only one fixation screw was used, and good results were obtained. The SLM titanium mesh plate was good adaptation in all cases, with bone occupancy greater than 90%. The average bone resorption of the marginal alveolar bone from the time of dental implant placement to the time of the superstructure placement was 0.69 ± 0.25 mm. Implant superstructures were placed in all cases, and bone augmentation with SLM titanium mesh plates was considered a useful technique.
Collapse
Affiliation(s)
| | - Kazuya Inoue
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki 569-8686, Osaka, Japan (K.Y.); (Y.S.); (T.M.)
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Ivanovski S, Breik O, Carluccio D, Alayan J, Staples R, Vaquette C. 3D printing for bone regeneration: challenges and opportunities for achieving predictability. Periodontol 2000 2023; 93:358-384. [PMID: 37823472 DOI: 10.1111/prd.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/18/2023] [Accepted: 08/26/2023] [Indexed: 10/13/2023]
Abstract
3D printing offers attractive opportunities for large-volume bone regeneration in the oro-dental and craniofacial regions. This is enabled by the development of CAD-CAM technologies that support the design and manufacturing of anatomically accurate meshes and scaffolds. This review describes the main 3D-printing technologies utilized for the fabrication of these patient-matched devices, and reports on their pre-clinical and clinical performance including the occurrence of complications for vertical bone augmentation and craniofacial applications. Furthermore, the regulatory pathway for approval of these devices is discussed, highlighting the main hurdles and obstacles. Finally, the review elaborates on a variety of strategies for increasing bone regeneration capacity and explores the future of 4D bioprinting and biodegradable metal 3D printing.
Collapse
Affiliation(s)
- Saso Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Omar Breik
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Danilo Carluccio
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jamil Alayan
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Ruben Staples
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Cedryck Vaquette
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| |
Collapse
|
10
|
Huang S, Wei H, Li D. Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress. Front Bioeng Biotechnol 2023; 11:1100155. [PMID: 36741746 PMCID: PMC9895117 DOI: 10.3389/fbioe.2023.1100155] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.
Collapse
Affiliation(s)
| | - Hongbo Wei
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Dehua Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi, China
| |
Collapse
|
11
|
Charbe NB, Tambuwala M, Palakurthi SS, Warokar A, Hromić‐Jahjefendić A, Bakshi H, Zacconi F, Mishra V, Khadse S, Aljabali AA, El‐Tanani M, Serrano‐Aroca Ã, Palakurthi S. Biomedical applications of three-dimensional bioprinted craniofacial tissue engineering. Bioeng Transl Med 2023; 8:e10333. [PMID: 36684092 PMCID: PMC9842068 DOI: 10.1002/btm2.10333] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023] Open
Abstract
Anatomical complications of the craniofacial regions often present considerable challenges to the surgical repair or replacement of the damaged tissues. Surgical repair has its own set of limitations, including scarcity of the donor tissues, immune rejection, use of immune suppressors followed by the surgery, and restriction in restoring the natural aesthetic appeal. Rapid advancement in the field of biomaterials, cell biology, and engineering has helped scientists to create cellularized skeletal muscle-like structures. However, the existing method still has limitations in building large, highly vascular tissue with clinical application. With the advance in the three-dimensional (3D) bioprinting technique, scientists and clinicians now can produce the functional implants of skeletal muscles and bones that are more patient-specific with the perfect match to the architecture of their craniofacial defects. Craniofacial tissue regeneration using 3D bioprinting can manage and eliminate the restrictions of the surgical transplant from the donor site. The concept of creating the new functional tissue, exactly mimicking the anatomical and physiological function of the damaged tissue, looks highly attractive. This is crucial to reduce the donor site morbidity and retain the esthetics. 3D bioprinting can integrate all three essential components of tissue engineering, that is, rehabilitation, reconstruction, and regeneration of the lost craniofacial tissues. Such integration essentially helps to develop the patient-specific treatment plans and damage site-driven creation of the functional implants for the craniofacial defects. This article is the bird's eye view on the latest development and application of 3D bioprinting in the regeneration of the skeletal muscle tissues and their application in restoring the functional abilities of the damaged craniofacial tissue. We also discussed current challenges in craniofacial bone vascularization and gave our view on the future direction, including establishing the interactions between tissue-engineered skeletal muscle and the peripheral nervous system.
Collapse
Affiliation(s)
- Nitin Bharat Charbe
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| | - Murtaza Tambuwala
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | | | - Amol Warokar
- Department of PharmacyDadasaheb Balpande College of PharmacyNagpurIndia
| | - Altijana Hromić‐Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural SciencesInternational University of SarajevoSarajevoBosnia and Herzegovina
| | - Hamid Bakshi
- School of Pharmacy and Pharmaceutical ScienceUlster UniversityColeraineUK
| | - Flavia Zacconi
- Departamento de Quimica Orgánica, Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Vijay Mishra
- School of Pharmaceutical SciencesLovely Professional UniversityPhagwaraIndia
| | - Saurabh Khadse
- Department of Pharmaceutical ChemistryR.C. Patel Institute of Pharmaceutical Education and ResearchDhuleIndia
| | - Alaa A. Aljabali
- Faculty of Pharmacy, Department of Pharmaceutical SciencesYarmouk UniversityIrbidJordan
| | - Mohamed El‐Tanani
- Pharmacological and Diagnostic Research Centre, Faculty of PharmacyAl‐Ahliyya Amman UniversityAmmanJordan
| | - Ãngel Serrano‐Aroca
- Biomaterials and Bioengineering Lab Translational Research Centre San Alberto MagnoCatholic University of Valencia San Vicente MártirValenciaSpain
| | - Srinath Palakurthi
- Irma Lerma Rangel College of PharmacyTexas A&M Health Science CenterKingsvilleTexasUSA
| |
Collapse
|
12
|
Degradable Pure Magnesium Used as a Barrier Film for Oral Bone Regeneration. J Funct Biomater 2022; 13:jfb13040298. [PMID: 36547558 PMCID: PMC9781112 DOI: 10.3390/jfb13040298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
The barrier membrane plays an extremely critical role in guided bone regeneration (GBR), which determines the success or failure of GBR technology. In order to obtain barrier membranes with high mechanical strength and degradability, some researchers have focused on degradable magnesium alloys. However, the degradation rate of pure Mg-based materials in body fluids is rather fast, thus posing an urgent problem to be solved in oral clinics. In this study, a novel micro-arc oxidation (MAO) surface-treated pure Mg membrane was prepared. Electrochemical tests, immersion experiments and in vivo experiments were carried out to investigate its potential use as a barrier membrane. The experimental results showed that the corrosion resistance of a pure Mg membrane treated by MAO is better than that of the uncoated pure Mg. The results of cell experiments showed no obvious cytotoxicity, which suggests the enhanced differentiation of osteoblasts. At the same time, the MAO-Mg membrane showed better biological activity than the pure Ti membrane in the early stage of implantation, exhibiting relatively good bone regeneration ability. Consequently, the MAO membrane has been proven to possess good application prospects for guided bone regeneration.
Collapse
|
13
|
Yang W, Chen D, Wang C, Apicella D, Apicella A, Huang Y, Li L, Zheng L, Ji P, Wang L, Fan Y. The effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium mesh. BMC Oral Health 2022; 22:557. [PMID: 36456929 PMCID: PMC9713982 DOI: 10.1186/s12903-022-02557-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Additively manufactured (3D-printed) titanium meshes have been adopted in the dental field as non-resorbable membranes for guided bone regeneration (GBR) surgery. However, according to previous studies, inaccuracies between planned and created bone volume and contour are common, and many reasons have been speculated to affect its accuracy. The size of the alveolar bone defect can significantly increase patient-specific titanium mesh design and surgical difficulty. Therefore, this study aimed to analyze and investigate the effect of bone defect size on the 3D accuracy of alveolar bone augmentation performed with additively manufactured patient-specific titanium meshes. METHODS Twenty 3D-printed patient-specific titanium mesh GBR surgery cases were enrolled, in which 10 cases were minor bone defect/augmentation (the planned bone augmentation surface area is less than or equal to 150 mm2 or one tooth missing or two adjacent front-teeth/premolars missing) and another 10 cases were significant bone defect/augmentation (the planned bone augmentation surface area is greater than 150 mm2 or missing adjacent teeth are more than two (i.e. ≥ three teeth) or missing adjacent molars are ≥ two teeth). 3D digital reconstruction/superposition technology was employed to investigate the bone augmentation accuracy of 3D-printed patient-specific titanium meshes. RESULTS There was no significant difference in the 3D deviation distance of bone augmentation between the minor bone defect/augmentation group and the major one. The contour lines of planned-CAD models in two groups were basically consistent with the contour lines after GBR surgery, and both covered the preoperative contour lines. Moreover, the exposure rate of titanium mesh in the minor bone defect/augmentation group was slightly lower than the major one. CONCLUSION It can be concluded that the size of the bone defect has no significant effect on the 3D accuracy of alveolar bone augmentation performed with the additively manufactured patient-specific titanium mesh.
Collapse
Affiliation(s)
- Wei Yang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Dan Chen
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Chao Wang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Davide Apicella
- Marrelly Health, calabrodental hospital, 88900 Crotone, Italy
| | - Antonio Apicella
- Advanced Materials Lab, Department of Architecture and Industrial Design, University of Campania, 81031 Aversa, Italy
| | - Yuanding Huang
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Linzhi Li
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Lingling Zheng
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Ping Ji
- grid.459985.cStomatological Hospital of Chongqing Medical University, Chongqing, 401147 China ,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Oral Higher Education Biomedical Engineering, Chongqing, 401147 China ,grid.203458.80000 0000 8653 0555Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147 China
| | - Lizhen Wang
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| | - Yubo Fan
- grid.64939.310000 0000 9999 1211Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, 100083 China
| |
Collapse
|
14
|
Abu-Mostafa NA, Alotaibi YN, Alkahtani RN, Almutairi FK, Alfaifi AA, Alshahrani OD. The Outcomes of Vertical Alveolar Bone Augmentation by Guided Bone Regeneration with Titanium Mesh: A Systematic Review. J Contemp Dent Pract 2022; 23:1280-1288. [PMID: 37125527 DOI: 10.5005/jp-journals-10024-3444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM This study aimed to systematically review the published studies on vertical alveolar bone augmentation (VABA) by guided bone regeneration (GBR) with titanium mesh (TM). BACKGROUND Guided bone regeneration is a procedure that can be used for VABA of the alveolar ridge. Titanium mesh is used as a barrier due to its ability to maintain a space that the newly formed bone will occupy. MATERIALS AND METHODS A computerized literature search was conducted on the databases PubMed, SCOPUS, Science Direct, and Cochrane Library to review the published article on VABA by TM from 2011 to 2021. REVIEW RESULTS Eight out of 574 retrieved articles were included in the qualitative analysis, three randomized clinical trials, two prospective clinical trials, and three retrospective trials. They were assessed for risk of bias using the critical appraisal skills program checklist. Titanium mesh was utilized as a barrier in three different ways, adapted directly on the alveolar bone, bent preoperatively on three-dimensional (3D) models, and 3D-printed. Two randomized clinical trials (RCTs) reported 20.8% bone gain, while the other studies reported the means ranging from 2.56 to 4.78 mm. All studies reported TM exposure that ranged from 7.69 to 66.66%. Exposure during the four postoperative weeks led to inadequate bone regeneration. However, late exposure had no effect or caused only slight bone resorption. Early TM removal was performed in two studies, one case per each, ranging from 2.4 to 11.1%. Infection was presented in three studies, one case per each, and the percentages were 5, 11.1, and 25%. CONCLUSION All types of TM had exposure, which was the most common complication, but early removal was indicated only in a few cases. Titanium mesh showed reliability and efficacy as a barrier for VABA by GBR. CLINICAL SIGNIFICANCE By this procedure, bone height can be restored, however, meticulous follow-up is recommended for the detection and management of TM exposures.
Collapse
Affiliation(s)
- Nedal A Abu-Mostafa
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, Riyadh Elm University, Kingdom of Saudi Arabia, Phone: +00966506275782, e-mail:
| | | | - Rose N Alkahtani
- King Saud bin Abdulaziz University for Health Sciences, Kingdom of Saudi Arabia
| | | | | | | |
Collapse
|
15
|
Duan DH, Wang HL, Xiao WC, Liu Z, Wang EB. Bone regeneration using titanium plate stabilization for the treatment of peri-implant bone defects: A retrospective radiologic pilot study. Clin Implant Dent Relat Res 2022; 24:792-800. [PMID: 36181244 DOI: 10.1111/cid.13139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 12/14/2022]
Abstract
AIM To 3-dimensional radiographically assess the effect of titanium plate in guided bone regeneration (GBR) for the treatment of peri-implant ridge defects in esthetic zone. MATERIAL AND METHODS Nineteen patients with buccal peri-implant defects in the maxillary esthetic zone were treated with GBR using xenograft, autogenous bone, and collagen membrane. Subjects were divided into two groups: control (conventional GBR, 10 patients with 16 implants) and test (GBR with an adjunctive titanium plate; nine patients with 15 implants). Cone-beam computed tomography (CBCT) images obtained immediately after and 5-7 months following GBR were used to assess buccal crestal bone level (BBL) and buccal bone thickness (BBT) at different implant levels. RESULTS Thirty-one implants in 19 patients were evaluated. Titanium plate exposure occurred in three cases (33.33%) of the test group. After 5-7 months, the mean BBL was located 1.48 ± 0.71 mm coronal to the platform in the test group and 0.90 ± 3.03 mm coronal to the platform in the control group (p = 0.03). The mean over all BBT (BBT-M) was 4.16 ± 0.48 mm in the test group and 2.38 ± 0.97 mm in the control group (p < 0.01). More resorption occurred in the control group than in the test group regarding mean BBL (3.00 ± 3.11 mm vs. 0.78 ± 0.79 mm, respectively; p = 0.04), BBT-M change (1.87 ± 1.59 mm vs. 0.56 ± 0.33 mm, respectively; p = 0.02), and percentage change in BBT-M (40.69 ± 24.01% vs. 11.53 ± 5.86%, respectively; p < 0.01). CONCLUSION In the short-term, titanium plate-enhanced GBR maintained ridge dimensions better than conventional GBR did.
Collapse
Affiliation(s)
- Deng-Hui Duan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Wu-Cai Xiao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - En-Bo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, People's Republic of China
| |
Collapse
|
16
|
Sufaru IG, Macovei G, Stoleriu S, Martu MA, Luchian I, Kappenberg-Nitescu DC, Solomon SM. 3D Printed and Bioprinted Membranes and Scaffolds for the Periodontal Tissue Regeneration: A Narrative Review. MEMBRANES 2022; 12:membranes12090902. [PMID: 36135920 PMCID: PMC9505571 DOI: 10.3390/membranes12090902] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 05/31/2023]
Abstract
Numerous technologies and materials were developed with the aim of repairing and reconstructing the tissue loss in patients with periodontitis. Periodontal guided bone regeneration (GBR) and guided tissue regeneration (GTR) involves the use of a membrane which prevents epithelial cell migration, and helps to maintain the space, creating a protected area in which tissue regeneration is favored. Over the time, manufacturing procedures of such barrier membranes followed important improvements. Three-dimensional (3D) printing technology has led to major innovations in periodontal regeneration methods, using technologies such as inkjet printing, light-assisted 3D printing or micro-extrusion. Besides the 3D printing of monophasic and multi-phasic scaffolds, bioprinting and tissue engineering have emerged as innovative technologies which can change the way we see GTR and GBR.
Collapse
Affiliation(s)
- Irina-Georgeta Sufaru
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| | - Georgiana Macovei
- Department of Oral and Dental Diagnostics, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| | - Simona Stoleriu
- Department of Cariology and Restorative Dental Therapy, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| | - Maria-Alexandra Martu
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| | - Ionut Luchian
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| | | | - Sorina Mihaela Solomon
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, Universitatii Street 16, 700115 Iasi, Romania
| |
Collapse
|
17
|
Bertran Faus A, Cordero Bayo J, Velasco-Ortega E, Torrejon-Moya A, Fernández-Velilla F, García F, López-López J. Customized Titanium Mesh for Guided Bone Regeneration with Autologous Bone and Xenograft. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15186271. [PMID: 36143583 PMCID: PMC9501097 DOI: 10.3390/ma15186271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/12/2023]
Abstract
The augmentation of the alveolar crest after the loss of one or several teeth can be carried out using different bone augmentation techniques. These techniques include bone distraction, ridge expansion, bone block grafts, etc. Guided bone regeneration is an alternative to increase the volume of the hard tissues for the subsequent placement of the implants in the optimal three-dimensional position. The objective of this paper is to show a case report of the use of customized titanium mesh for posterior vertical bone regeneration. Case report and Results: A 59-year-old woman comes to rehabilitate edentulous spaces with implants. After taking the anamnesis and the intra and extraoral exploration, a vertical and horizontal bone defect is observed in the third quadrant. After the radiological study with CBCT, a bone height of 6.04 mm to the inferior alveolar nerve and a width of the bone crest of 3.95 mm was observed. It was decided to carry out a regeneration with a preformed titanium mesh (Avinent®, Santpedor, Spain) and four microscrews (Avinent®, Santpedor, Spain). The flap was closed without tension. Regular check-ups were performed without complications. At 7 months, the mesh was removed and two osteoingrated implants (Avinent®, Santpedor, Spain) were placed with a torque greater than 45 N/cm and an ISQ of 82 and 57 N/cm, respectively. The bone gain obtained was 1.84 and 1.92 mm in width and 4.2 and 3.78 mm in height for positions 3.5 and 3.6. The newly formed bone, obtained by trephine, was well-structured and histologically indistinguishable from the previous bone. Conclusion: The use of a customized pre-formed titanium mesh together with the mixture of autologous bone and xenograft is a feasible and predictable technique for vertical bone regeneration.
Collapse
Affiliation(s)
- Anna Bertran Faus
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - José Cordero Bayo
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Eugenio Velasco-Ortega
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Aina Torrejon-Moya
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Francesca Fernández-Velilla
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Fernando García
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - José López-López
- Department of Oral Medicine, Faculty of Dentistry, Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, 08907 Barcelona, Spain
| |
Collapse
|
18
|
Shi Y, Liu J, Du M, Zhang S, Liu Y, Yang H, Shi R, Guo Y, Song F, Zhao Y, Lan J. Customized Barrier Membrane (Titanium Alloy, Poly Ether-Ether Ketone and Unsintered Hydroxyapatite/Poly-l-Lactide) for Guided Bone Regeneration. Front Bioeng Biotechnol 2022; 10:916967. [PMID: 35837554 PMCID: PMC9273899 DOI: 10.3389/fbioe.2022.916967] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Sufficient bone volume is indispensable to achieve functional and aesthetic results in the fields of oral oncology, trauma, and implantology. Currently, guided bone regeneration (GBR) is widely used in reconstructing the alveolar ridge and repairing bone defects owing to its low technical sensitivity and considerable osteogenic effect. However, traditional barrier membranes such as collagen membranes or commercial titanium mesh cannot meet clinical requirements, such as lack of space-preserving ability, or may lead to more complications. With the development of digitalization and three-dimensional printing technology, the above problems can be addressed by employing customized barrier membranes to achieve space maintenance, precise predictability of bone graft, and optimization of patient-specific strategies. The article reviews the processes and advantages of three-dimensional computer-assisted surgery with GBR in maxillofacial reconstruction and alveolar bone augmentation; the properties of materials used in fabricating customized bone regeneration sheets; the promising bone regeneration potency of customized barrier membranes in clinical applications; and up-to-date achievements. This review aims to present a reference on the clinical aspects and future applications of customized barrier membranes.
Collapse
Affiliation(s)
- Yilin Shi
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Jin Liu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Mi Du
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Shengben Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yue Liu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Hu Yang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Ruiwen Shi
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yuanyuan Guo
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Feng Song
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yajun Zhao
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Jing Lan
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| |
Collapse
|
19
|
Li L, Gao H, Wang C, Ji P, Huang Y, Wang C. Assessment of Customized Alveolar Bone Augmentation Using Titanium Scaffolds vs Polyetheretherketone (PEEK) Scaffolds: A Comparative Study Based on 3D Printing Technology. ACS Biomater Sci Eng 2022; 8:2028-2039. [PMID: 35443132 DOI: 10.1021/acsbiomaterials.2c00060] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Customized alveolar bone augmentation provides sufficient and precisely regenerated bone tissue for subsequent dental implant placement. Although some clinical cases have confirmed the successful use of the patient-specific polyetheretherketone (PEEK) scaffolds, the biomechanical property and osteogenic performance of the patient-specific PEEK scaffolds remain unclear. The objectives of this study were (1) to evaluate the space maintenance capacity and osteogenic performance of the patient-specific PEEK scaffolds for customized alveolar bone augmentation and (2) to compare the biomechanical properties of three-dimensionally printed titanium scaffolds and PEEK scaffolds. Both titanium scaffolds and PEEK scaffolds were designed and manufactured via additive manufacturing technology combined with computer-aided design (CAD). In three-point bending tests, the bending strength of the PEEK scaffold was about 1/3 that of the titanium scaffold. Accordingly, the equivalent strain value of the internal bone graft beneath the PEEK scaffold was about 3 times that beneath the titanium scaffold in finite element analysis, but the maximum deformations of both scaffolds were less than 0.05 mm. Meanwhile, in in vivo experiments, it is demonstrated that both scaffolds have similar space maintenance capacity and bone ingrowth efficiency. In conclusion, patient-specific PEEK scaffolds showed significantly lower biomechanical strength but comparable space maintenance and osteogenic properties to the titanium counterpart. Compared with traditional guided bone regeneration (GBR) surgery, both patient-specific PEEK and titanium scaffolds can achieve excellent osteogenic space maintenance ability. This study provides a preliminary basis for the clinical translation of the nonmetallic barrier membrane in customized alveolar bone augmentation.
Collapse
Affiliation(s)
- Linzhi Li
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Hui Gao
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Chunjuan Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Ping Ji
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Yuanding Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.,Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China
| |
Collapse
|
20
|
Lizio G, Pellegrino G, Corinaldesi G, Ferri A, Marchetti C, Felice P. Guided Bone Regeneration using Titanium Mesh to Augment 3-dimensional alveolar defects prior to implant placement. A Pilot Study. Clin Oral Implants Res 2022; 33:607-621. [PMID: 35305283 PMCID: PMC9314996 DOI: 10.1111/clr.13922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 11/27/2022]
Abstract
Objectives To evaluate the outcomes of bone regeneration using a customized titanium mesh scaffold to cover a bone graft for reconstruction of complex defects of the jaws. Materials and Methods 19 large defects were digitally reconstructed using CT scans according to the prosthetic requirements. A titanium mesh scaffold was designed to cover the bone (autologous/bovine bone particulate) graft. At least 6 months after surgery, a new cone‐beam CT was taken. The pre‐ and postoperative CT datasets were then converted into three‐dimensional models and digitally aligned. The actual mesh position was compared to the virtual position to assess the reliability of the digital project. The reconstructed bone volumes (RBVs) were calculated according to the planned bone volumes (PBVs), outlining the areas under the mesh. These values were then correlated with the number of exposures, locations of atrophy, and virtually planned bone volume. Results The mean matching value between the planned position of the mesh and the actual one was 82 ± 13.4%. 52.3% (40% early and 60% late) exposures were observed, with 15.8% exhibiting infection. 26.3% resulted as failures. The amount of reconstructed bone volume (RBV) in respect to PBV was 65 ± 40.5%, including failures, and 88.2 ± 8.32% without considering the failures. The results of the exposure event were statistically significant (p = .006) in conditioning the bone volume regenerated. Conclusions This study obtained up to 88% of bone regeneration in 74% of the cases. The failures encountered (26%) should underline the operator's expertise relevance in conditioning the final result.
Collapse
Affiliation(s)
- Giuseppe Lizio
- Unit of Oral Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| | - Gerardo Pellegrino
- Unit of Oral Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of Oral Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| | - Agnese Ferri
- Unit of Oral Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| | - Claudio Marchetti
- Unit of Maxillofacial Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| | - Pietro Felice
- Unit of Oral Surgery, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
| |
Collapse
|
21
|
Implementation of 3D Printing and Computer-Aided Design and Manufacturing (CAD/CAM) in Craniofacial Reconstruction. J Craniofac Surg 2022; 33:1714-1719. [DOI: 10.1097/scs.0000000000008561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/28/2022] [Indexed: 11/27/2022] Open
|
22
|
Hoshi I, Kawai T, Kurosu S, Minamino T, Onodera K, Miyamoto I, Yamada H. Custom-Made Titanium Mesh Tray for Mandibular Reconstruction Using an Electron Beam Melting System. MATERIALS 2021; 14:ma14216556. [PMID: 34772076 PMCID: PMC8585206 DOI: 10.3390/ma14216556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 10/22/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022]
Abstract
Mandibular reconstruction using a titanium mesh tray and autologous bone is a common procedure in oral and maxillofacial surgery. However, there can be material problems-such as broken titanium mesh trays-which may undermine long-term functionality. This study was designed to investigate the optimal conditions for a titanium mesh tray with an ideal mandibular shape and sufficient strength, using computer-aided design, computer-aided manufacturing technology, and electron beam additive manufacturing. Specimens were prepared using Ti-6Al-4V extra low interstitial titanium alloy powder and an electron beam melting (EBM) system. The mechanical strength of the plate-shaped specimens was examined for differences in the stretch direction with respect to the stacking direction and the presence or absence of surface treatment. While evaluating the mechanical strength of the tray-shaped specimens, the topology was optimized and specimens with a honeycomb structure were also verified. Excellent mechanical strength was observed under the condition that the specimen was stretched vertically in the stacking direction and the surface was treated. The results of the tray-shaped specimens indicated that the thickness was 1.2 mm, the weight reduction rate was 20%, and the addition of a honeycomb structure could withstand an assumed bite force of 2000 N. This study suggests that the EBM system could be a useful technique for preparing custom-made titanium mesh trays of sufficient strength for mandibular reconstruction by arranging various manufacturing conditions.
Collapse
Affiliation(s)
- Isao Hoshi
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1, Uchimaru, Morioka 020-8505, Iwate, Japan; (I.H.); (K.O.); (I.M.); (H.Y.)
| | - Tadashi Kawai
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1, Uchimaru, Morioka 020-8505, Iwate, Japan; (I.H.); (K.O.); (I.M.); (H.Y.)
- Correspondence: ; Tel.: +81-19-651-5111; Fax: +81-19-623-6757
| | - Shingo Kurosu
- Department of Elementary Material Process Technology, Iwate Industrial Research Institute, 2-4-25, Kitaiioka, Morioka 020-0857, Iwate, Japan; (S.K.); (T.M.)
| | - Tadaharu Minamino
- Department of Elementary Material Process Technology, Iwate Industrial Research Institute, 2-4-25, Kitaiioka, Morioka 020-0857, Iwate, Japan; (S.K.); (T.M.)
| | - Kei Onodera
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1, Uchimaru, Morioka 020-8505, Iwate, Japan; (I.H.); (K.O.); (I.M.); (H.Y.)
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1, Uchimaru, Morioka 020-8505, Iwate, Japan; (I.H.); (K.O.); (I.M.); (H.Y.)
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1, Uchimaru, Morioka 020-8505, Iwate, Japan; (I.H.); (K.O.); (I.M.); (H.Y.)
| |
Collapse
|
23
|
Cucchi A, Vignudelli E, Franceschi D, Randellini E, Lizio G, Fiorino A, Corinaldesi G. Vertical and horizontal ridge augmentation using customized CAD/CAM titanium mesh with versus without resorbable membranes. A randomized clinical trial. Clin Oral Implants Res 2021; 32:1411-1424. [PMID: 34551168 PMCID: PMC9293224 DOI: 10.1111/clr.13841] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
Objectives The aim was to evaluate the role of resorbable membranes applied over customized titanium meshes related to soft tissue healing and bone regeneration after vertical/horizontal bone augmentation. Materials and Methods Thirty patients with partial edentulism of the maxilla/mandible, with vertical/horizontal reabsorption of the alveolar bone, and needing implant‐supported restorations, were randomly divided into two groups: Group A was treated using only custom‐made meshes (Mesh‐) and Group B using custom‐made meshes with cross‐linked collagen membranes (Mesh+). Data collection included surgical/technical and healing complications, “pseudo‐periosteum” thickness, bone density, planned bone volume (PBV), regenerated bone volume (RBV), regeneration rate (RR), vertical bone gain (VBG), and implant survival in regenerated areas. Statistical analysis was performed between the two study groups using a significance level of α = .05. Results Regarding the healing complications, the noninferiority analysis proved to be inconclusive, despite the better results of group Mesh+ (13%) compared to group Mesh‐ (33%): estimated value −1.13 CI‐95% from −0.44 to 0.17. Superiority approach confirmed the absence of significant differences (p = .39). RBV was 803.27 mm3 and 843.13 mm3, respectively, and higher RR was observed in group Mesh+ (82.3%) compared to Mesh‐ (74.3%), although this value did not reach a statistical significance (p = .44). All 30 patients completed the study, receiving 71 implants; 68 out of them were clinically stable and in function. Conclusion The results showed that customized meshes alone do not appear to be inferior to customized meshes covered by cross‐linked collagen membranes in terms of healing complication rates and regeneration rates, although superior results were observed in group Mesh+compared to group Mesh‐ for all variables.
Collapse
Affiliation(s)
| | - Elisabetta Vignudelli
- Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy
| | - Debora Franceschi
- Department of Experimental and clinical Medicine, University of Florence, Florence, Italy
| | | | - Giuseppe Lizio
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Trans-plant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Antonino Fiorino
- Catholic University of Sacred Heart, University Polyclinic Foundation A. Gemelli (IRCCS), Rome, Italy
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy
| |
Collapse
|
24
|
Mufarrih SH, Mahmood F, Qureshi NQ, Yunus R, Quraishi I, Baribeau V, Sharkey A, Matyal R, Khabbaz KR. Three-Dimensional Printing of Patient-Specific Heart Valves: Separating Facts From Fiction and Myth From Reality. J Cardiothorac Vasc Anesth 2021; 36:2643-2655. [PMID: 34654635 DOI: 10.1053/j.jvca.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/05/2021] [Accepted: 09/08/2021] [Indexed: 11/11/2022]
Abstract
The development of prosthetic heart valves by Dr. Charles Hufnagel in 1952 was a major clinical innovation; however, it was not an ideal solution. Mechanical prosthetic heart valves are rigid, immunogenic, require anticoagulation, do not grow with the patient, and have a finite life.1 An ideal prosthetic valve should overcome all these limitations. Considering the prevalence of valvular heart disorders, there is considerable interest in the creation of patient-specific heart valves. Following the introduction of three-dimensional (3D) printing in 1986 by Chuck Hill, rapid advances in multimodality 3D imaging and modeling have led to a generation of tangible replicas of patient-specific anatomy. The science of organogenesis has gained importance for a multitude of valid reasons: as an alternate source of organs, for realistic drug testing, as an alternative to animal testing, and for transplants that grow with the patient. What scientists imagined to be seemingly impossible in the past now seems just a step away from becoming a reality. However, due to the disruptive nature of this technology, often there are commercially-motivated claims of originality and overstatement of the scope and applicability of 3D printing. It often is difficult to separate fact from fiction and myth from reality. In this manuscript, the authors have reviewed the historic perspective, status of the basic techniques of organogenesis with specific reference to heart valves, and their potential.
Collapse
Affiliation(s)
- Syed Hamza Mufarrih
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Nada Qaisar Qureshi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Rayaan Yunus
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Ibrahim Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Vincent Baribeau
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Kamal R Khabbaz
- Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| |
Collapse
|
25
|
Latimer JM, Maekawa S, Yao Y, Wu DT, Chen M, Giannobile WV. Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects. Front Bioeng Biotechnol 2021; 9:704048. [PMID: 34422781 PMCID: PMC8378232 DOI: 10.3389/fbioe.2021.704048] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/29/2021] [Indexed: 01/10/2023] Open
Abstract
Additive manufacturing (AM) is the automated production of three-dimensional (3D) structures through successive layer-by-layer deposition of materials directed by computer-aided-design (CAD) software. While current clinical procedures that aim to reconstruct hard and soft tissue defects resulting from periodontal disease, congenital or acquired pathology, and maxillofacial trauma often utilize mass-produced biomaterials created for a variety of surgical indications, AM represents a paradigm shift in manufacturing at the individual patient level. Computer-aided systems employ algorithms to design customized, image-based scaffolds with high external shape complexity and spatial patterning of internal architecture guided by topology optimization. 3D bioprinting and surface modification techniques further enhance scaffold functionalization and osteogenic potential through the incorporation of viable cells, bioactive molecules, biomimetic materials and vectors for transgene expression within the layered architecture. These computational design features enable fabrication of tissue engineering constructs with highly tailored mechanical, structural, and biochemical properties for bone. This review examines key properties of scaffold design, bioresorbable bone scaffolds produced by AM processes, and clinical applications of these regenerative technologies. AM is transforming the field of personalized dental medicine and has great potential to improve regenerative outcomes in patient care.
Collapse
Affiliation(s)
- Jessica M Latimer
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Shogo Maekawa
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yao Yao
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - David T Wu
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States.,Laboratory for Cell and Tissue Engineering, Harvard John A. Paulson School of Engineering and Applied Sciences, Boston, MA, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Michael Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| |
Collapse
|
26
|
Mechanical Properties and Corrosion Resistance of TiAl6V4 Alloy Produced with SLM Technique and Used for Customized Mesh in Bone Augmentations. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Bone augmentation procedures represent a real clinical challenge. One option is the use of titanium meshes. Additive manufacturing techniques can provide custom-made devices in titanium alloy. The purpose of this study was to investigate the material used, which can influence the outcomes of the bone augmentation procedure. Specific test samples were obtained from two different manufacturers with two different shapes: surfaces without perforations and with calibrated perforations. Three-point bending tests were run as well as internal friction tests to verify the Young’s modulus. Test samples were placed in two different buffered solutions and analyzed with optical microscopy. A further SEM analysis was done to observe any microstructural modification. Three-point flexural tests were conducted on 12 specimens. Initial bending was observed at lower applied stresses for the perforated samples (503 MPa) compared to non-perforated ones (900 MPa); the ultimate flexural strength was registered at 513 MPa and 1145 MPa for perforated and non-perforated samples, respectively. Both microscopic analyses (optical and SEM) showed no significant alterations. Conclusions: A normal masticatory load cannot modify the device. Chemical action in the case of exposure does not create macroscopic and microscopic alterations of the surface.
Collapse
|
27
|
Dellavia C, Canciani E, Pellegrini G, Tommasato G, Graziano D, Chiapasco M. Histological assessment of mandibular bone tissue after guided bone regeneration with customized computer-aided design/computer-assisted manufacture titanium mesh in humans: A cohort study. Clin Implant Dent Relat Res 2021; 23:600-611. [PMID: 34139056 DOI: 10.1111/cid.13025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/07/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Innovative customized computer-aided design/computer-assisted manufacture (CAD-CAM) titanium meshes have been proposed for guided alveolar bone regeneration. Histological confirmation on the quality of the regenerated bone is needed. Purpose of the study is to assess the integration capabilities of these innovative meshes and to evaluate the histological features of the regenerated alveolar bone. MATERIALS AND METHODS Twenty partially edentulous patients, with severe posterior mandibular atrophy, underwent a guided bone regeneration technique by means of customized CAD-CAM titanium mesh in association with a mixture of autologous bone in chips and deproteinized bovine bone (1:1). At 9 months of healing, titanium meshes and bone samples were collected and histomorphometrically analyzed. RESULTS In all patients, implants were placed according to the original plan. At histologic analysis, mesh appeared well osseointegrated, except that in sites where membrane exposure occurred. In all sites, newly formed tissue resulted highly mineralized, well-organized, and formed by 35.88% of new lamellar bone, 16.42% of woven bone, 10.88% of osteoid matrix, 14.10% of grafted remnants, and 22.72% of medullary spaces. Blood vessels were the 4% of the tissue. CONCLUSIONS Data from this study support the use of customized CAD/CAM titanium mesh for regeneration of vital, well-structured, and vascularized alveolar bone.
Collapse
Affiliation(s)
- Claudia Dellavia
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Elena Canciani
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Gaia Pellegrini
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Grazia Tommasato
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| | - Daniele Graziano
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Chiapasco
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Clinical Unit of Oral Surgery, ASST Santi Paolo e Carlo - San Paolo Hospital, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
28
|
Zhou L, Su Y, Wang J, Wang J, Wang X, Liu Q. Effect of Exposure Rates with Customized versus Conventional Titanium Mesh on Guided Bone Regeneration: A Systematic Review and Meta-Analysis. J ORAL IMPLANTOL 2021; 48:339-346. [PMID: 34091682 DOI: 10.1563/aaid-joi-d-20-00200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Titanium mesh exposure is the main complication of bone regeneration. In this study, a meta-analysis and performed to clarify the effect of customized titanium mesh versus conventional titanium mesh complications and the time of mesh exposure on edentulous alveolar ridge GBR. Databases, including PubMed, EMBASE, Web of Science and Cochrane Central Register Controlled Trials, were searched by two independent reviewers to retrieve articles published from January 2010 to March 2020, regarding the incidence of complications after GBR surgery, with language limited to English articles. A total of 705 articles were found, and 9 articles were quantitatively analyzed. A funnel plot was made for 10 comprehensive datasets. The combined value of the total exposure rate of titanium mesh was 0.44 (44%, 95% CI=0.30~0.58). The results of subgroup analysis showed that the combined value of the customized titanium mesh exposure rate was 0.31 (31%, 95% CI=0.15~0.51), and the combined value of the conventional titanium mesh exposure rate was 0.51 (51%, 95% CI=0.33~0.69). Based on the findings of the present study, the exposure rate of customized titanium mesh is lower than that of conventional titanium mesh. The design of 3D printing customized titanium mesh avoids nerves and blood vessels, which is of great significance to improve the accurate reconstruction of GBR and provides enough space for implantation and reducing the exposure rate. Soft tissue management (i.e., technical sensitivity) is also an important factor to avoid soft tissue fractures.
Collapse
Affiliation(s)
| | - Yucheng Su
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Hospital Dental Department Dongcheng District CHINA Beijing Beijing 100032 Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Hospital
| | - Jing Wang
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University
| | | | | | - Qian Liu
- Beijing Citident Stomatology Hospital
| |
Collapse
|
29
|
Hartmann A, Peetz M, Al-Nawas B, Seiler M. Patient-specific titanium meshes: Future trend or current technology? Clin Implant Dent Relat Res 2021; 23:3-4. [PMID: 33620778 DOI: 10.1111/cid.12981] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Amely Hartmann
- Private Practice for Oral and Maxillofacial Surgery, Private Practice Dr. Seiler and Colleagues, Filderstadt, Germany.,Department of Oral and Maxillofacial Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | | | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marcus Seiler
- Private Practice for Oral and Maxillofacial Surgery, Private Practice Dr. Seiler and Colleagues, Filderstadt, Germany
| |
Collapse
|
30
|
Abstract
The presence of satisfactory bone volume is fundamental for the achievement of osseointegration. This systematic review aims to analyse the use of titanium meshes in guided bone regeneration in terms of bone gain, survival and success rates of implants, and percentages of exposure. An electronic search was conducted Articles were selected from databases in MEDLINE (PubMed), SCOPUS, Scielo, and Cochrane Library databases to identify studies in which bone regeneration was performed through particulate bone and the use of titanium meshes. Twenty-one studies were included in the review. In total, 382 patients, 416 titanium meshes, and 709 implants were evaluated. The average bone gain was 4.3 mm in horizontal width and 4.11 mm in vertical height. The mesh exposure was highly prevalent (28%). The survival rate of 145 simultaneous implants was 99.5%; the survival rate of 507 delayed implants was 99%. The success rate of 105 simultaneous implants was 97%; the success rate of 285 delayed implants was 95.1%. The clinical studies currently available in the literature have shown the predictability of this technique. It has a high risk of soft tissue dehiscence and membrane exposure although the optimal management of membrane exposition permits obtaining a sufficient bone regeneration volume and prevents compromising the final treatment outcome.
Collapse
|
31
|
Chiapasco M, Casentini P, Tommasato G, Dellavia C, Del Fabbro M. Customized CAD/CAM titanium meshes for the guided bone regeneration of severe alveolar ridge defects: Preliminary results of a retrospective clinical study in humans. Clin Oral Implants Res 2021; 32:498-510. [PMID: 33548069 DOI: 10.1111/clr.13720] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To present the results of guided bone regeneration (GBR) of atrophic edentulous ridges with customized CAD/CAM titanium meshes. MATERIAL AND METHODS Forty-one patients, presenting with 53 atrophic sites, were enrolled between 2018 and 2019. GBR was obtained with titanium meshes filled with autogenous bone chips and bovine bone mineral (BBM). After a mean of 7 months (range: 5-12 months), meshes were removed and 106 implants placed. After a mean of 3.5 months (range: 2-5 months), implants were uncovered and prosthetic restorations started. The outcomes were vertical and horizontal bone augmentation changes, biological complications and implant survival. RESULTS Out of 53 sites, 11 underwent mesh exposure: eight of them were followed by uneventful integration of the graft, while three by partial bone loss. The mean vertical and horizontal bone gain after reconstruction was 4.78 ± 1.88 mm (range 1.00-8.90 mm) and 6.35 ± 2.10 mm (range 2.14-11.48 mm), respectively. At the time of implant placement, mean changes of initial bone gain were -0.39 ± 0.64 mm (range -3.1 to + 0.80 mm) and -0.49 ± 0.83 mm (range -3.7 to +0.4 mm), in the vertical and horizontal dimensions, respectively. Reduction of bone volume was significantly higher (p < .001 for both dimensions) in the exposed sites. The mean follow-up of implants after loading was 10.6 ± 6.5 months (range: 2-26 months). The survival rate of implants was 100%. CONCLUSION Customized titanium meshes can represent a reliable tool for GBR of severely atrophic sites, with simplification of the surgical phases.
Collapse
Affiliation(s)
- Matteo Chiapasco
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, Dental Clinic, St. Paolo and St. Carlo Hospitals, University of Milan, Milan, Italy
| | | | - Grazia Tommasato
- Unit of Oral Surgery, Department of Biomedical, Surgical, and Dental Sciences, Dental Clinic, St. Paolo and St. Carlo Hospitals, University of Milan, Milan, Italy
| | - Claudia Dellavia
- Unit of Human Anatomy, Thin Section Laboratory, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy.,Dental Clinic, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| |
Collapse
|
32
|
Garot C, Bettega G, Picart C. Additive Manufacturing of Material Scaffolds for Bone Regeneration: Toward Application in the Clinics. ADVANCED FUNCTIONAL MATERIALS 2021; 31:2006967. [PMID: 33531885 PMCID: PMC7116655 DOI: 10.1002/adfm.202006967] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Indexed: 05/07/2023]
Abstract
Additive manufacturing (AM) allows the fabrication of customized bone scaffolds in terms of shape, pore size, material type and mechanical properties. Combined with the possibility to obtain a precise 3D image of the bone defects using computed tomography or magnetic resonance imaging, it is now possible to manufacture implants for patient-specific bone regeneration. This paper reviews the state-of-the-art of the different materials and AM techniques used for the fabrication of 3D-printed scaffolds in the field of bone tissue engineering. Their advantages and drawbacks are highlighted. For materials, specific criteria, were extracted from a literature study: biomimetism to native bone, mechanical properties, biodegradability, ability to be imaged (implantation and follow-up period), histological performances and sterilization process. AM techniques can be classified in three major categories: extrusion-based, powder-based and liquid-base. Their price, ease of use and space requirement are analyzed. Different combinations of materials/AM techniques appear to be the most relevant depending on the targeted clinical applications (implantation site, presence of mechanical constraints, temporary or permanent implant). Finally, some barriers impeding the translation to human clinics are identified, notably the sterilization process.
Collapse
Affiliation(s)
- Charlotte Garot
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
| | - Georges Bettega
- Service de chirurgie maxillo-faciale, Centre Hospitalier Annecy-Genevois, 1 avenue de l’hôpital, F-74370 Epagny Metz-Tessy, France
- INSERM U1209, Institut Albert Bonniot, F-38000 Grenoble, France
| | - Catherine Picart
- CEA, Université de Grenoble Alpes, CNRS, ERL 5000, IRIG Institute, 17 rue des Martyrs, F-38054, Grenoble, France
- CNRS and Grenoble Institute of Engineering, UMR 5628, LMGP, 3 parvis Louis Néel F-38016 Grenoble, France
| |
Collapse
|
33
|
Xie Y, Li S, Zhang T, Wang C, Cai X. Titanium mesh for bone augmentation in oral implantology: current application and progress. Int J Oral Sci 2020; 12:37. [PMID: 33380722 PMCID: PMC7773733 DOI: 10.1038/s41368-020-00107-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023] Open
Abstract
Guided bone regeneration (GBR) is an effective and simple method for bone augmentation, which is often used to reconstruct the alveolar ridge when the bone defect occurs in the implant area. Titanium mesh has expanded the indications of GBR technology due to its excellent mechanical properties and biocompatibility, so that the GBR technology can be used to repair alveolar ridges with larger bone defects, and can obtain excellent and stable bone augmentation results. Currently, GBR with titanium mesh has various clinical applications, including different clinical procedures. Bone graft materials, titanium mesh covering methods, and titanium mesh fixing methods are also optional. Moreover, the research of GBR with titanium mesh has led to multifarious progresses in digitalization and material modification. This article reviews the properties of titanium mesh and the difference of titanium mesh with other barrier membranes; the current clinical application of titanium mesh in bone augmentation; common complications and management and prevention methods in the application of titanium mesh; and research progress of titanium mesh in digitization and material modification. Hoping to provide a reference for further improvement of titanium mesh in clinical application and related research of titanium mesh.
Collapse
Affiliation(s)
- Yu Xie
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songhang Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tianxu Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chao Wang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Xiaoxiao Cai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Head and Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|
34
|
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 2020; 23:5-18. [PMID: 33336492 DOI: 10.1111/cid.12966] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few studies have focused on the dimensional accuracy of customized bone grafting by means of guided bone regeneration (GBR) with 3D-Printed Individual Titanium Mesh (3D-PITM). PURPOSE Digital technologies were applied to evaluate the dimensional accuracy of customized bone augmentation with 3D-PITM with a two-stage technique. MATERIALS AND METHODS Sixteen patients were included in this study. The CBCT data of post-GBR (immediate post-GBR) and post-implantation (immediate post-implant placement) were 3D reconstructed and compared with the pre-surgical planned bone augmentation. The dimensional differences were evaluated by superimposition using the Materialize 3-matic software. RESULTS The superimposition analysis showed that the maximum deviations of contour between were 3.4 mm, and the average differences of the augmentation contour were 0.5 ± 0.4 and 0.6 ± 0.5 mm respectively. The planned volume of bone regeneration was approximately equal to the amount of regenerated bone present 6 to 9 months after the surgical procedure. On average, the vertical gain in bone height was about 0.5 mm less than planned. And, the horizontal bone gain on the straight buccal of the dental implants and 2 to 4 mm apical of the platform fell also about a 0.5 mm short on average. Statistically significant differences were observed between the augmented volume of virtual and post-GBR, and the horizontal bone gain of post-implantation on the level of 4 mm apical to the implant platform (P < .05). CONCLUSIONS The dimensional accuracy of customized bone augmentation with the 3D-PITM approach needs further improvement and compared to other surgical approaches of bone augmentation.
Collapse
Affiliation(s)
- Linzhi Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - Xian Li
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Gang Fu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dan Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuanding Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| |
Collapse
|
35
|
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; 6:83. [PMID: 33300105 PMCID: PMC7726098 DOI: 10.1186/s40729-020-00269-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study was to evaluate the volumetric changes in partially edentulous alveolar ridges augmented with customized titanium ridge augmentation matrices (CTRAM), freeze-dried bone allograft, and a resorbable collagen membrane. Methods A pre-surgical cone beam computed tomography (CBCT) scan was obtained for CTRAM design/fabrication and to evaluate pre-surgical ridge dimensions. Ridge augmentation surgery using CTRAM, freeze-dried bone allograft, and a resorbable collagen membrane was performed at each deficient site. Clinical measurements of the area of augmentation were made at the time of CTRAM placement and re-entry, and a 2nd CBCT scan 7 months after graft placement was used for volumetric analysis. Locations of each CTRAM in situ were also compared to their planned positions. Re-entry surgery and implant placement was performed 8 months after CTRAM placement. Results Nine subjects were treated with CTRAM and freeze-dried bone allograft. Four out of the nine patients enrolled (44.4%) experienced premature CTRAM exposure during healing, and in two of these cases, CTRAM were removed early. Early exposure did not result in total graft failure in any case. Mean volumetric bone gain was 85.5 ± 30.9% of planned augmentation volume (61.3 ± 33.6% in subjects with premature CTRAM exposure vs. 104.9% for subjects without premature exposure, p = 0.03). Mean horizontal augmentation (measured clinically) was 3.02 mm, and vertical augmentation 2.86 mm. Mean surgical positional deviation of CTRAM from the planned location was 1.09 mm. Conclusion The use of CTRAM in conjunction with bone graft and a collagen membrane resulted in vertical and horizontal bone gain suitable for implant placement.
Collapse
|
36
|
Imagawa N, Inoue K, Matsumoto K, Ochi A, Omori M, Yamamoto K, Nakajima Y, Kato-Kogoe N, Nakano H, Matsushita T, Yamaguchi S, Thi Minh Le P, Maruyama S, Ueno T. Mechanical, Histological, and Scanning Electron Microscopy Study of the Effect of Mixed-Acid and Heat Treatment on Additive-Manufactured Titanium Plates on Bonding to the Bone Surface. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5104. [PMID: 33198250 PMCID: PMC7696444 DOI: 10.3390/ma13225104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022]
Abstract
The additive manufacturing (AM) technique has attracted attention as one of the fully customizable medical material technologies. In addition, the development of new surface treatments has been investigated to improve the osteogenic ability of the AM titanium (Ti) plate. The purpose of this study was to evaluate the osteogenic activity of the AM Ti with mixed-acid and heat (MAH) treatment. Fully customized AM Ti plates were created with a curvature suitable for rat calvarial bone, and they were examined in a group implanted with the MAH-treated Ti in comparison with the untreated (UN) group. The AM Ti plates were fixed to the surface of rat calvarial bone, followed by extraction of the calvarial bone 1, 4, 8, and 12 weeks after implantation. The bonding between the bone and Ti was evaluated mechanically. In addition, AM Ti plates removed from the bone were examined histologically by electron microscopy and Villanueva-Goldner stain. The mechanical evaluation showed significantly stronger bone-bonding in the MAH group than in the UN group. In addition, active bone formation was seen histologically in the MAH group. Therefore, these findings indicate that MAH resulted in rapid and strong bonding between cortical bone and Ti.
Collapse
Affiliation(s)
- Naoko Imagawa
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Kazuya Inoue
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Keisuke Matsumoto
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Ayako Ochi
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Michi Omori
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Kayoko Yamamoto
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Yoichiro Nakajima
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Nahoko Kato-Kogoe
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Hiroyuki Nakano
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| | - Tomiharu Matsushita
- Department of Biomedical Science, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan; (T.M.); (S.Y.); (P.T.M.L.)
| | - Seiji Yamaguchi
- Department of Biomedical Science, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan; (T.M.); (S.Y.); (P.T.M.L.)
| | - Phuc Thi Minh Le
- Department of Biomedical Science, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai, Aichi 487-8501, Japan; (T.M.); (S.Y.); (P.T.M.L.)
| | - Shinpei Maruyama
- Osaka Yakin Kogyo Co., Ltd., 4-4-28, Zuiko, Yodogawa-ku, Osaka 533-0005, Japan;
| | - Takaaki Ueno
- Division of Medicine for Function and Morphology of Sensor Organs, Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; (N.I.); (K.M.); (A.O.); (M.O.); (K.Y.); (Y.N.); (N.K.-K.); (H.N.); (T.U.)
| |
Collapse
|
37
|
Li S, Zhang T, Zhou M, Zhang X, Gao Y, Cai X. A novel digital and visualized guided bone regeneration procedure and digital precise bone augmentation: A case series. Clin Implant Dent Relat Res 2020; 23:19-30. [PMID: 33079419 DOI: 10.1111/cid.12959] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although the traditional bone augmentation technology can basically meet the clinical needs at present, the effect of bone augmentation in most cases is related to the experience of the operator. PROPOSE This study commits to providing a digital solution for precise bone augmentation in the field of oral implantology. MATERIALS AND METHODS After collecting the data of patients' intraoral scanning and DICOM (digital imaging and communications in medicine), the implant position is digitally designed, and the alveolar bone is digitally augmented around the ideal implant position. On the premise of ensuring that the thickness of labial bone is 2 mm, and there is sufficient alveolar bone 3 to 4 mm apically from the ideal gingival margin for implant placing, we carry out excessive augmentation of 0.5 and 1 mm on the labial bone and alveolar crest, respectively, to compensate for possible bone resorption after 6 months. After 3D printing the reconstructed alveolar bone model, the titanium mesh is trimmed and preformed on the alveolar bone model. Outcomes are reported in terms of mean values (5%-95% percentile values). RESULTS Thirty implant sites have accepted this novel virtually designed alveolar bone augmentation. Before the second-stage surgery, the average vertical bone gain was 2.48 mm (0.29-6.32), the average horizontal bone gain was 4.11 mm (1.19-8.74), the average height of the residual alveolar bone above the implant platform was 1.44 mm (0.59-2.92), the average thickness of the labial bone width at the implant platform was 2.00 mm (0.93-3.64), the average thickness of the labial bone width at 2 mm apically from the implant platform was 2.74 mm (1.40-5.46). The virtual augmentation of each tooth position was 349.41 mm3 (165.70-482.70), while the actual augmentation of each tooth position was 352.94 mm3 (159.24-501.78), the accuracy of the final actual augmentation reached 95.82% (range from 88.53% to 99.15%). CONCLUSION This case series suggests that a virtually digital guided bone regeneration (GBR) workflow is precise and controllable. The practicality, safety and effectiveness of this procedure needs to be compared to other bone augmentation procedures in randomized controlled trials.
Collapse
Affiliation(s)
- Songhang Li
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Tianxu Zhang
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mi Zhou
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaolin Zhang
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Gao
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoxiao Cai
- Department of Implant Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
38
|
Toledo Stuani VD, do Prado Manfredi GG, Miyahara Kondo VA, Noritomi PY, Lisboa-Filho PN, Passanezi Sant’Ana AC. The use of additively manufactured scaffolds for treating gingival recession associated with interproximal defects. ACTA ACUST UNITED AC 2020. [DOI: 10.2217/3dp-2020-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Gingival recessions are a highly prevalent issue that is often associated with interproximal tissue deficiency. An intervention in these scenarios is of extreme importance since these defects can lead to aesthetic, phonetic and other dental problems. Unfortunately, the treatment of advanced gingival recessions is a major challenge in periodontics because of its unpredictability. In such cases, the use of injectable fillings, connective tissue grafts or bone grafts for vertical regeneration in interproximal area presents limited results. Considering that, this special report reviewed the possible use of additively manufactured scaffolds as a therapeutic option. A 3D-printed personalized therapy is expected to simplify the regeneration of interproximal area, enabling bone regeneration, new papilla formation and root coverage.
Collapse
Affiliation(s)
- Vitor de Toledo Stuani
- Discipline of Periodontology, Bauru School of Dentistry – University of Sao Paulo, Bauru, Brazil
| | | | | | - Pedro Yoshito Noritomi
- Nucleus of Three-Dimensional Technologies (NT3D), Center for Information Technology Renato Archer, Campinas, Brazil
| | | | | |
Collapse
|
39
|
Cucchi A, Bianchi A, Calamai P, Rinaldi L, Mangano F, Vignudelli E, Corinaldesi G. Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study. BMC Oral Health 2020; 20:219. [PMID: 32758217 PMCID: PMC7409710 DOI: 10.1186/s12903-020-01205-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. Methods Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. Results All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. Conclusions The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.
Collapse
Affiliation(s)
- Alessandro Cucchi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
| | - Alessandro Bianchi
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Lisa Rinaldi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Francesco Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Moscow, Russia
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| |
Collapse
|
40
|
Revilla‐León M, Sadeghpour M, Özcan M. A Review of the Applications of Additive Manufacturing Technologies Used to Fabricate Metals in Implant Dentistry. J Prosthodont 2020; 29:579-593. [DOI: 10.1111/jopr.13212] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Marta Revilla‐León
- Comprehensive Dentistry Department, College of DentistryTexas A&M University Dallas TX
- Gradute Prosthodontics, Department of Restorative Dentistry, School of DentistryUniversity of Washington Seattle WA
| | - Mehrad Sadeghpour
- Revilla Research Center Madrid Spain
- Private practice in Dallas Dallas TX
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center for Dental and Oral MedicineUniversity of Zurich Zürich Switzerland
| |
Collapse
|
41
|
Yang J, Yu X, Zhang Z, Xu R, Wu F, Wang T, Liu Y, Ouyang J, Deng F. Surface modification of titanium manufactured through selective laser melting inhibited osteoclast differentiation through mitogen-activated protein kinase signaling pathway. J Biomater Appl 2020; 35:169-181. [PMID: 32340522 DOI: 10.1177/0885328220920457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Selective laser melting used in manufacturing custom-made titanium implants becomes more popular. In view of the important role played by osteoclasts in peri-implant bone resorption and osseointegration, we modified selective laser melting-manufactured titanium surfaces using sandblasting/alkali-heating and sandblasting/acid-etching, and investigated their effect on osteoclast differentiation as well as their underlying mechanisms. The properties of the surfaces, including elements, roughness, wettability and topography, were analyzed. We evaluated the proliferation and morphology of primary mouse bone marrow-derived monocytes, as well as induced osteoclasts derived from bone marrow-derived monocytes, on samples. Then, osteoclast differentiation was determined by the tartrate-resistant acid phosphatase activity assay, calcitonin receptors immunofluorescence staining and the expression of osteoclast-related genes. The results showed that sandblasting/alkali-heating established nanonet structure with the lowest water contact angle, and both sandblasting/alkali-heating and sandblasting/acid-etching significantly decreased surface roughness and heterogeneity compared with selective laser melting. Surface modifications of selective laser melting-produced titanium altered bone marrow-derived monocyte morphology and suppressed bone marrow-derived monocyte proliferation and osteoclastogenesis in vitro (sandblasting/alkali-heating>sandblasting/acid-etching>selective laser melting). These surface modifications reduced the activation of extracellular signal-regulated kinase and c-Jun N-terminal kinases compared to native-selective laser melting. Sandblasting/alkali-heating additionally blocked tumor necrosis factor receptor-associated factor 6 recruitment. The results suggested that sandblasting/alkali-heating and sandblasting/acid-etching modifications on selective laser melting titanium could inhibit osteoclast differentiation through suppressing extracellular signal-regulated kinase and c-Jun N-terminal kinase phosphorylation in mitogen-activated protein kinase signaling pathway and provide a promising technique which might reduce peri-implant bone resorption for optimizing native-selective laser melting implants.
Collapse
Affiliation(s)
- Jiamin Yang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Xiaolin Yu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Zhengchuan Zhang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Ruogu Xu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Fan Wu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Tianlu Wang
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Yun Liu
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Jianglin Ouyang
- Guangzhou Institute of Advanced Technology, Chinese Academy of Science, Guangzhou, PR China.,Guangzhou Janus Biotechnology Co., Ltd, Chinese Academy of Sciences, Guangzhou, PR China
| | - Feilong Deng
- Department of Oral Implantology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| |
Collapse
|
42
|
Hartmann A, Seiler M. Minimizing risk of customized titanium mesh exposures - a retrospective analysis. BMC Oral Health 2020; 20:36. [PMID: 32013940 PMCID: PMC6998104 DOI: 10.1186/s12903-020-1023-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 01/27/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recommendations for soft tissue management associated with customized bone regeneration should be developed. The aim of this study was to evaluate a new protocol for customized bone augmentation in a digital workflow. METHODS The investigators implemented a treatment of three-dimensional bone defects based on a customized titanium mesh (Yxoss CBR®, ReOSS, Filderstadt, Germany). Patients and augmentation sites were retrospectively analysed focussing on defect regions, demographic factors, healing difficulties and potential risk factors. An exposure rate was investigated concerning surgical splint application, A®- PRF and flap design. RESULTS In total, 98 implants could be placed. Yxoss CBR® was removed after mean time of 6.53 ± 2.7 months. Flap design was performed as full flap preparation (27.9%), full flap and periosteal incision (39.7%), periosteal incision (1.5%), poncho/split flap (27.9%) and rotation flap (2.9%). In 25% of the cases, exposures of the meshes were documented. Within this exposure rate, most of them were slight and only punctual (A = 16.2%), like one tooth width (B = 1.5%) and complete (C = 7.4%). A®- PRF provided significantly less exposures of the titanium meshes (76.5% no exposure vs. 23.5% yes, p = 0.029). Other parameters like tobacco abuse (p = 0.669), diabetes (p = 0.568) or surgical parameters (mesh size, defect region, flap design) did not influence the exposure rate. Surgical splints were not evaluated to reduce the exposure rate (p = 0.239). Gender (female) was significantly associated with less exposure rate (78,4% female vs. 21.6% male, p = 0.043). CONCLUSIONS The results of this study suggest that the new digital protocol including patient-specific titanium meshes, resorbable membranes and bone grafting materials was proven to be a promising technique. To improve soft tissue healing, especially A®-PRF should be recommended.
Collapse
Affiliation(s)
- Amely Hartmann
- Private Practitioner, Affiliate to the Department of Oral and Maxillofacial Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany. .,Department Head, Private Dental Practice, Echterdinger Str. 7, 70794, Filderstadt, Germany.
| | - Marcus Seiler
- Department Head, Private Dental Practice, Echterdinger Str. 7, 70794, Filderstadt, Germany
| |
Collapse
|
43
|
Serrano C, van den Brink H, Pineau J, Prognon P, Martelli N. Benefits of 3D printing applications in jaw reconstruction: A systematic review and meta-analysis. J Craniomaxillofac Surg 2019; 47:1387-1397. [DOI: 10.1016/j.jcms.2019.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/08/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022] Open
|
44
|
Evaluation of Risk Parameters in Bone Regeneration Using a Customized Titanium Mesh. IMPLANT DENT 2019; 28:543-550. [DOI: 10.1097/id.0000000000000933] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
45
|
Biomaterial-based bone regeneration and soft tissue management of the individualized 3D-titanium mesh: An alternative concept to autologous transplantation and flap mobilization. J Craniomaxillofac Surg 2019; 47:1633-1644. [PMID: 31420282 DOI: 10.1016/j.jcms.2019.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/11/2019] [Accepted: 07/14/2019] [Indexed: 12/14/2022] Open
Abstract
Three-dimensional augmentation in severely atrophic bone and after cancer resection is a challenging clinical indication that is mostly solved using autologous bone transplantation. The development of the digital technique along with the additive manufacturing and three-dimensional (3D) printing opened new avenues for reconstructive oral and maxillofacial surgery. Therefore, patient-specific titanium mesh is a novel means of stabilizing the augmentation region using particulate bone substitute materials (BSMs) combined with autologous bone as a minimally invasive concept. However, dehiscence is a frequently reported complication in this field. Therefore, the aim of the present case series was to introduce a biomaterial-based regenerative concept in terms of exposed open healing to overcome the dehiscence related to 3D-titanium meshes. Additionally, this case series presents a novel protocol using a combination of xenogeneic BSMs with an autologous blood concentrate system (platelet-rich fibrin [PRF]) and collagen matrices without any autologous transplantation. Seven patients with alveolar ridge atrophy with different etiologies (cancer resection, severe atrophy after tooth loss, aplasia, trauma, implant infections) were treated using the open-healing concept. Therefore, after 3D augmentation using the described biomaterials, the flap margins were approximated, and the gap between the flap margins was bridged using a collagen matrix loaded with liquid PRF that was then covered by either a PTFE-based membrane or sterile latex. No periosteum splitting was performed at any time point. After a healing period of 4-8 months, all patients received dental implants as virtually planned. Bone biopsies were performed during dental insertion for histological evaluation. The augmentation area displayed a vital and well-vascularized newly formed bone that incorporated the BSM granules to build a hybrid bone. Additionally, open healing resulted in newly formed soft tissue without any signs of scar formation or fibrosis. The regenerated soft tissue was used to build a new flap during implant insertion and showed good functional and aesthetic results after implant insertion. The open-healing concept of the regeneration of the soft tissue along with bone tissue to regenerate a harmonic implantation bed is a minimally invasive intervention without periosteum splitting or large flap mobilization. However, further controlled clinical studies are needed to evaluate this concept in a larger patient cohort to outline the potential clinical benefit.
Collapse
|
46
|
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‐ether‐ketone (PEEK) mesh: A randomized clinical trial. Clin Implant Dent Relat Res 2019; 21:960-967. [DOI: 10.1111/cid.12748] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/07/2019] [Accepted: 02/16/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Mohamed Mounir
- Oral and Maxillofacial Surgery, Faculty of DentistryCairo University and New Giza University Cairo Egypt
| | - Mahmoud Shalash
- Surgery and Oral Medicine DepartmentNational Research Centre Cairo Egypt
| | - Samy Mounir
- Oral and Maxillofacial Surgery, Faculty of DentistryMSA University 6th of October City Egypt
| | - Yasmine Nassar
- Oral and Maxillofacial Surgery, Faculty of DentistryCairo University Cairo Egypt
| | - Omar El Khatib
- Oral and Maxillofacial Surgery, Faculty of DentistryCairo University Cairo Egypt
| |
Collapse
|
47
|
Zhang T, Zhang T, Cai X. The application of a newly designed L‐shaped titanium mesh for GBR with simultaneous implant placement in the esthetic zone: A retrospective case series study. Clin Implant Dent Relat Res 2019; 21:862-872. [PMID: 30884096 DOI: 10.1111/cid.12726] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/08/2018] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Tianxu Zhang
- Department of Implant DentistryWest China Hospital of Stomatology; Sichuan University Chengdu China
| | - Tao Zhang
- Department of General DentistryWest China Hospital of Stomatology; Sichuan University Chengdu China
| | - Xiaoxiao Cai
- Department of Implant DentistryWest China Hospital of Stomatology; Sichuan University Chengdu China
| |
Collapse
|
48
|
Mechanical Characterization of 3D-Printed Individualized Ti-Mesh (Membrane) for Alveolar Bone Defects. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:4231872. [PMID: 30838123 PMCID: PMC6374856 DOI: 10.1155/2019/4231872] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/13/2018] [Indexed: 11/17/2022]
Abstract
Individualized titanium mesh holds many advantages over conventional mesh. There are few reports in the literature about the effect of mesh pore size and mesh thickness on the mechanical properties of titanium mesh. This study is designed to develop an individualized titanium mesh using computer-assisted design and additive manufacturing technology. This study will also explore the effect of different thicknesses and pore sizes of titanium mesh on its mechanical properties through 3D FEA. According to this study, the mechanical properties of titanium mesh increased when the thickness decreased (0.5 mm to 0.3 mm). With an increase in mesh diameter (3 mm to 5 mm), the mechanical properties of mesh decreased. The diameter of titanium mesh has less influence on its mechanical properties than does the thickness of the mesh. Titanium mesh with a thickness of 0.4 mm is strong enough and causes less stimulation to mucosa; therefore, it is more suitable for clinical use. In addition, parameters of titanium mesh should be decided clinically according to bone defect size, defect location, and force situation.
Collapse
|
49
|
Gul M, Arif A, Ghafoor R. Role of three-dimensional printing in periodontal regeneration and repair: Literature review. J Indian Soc Periodontol 2019; 23:504-510. [PMID: 31849394 PMCID: PMC6906903 DOI: 10.4103/jisp.jisp_46_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Three-dimensional (3D) printing is the process of building 3D objects by additive manufacturing approach. It is being used in endodontics, periodontology, maxillofacial surgery, prosthodontics, orthodontics, and restorative dentistry, but our review article is focused on periodontal application. A detailed literature search was done on PubMed/Medline and Google Scholar using various key terms. A total of 45 articles were included in this study. Most of the studies were in vitro, preclinical, case reports, retrospective, and prospective studies. Few clinical trials have also been done. Periodontal applications included education models, scaffolds, socket preservation, and sinus and bone augmentation and guided implant placement. It showed better alveolar ridge preservation, better regenerative capabilities, greater reduction in pocket depth and bony fill, ease of implant placement in complex cases with greater precision and reduced time with improved outcome and an important tool for education and training using simulated models.
Collapse
Affiliation(s)
- Meisha Gul
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
| | - Aysha Arif
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
| | - Robia Ghafoor
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
50
|
Applications of 3D printing on craniofacial bone repair: A systematic review. J Dent 2019; 80:1-14. [DOI: 10.1016/j.jdent.2018.11.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/09/2018] [Accepted: 11/07/2018] [Indexed: 12/14/2022] Open
|