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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.
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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
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Kämmerer PW, Al-Nawas B. Bone reconstruction of extensive maxillomandibular defects in adults. Periodontol 2000 2023; 93:340-357. [PMID: 37650475 DOI: 10.1111/prd.12499] [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: 03/26/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 09/01/2023]
Abstract
Reconstruction of significant maxillomandibular defects is a challenge that has been much discussed over the last few decades. Fundamental principles were developed decades ago (bone bed viability, graft immobilization). Clinical decision-making criteria are highly relevant, including local/systemic factors and incision designs, the choice of material, grafting technique, and donor site morbidity. Stabilizing particulated grafts for defined defects-that is, via meshes or shells-might allow significant horizontal and vertical augmentation; the alternatives are onlay and inlay techniques. More significant defects might require extra orally harvested autologous bone blocks. The anterior iliac crest is often used for nonvascularized augmentation, whereas more extensive defects often require microvascular reconstruction. In those cases, the free fibula flap has become the standard of care. The development of alternatives is still ongoing (i.e., alloplastic reconstruction, zygomatic implants, obturators, distraction osteogenesis). Especially for these complex procedures, three-dimensional planning tools enable facilitated planning and a surgical workflow.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Bhattacharya S, Bhattacharya N, Bhattacharya K. Role of 3D Printing in Surgery. Indian J Surg 2023. [DOI: 10.1007/s12262-023-03725-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Kämmerer PW, Tunkel J, Götz W, Würdinger R, Kloss F, Pabst A. The allogeneic shell technique for alveolar ridge augmentation: a multicenter case series and experiences of more than 300 cases. Int J Implant Dent 2022; 8:48. [PMID: 36316597 PMCID: PMC9622968 DOI: 10.1186/s40729-022-00446-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Allogeneic cortical bone plates (CP) might be used for alveolar ridge augmentation as an alternative to autogenous grafts (AG) and bone substitutes (BS). We report about a multicenter case series and our experiences of more than 300 cases using CP and the shell technique for reconstruction of the alveolar process to illustrate surgical key steps, variations, and complication management. METHODS Different types of alveolar ridge defects were augmented using the shell technique via CP. The space between the CP and the alveolar bone was filled with either autogenous or allogeneic granules (AUG, ALG) or a mixture of both. Implants were placed after 4-6 months. Microscopic and histological assessments were performed. In addition, space filling using AUG, ALG and bovine BS was discussed. RESULTS Scanning electron microscopy demonstrated the compact cortical structure of CP and the porous structure of ALG allowing micro-vessel ingrowth and bone remodeling. Histological assessment demonstrated sufficient bone remodeling and graft resorption after 4-6 months. In total, 372 CP cases and 656 implants were included to data analysis. The mean follow-up period was about 3.5 years. Four implants failed, while all implant failures were caused by peri-implantitis. Next, 30 CP complications were seen, while in 26 CP complications implant placement was possible. CP rehydration, stable positioning by adjusting screws, smoothing of sharp edges, and a tension-free wound closure were identified as relevant success factors. Space filling using ALG and a mixture of AUG/ALG resulted in sufficient bone remodeling, graft resorption and stability of the augmented bone. CONCLUSIONS CP and the shell technique is appropriate for alveolar ridge augmentation with adequate bone remodeling and low complication rates. Allografts can prevent donor site morbidity and therefore may decrease discomfort for the patient.
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Affiliation(s)
- Peer W. Kämmerer
- grid.410607.4Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Jochen Tunkel
- Private Practice for Oral Surgery and Periodontology, Königstraße 19, 32545 Bad Oeynhausen, Germany
| | - Werner Götz
- grid.15090.3d0000 0000 8786 803XDepartment of Orthodontics, University Hospital Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
| | - Robert Würdinger
- Private Practice for Oral Surgery and Periodontology, Frankfurter Str. 6, 35037 Marburg, Germany
| | - Frank Kloss
- Private Practice for Oral and Maxillofacial Surgery, Kärtnerstraße 62, 9900 Lienz, Austria
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstraße 170, 56072 Koblenz, Germany
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Kamal M, Al‐Obaidly S, Lethaus B, Bartella AK. A novel pilot animal model for bone augmentation using osseous shell technique for preclinical in vivo studies. Clin Exp Dent Res 2022; 8:1331-1340. [PMID: 35933723 PMCID: PMC9760144 DOI: 10.1002/cre2.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Bone grafting is commonly used to reconstruct skeletal defects in the craniofacial region. Several bone augmentation models have been developed to evaluate bone formation using novel bone substitute materials. The aim of this study was to evaluate a surgical animal model for establishing a three-dimensional (3D) grafting environment in the animal's mandibular ramus for bone augmentation using the osseous shell technique, as in humans. MATERIALS AND METHODS Osteological survey of New Zealand white (NZW) rabbit skull (Oryctolagus cuniculus): Initial osteological and imaging surveys were performed on a postmortem skull for a feasibility assessment of the surgical procedure. Postmortem pilot surgery and cone beam computed tomography imaging: a 3D osseous defect was created in the mandibular ramus through a submandibular incision. The osseous shell plates were stabilized with osteosynthesis fixation screws, and defects were filled with particular bone grafting material. In vivo surgical procedure: surgeries were conducted in four 8-week-old NZW rabbits utilizing two osseous shell materials: xenogeneic human cortical plates and autogenous rabbit cortical plates. The created 3D defects were filled using xenograft and allograft bone grafting materials. The healed defects were evaluated for bone formation after 12 weeks using histological and cone beam computed tomography imaging analysis. RESULTS Clinical analysis 12 weeks after surgery revealed the stability of the 3D grafted bone augmentation defects using the osseous shell technique. Imaging and histological analyses confirmed the effectiveness of this model in assessing bone formation. CONCLUSIONS The proposed animal model is a promising model with the potential to study various bone grafting materials for augmentation in the mandibular ramus using the osseous shell technique without compromising the health of the animal. The filled defects could be analyzed for osteogenesis, quantification of bone formation, and healing potential using histomorphometric analysis, in addition to 3D morphologic evaluation using radiation imaging.
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Affiliation(s)
- Mohammad Kamal
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences CenterKuwait UniversityJabryiaKuwait
| | - Sara Al‐Obaidly
- Kuwait Dental AdministrationKuwait Ministry of HealthSafatKuwait
| | - Bernd Lethaus
- Department of Oral and Maxillofacial SurgeryLeipzig University HospitalLeipzigGermany
| | - Alexander K. Bartella
- Department of Oral and Maxillofacial SurgeryLeipzig University HospitalLeipzigGermany
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Mu X, Zhang J, Jiang Y. 3D Printing in Breast Reconstruction: From Bench to Bed. Front Surg 2021; 8:641370. [PMID: 34095200 PMCID: PMC8173201 DOI: 10.3389/fsurg.2021.641370] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Surgical management of breast cancer often results in the absence of the breast. However, existing breast reconstruction methods may not meet the need for a replacement tissue. Tissue engineering with the use of emerging materials offers the promise of generating appropriate replacements. Three-dimensional (3D) printing technology has seen a significantly increased interest and application in medically-related fields in the recent years. This has been especially true in complex medical situations particularly when abnormal or complicated anatomical surgical considerations or precise reconstructive procedures are contemplated. In addition, 3D bio-printing which combines cells with bio-material scaffolds offers an exciting technology with significant applications in the field of tissue engineering. The purpose of this manuscript was to review a number of studies in which 3D printing technology has been used in breast reconstructive surgical procedures, and future directions and applications of 3D bio-printing.
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Affiliation(s)
- Xingdou Mu
- Department of Breast and Thyroid Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Juliang Zhang
- Department of Breast and Thyroid Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yue Jiang
- Department of Breast and Thyroid Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Alevizakos V, Mitov G, Schiller M, von See C. Ridge augmentation-The new field of computerized guided surgery: A technical note for minimal-invasive bone splitting. Clin Case Rep 2021; 9:2390-2396. [PMID: 33936701 PMCID: PMC8077347 DOI: 10.1002/ccr3.4046] [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: 01/30/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/08/2022] Open
Abstract
Different instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration have proven to be effective for successful implant placement in cases of alveolar bone width between 3mm and 6mm. Conventional bone splitting techniques require flap arising. This technical note demonstrates a method for flapless guided bone splitting. For this purpose, a newly developed surgical guide with internal irrigation channels was used. Using CAD-CAM additive technology, a narrow slot along the field of interest and a pin of a cooling pipe was designed and implemented in a surgical guide template. The bone split was performed flapless through the surgical guide while the cooling pipe was connected to it. During surgery, the piezo-driven instrument was moved within that slot, and the irrigation solution was directly rinsing it at point of entry through the irrigation channel. This procedure was performed on a 3.3 mm wide alveolar ridge achieving over 3 mm of bone gain. The described method combines several positive aspects. The micro-invasive flapless surgical procedure might improve postoperative healing. Additionally, sufficient cooling of the bone might lead to less thermal affection of bone cells and less resorption of the cortical bone. However, systematic studies are needed to confirm the observations of the presented case report.
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Affiliation(s)
- Vasilios Alevizakos
- Department of Digital Technologies in Dentistry and CAD-CAM Danube Private University Krems an der Donau Austria
| | - Gergo Mitov
- Department of Prosthodontics and Biomaterials Danube Private University Krems an der Donau Austria
| | - Marcus Schiller
- Department of Oral and Maxillofacial Surgery Hannover Medical School Hanover Germany
| | - Constantin von See
- Department of Digital Technologies in Dentistry and CAD-CAM Danube Private University Krems an der Donau Austria
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Preclinical evaluation of a 3D-printed hydroxyapatite/poly(lactic-co-glycolic acid) scaffold for ridge augmentation. J Formos Med Assoc 2020; 120:1100-1107. [PMID: 33191094 DOI: 10.1016/j.jfma.2020.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/16/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/PURPOSE Supracrestal ridge augmentation (SRA) is a major challenge for clinicians. This study investigated the efficacy of a 3D-printed (3DP) hydroxyapatite/poly(lactic-co-glycolic acid) (HA/PLGA) scaffold as a potential biologic for SRA. METHODS Scaffolds that were 5 mm in diameter and 2.5-mm thick with a 1.2-mm diameter through-and-through central hole composed of 90% HA and 10% PLGA were printed using an extrusion-based bioprinter. The HA/PLGA scaffold was fixed with a 1.2-mm titanium mini-implant on the buccal surface of rat mandible (Ti-HPS), and the outcome of SRA were compared with sites treated with a titanium mini-implant alone (control) and a titanium mini-implant covered with deproteinized bovine bone-derived matrix (Ti-DBBM) at 4 and 8 weeks by microcomputed tomography (micro-CT), back-scattered SEM, and histology assessments. RESULTS The HA/PLGA scaffolds were 2.486 ± 0.082 mm thick with an outer diameter of 4.543 ± 0.057 mm and an inner diameter of 1.089 ± 0.045 mm, and the pore dimensions were 0.48-0.52 mm. There was significantly more mineralized tissue in the Ti-DBBM and Ti-HPS groups than in the control group at both time points. Newly formed bone (NB) was well-integrated with the DBBM and HA/PLGA scaffolds. The framework of the 3DP-HA/PLGA scaffold remained in place, and NB-implant contact (NBIC) was advanced to the middle level in the Ti-HPS group until 8 weeks, whereas dispersion of DBBM with a lower level NBIC was noted in the Ti-DBBM group at both time points. CONCLUSION The 3DP HA/PLGA scaffold maintains supracrestal space and demonstrates osteoconductivity to facilitate SRA.
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Yu N, Nguyen T, Cho YD, Kavanagh NM, Ghassib I, Giannobile WV. Personalized scaffolding technologies for alveolar bone regenerative medicine. Orthod Craniofac Res 2019; 22 Suppl 1:69-75. [PMID: 31074155 DOI: 10.1111/ocr.12275] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2018] [Indexed: 01/09/2023]
Abstract
The reconstruction of alveolar bone defects associated with teeth and dental implants remains a clinical challenge in the treatment of patients affected by disease or injury of the alveolus. The aim of this review was to provide an overview on advances made in the use of personalized scaffolding technologies coupled with biologics, cells and gene therapies that offer future clinical applications for the treatment of patients requiring periodontal and alveolar bone regeneration. Over the past decade, advancements in three-dimensional (3D) imaging acquisition technologies such as cone-beam computed tomography (CBCT) and precise scaffold fabrication methods such as 3D bioprinting have resulted in personalized scaffolding constructs based on individual patient-specific anatomical data. Furthermore, 'fiber-guiding' scaffold designs utilize topographical cues to guide ligamentous fibers to form in orientation towards the root surface to improve tooth support. Therefore, a topic-focused literature search was conducted looking into fiber-guiding and image-based scaffolds and their associated clinical applications.
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Affiliation(s)
- Ning Yu
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Trang Nguyen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Young D Cho
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan.,Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Nolan M Kavanagh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Iya Ghassib
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, College of Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan.,Biointerfaces Institute, University of Michigan North Campus Research Complex, Ann Arbor, Michigan
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Jian B, Wu W, Song Y, Tan N, Ma C. Microporous elastomeric membranes fabricated with polyglycerol sebacate improved guided bone regeneration in a rabbit model. Int J Nanomedicine 2019; 14:2683-2692. [PMID: 31043781 PMCID: PMC6472284 DOI: 10.2147/ijn.s192167] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Purpose We aimed to fabricate guided bone regeneration (GBR) membrane using polyglycerol sebacate (PGS) and investigate the impact of scaffold pore size on osteogenesis. Materials and methods PGS microporous membrane was fabricated by salt-leaching technique with various pore sizes. Twenty-eight male New Zealand rabbits were randomly divided into four groups: 25 µm PGS membrane, 53 µm PGS membrane, collagen membrane, and blank control group. Subsequently, standardized and critical-sized tibia defects were made in rabbits and the defective regions were covered with the specifically prepared membranes. After 4 and 12 weeks of in vivo incubation, bone samples were harvested from tibia. Micro-computed tomography scanning was performed on all bone samples. A three-dimensional visible representation of the constructs was obtained and used to compare the ratios of the ossifying volume to total construct volume (bone volume to tissue volume [BV/TV]) of each sample in different groups; then, bone samples were stained with H&E and Masson's trichrome stain for general histology. Results At 4 weeks, the BV/TV in the 25 µm PGS group was found higher than that in the 53 µm PGS and collagen groups. At 12 weeks, the bone defect site guided by the 25 µm PGS membrane was almost completely covered by the new bone. However, the site guided by the 53 µm PGS membrane or collagen membrane was covered only most of the defects and the left part of the defect was unoccupied. Histological observation further verified these findings. Conclusion We thus concluded that the 25 µm PGS membrane played an advantageous role during 4-12 weeks as compared with those earlier degraded counterparts.
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Affiliation(s)
- Bo Jian
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China, .,Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China,
| | - Wei Wu
- Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China,
| | - Yingliang Song
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China,
| | - Naiwen Tan
- Department of Stomatology, Hospital 463 of PLA, Shenyang, Liaoning, People's Republic of China
| | - Chao Ma
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China,
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Yen HH, Stathopoulou PG. CAD/CAM and 3D-Printing Applications for Alveolar Ridge Augmentation. ACTA ACUST UNITED AC 2018; 5:127-132. [PMID: 30505646 DOI: 10.1007/s40496-018-0180-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose of review CAD/CAM and 3D-printing are emerging manufacturing technologies in dentistry. In the field of alveolar ridge augmentation, graft customization utilizing these technologies can result in significant reduction of surgical time. A review of the literature on materials, techniques and applications of CAD/CAM and 3D-printing available for alveolar ridge augmentation was performed. Recent findings CAD/CAM applications for milling of customized block grafts of allogeneic, xenogeneic, and alloplastic origins have been reported, and currently only limited products are commercially available. 3D-printing applications are limited to alloplastic graft materials and containment shells, and have been mostly used in animal studies for optimizing biomaterials' properties. Summary While current data support the potential use of CAD/CAM and 3D-printing for graft customization for alveolar ridge augmentation procedures, additional research is needed on predictability and long-term stability of the grafted sites.
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Affiliation(s)
- Howard H Yen
- Postdoctoral Periodontics Resident, Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Panagiota G Stathopoulou
- Assistant Professor of Periodontics and Director of Postdoctoral Periodontics, Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
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Rankin TM, Wormer BA, Miller JD, Giovinco NA, Al Kassis S, Armstrong DG. Image once, print thrice? Three-dimensional printing of replacement parts. Br J Radiol 2018; 91:20170374. [PMID: 29091482 DOI: 10.1259/bjr.20170374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The last 20 years has seen an exponential increase in 3D printing as it pertains to the medical industry and more specifically surgery. Previous reviews in this domain have chosen to focus on applications within a specific field. To our knowledge, none have evaluated the broad applications of patient-specific or digital imaging and communications in medicine (DICOM) derived applications of this technology. METHODS We searched PUBMED and CINAHL from April 2012 to April 2017. RESULTS 261 studies fulfilled the inclusion criteria. Proportions of articles reviewed: DICOM (5%), CT (38%), MRI (20%), Ultrasonography (28%), and Bio-printing (9%). CONCLUSION There is level IV evidence to support the use of 3D printing for education, pre-operative planning, simulation and implantation. In order to make this technology widely applicable, it will require automation of DICOM to standard tessellation language to implant. Advances in knowledge: Recent lapses in intellectual property and greater familiarity with rapid prototyping in medicine has set the stage for the next generation of custom implants, simulators and autografts. Radiologists may be able to help establish reimbursable procedural terminology.
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Affiliation(s)
- Timothy M Rankin
- 1 Department of Plastic and Reconstructive Surgery, Vanderbilt University , Nashville, TN , USA
| | - Blair A Wormer
- 1 Department of Plastic and Reconstructive Surgery, Vanderbilt University , Nashville, TN , USA
| | - John D Miller
- 2 Baltimore VA Health System, Rubin Institute for Orthopedics , Baltimore, MD , USA
| | | | - Salam Al Kassis
- 1 Department of Plastic and Reconstructive Surgery, Vanderbilt University , Nashville, TN , USA
| | - David G Armstrong
- 4 Department of Surgery, Southwestern Academic Limb Salvage Alliance (SALSA), Keck School of Medicine of University of Southern California , Los Angeles, CA , USA
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Wilke CT, Zaid M, Chung C, Fuller CD, Mohamed ASR, Skinner H, Phan J, Gunn GB, Morrison WH, Garden AS, Frank SJ, Rosenthal DI, Chambers MS, Koay EJ. Design and fabrication of a 3D-printed oral stent for head and neck radiotherapy from routine diagnostic imaging. 3D Print Med 2017; 3:12. [PMID: 29782600 PMCID: PMC5954788 DOI: 10.1186/s41205-017-0021-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 11/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Oral stents have been shown to reduce the deleterious effects of head and neck radiotherapy through the displacement of normal tissues away from the areas of high dose irradiation. While these stents are commonly used in the treatment of patients with head and neck cancer at many large academic cancer centers, their use is much more limited outside of these institutions due to the time and expertise required for their fabrication. Results In the study, we describe a novel method to design and manufacture oral stents from routine computed tomography (CT) imaging studies through the use of 3D printing technologies. Conclusion Our proposed method may help to greatly expand access to these beneficial devices for patients undergoing radiation treatment at centers without access to dental and oral/maxillofacial specialists.
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Affiliation(s)
- Christopher T Wilke
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN USA.,2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Mohamed Zaid
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Caroline Chung
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Clifton D Fuller
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Abdallah S R Mohamed
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Heath Skinner
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Jack Phan
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - G Brandon Gunn
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - William H Morrison
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Adam S Garden
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Steven J Frank
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - David I Rosenthal
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
| | - Mark S Chambers
- 3Department of Head and Neck Surgery, Section of Oral Oncology, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Eugene J Koay
- 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1220 Holcombe Blvd, MS97, Houston, TX 77030 USA
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