Bone augmentation using bioresorbable mesh domes containing bone graft granules

Bone graft granules are valuable tools for ridge area bone grafting owing to their ease of manipulation and interconnected porous structure. Guided bone regeneration (GBR) using barrier membranes is commonly used for alveolar ridge augmentation; however, the surgical procedures are technically complicated. In this study, we fabricated bioresorbable mesh domes (BMDs) using two types of Vicryl mesh (woven and knitted types) containing carbonate apatite granules. BMD samples were prepared in three groups: upper sides made from the woven type (UW) and lower sides made from the woven type (LW) (the UW/LW group), upper sides made from the woven type (UW) and lower sides made from the knitted type (LK) (the UW/LK group), and upper sides made from the knitted type (UK) and lower sides made from the knitted type (LK) (the UK/LK group). The samples were subsequently implanted into rabbit calvaria, and radiomorphometric and histological analyses were conducted. The UK/LK group exhibited enhanced appositional bone formation because the knitted mesh on the skin side prevented the infiltration of a substantial amount of fibrous tissue. This increase in bone formation could be attributed to the interaction between granules and osteoprogenitors that pass through the mesh from the host bone. Conversely, the UW/LW and UW/LK groups presented limited appositional bone formation. Compared with knitted mesh, woven mesh might tend to be absorbed over a short span, allowing fibrous tissue invasion and inhibiting new bone formation. Additionally, BMDs could retain granules in a targeted location and avoid displacement of the granules to unintended locations.

Utilization of Tenting Pole Abutments for the Reconstruction of Severely Resorbed Alveolar Bone: Technical Considerations and Case Series Reports

INTRODUCTION

Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient's edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device.

CASE PRESENTATION

The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension.

CONCLUSIONS

In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5-6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation.

The influence of vertical ridge augmentation techniques on peri-implant bone loss: A systematic review and meta-analysis

INTRODUCTION

The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to peri-implant bone loss (PBL), after at least 12 months of functional loading.

MATERIAL AND METHODS

The search was conducted to find all the studies about VRA and measurements of PBL with at least 12 months follow-up. Three pairwise meta-analysis (MA) was performed to completely evaluate the outcomes.

RESULTS

A total of 42 studies were included, of which 11 were randomized clinical trials (RCTs). RCTs were available only for guided bone regeneration (GBR), onlay, and inlay techniques. The weighted mean estimate (WME) of PBL value was found to be 1.38 mm (95% confidence interval [95% CI]: 1.10-1.66) after a mean follow-up of 41.0 ± 27.8 months. GBR, Inlay, Onlay, osteodistraction, and SBB represented in weight 32.9%, 30.6%, 25.0%, 7.6%, and 3.9%, respectively; and their WME (95% CI) were 1.06 (0.87-1.26) mm, 1.72 (1.00-2.43) mm, 1.31 (0.87-1.75) mm, 1.81 (0.87-1.75) mm, and 0.66 (0.55-0.77) mm, respectively. Among the secondary outcomes, the analysis was conducted for vertical bone gain, healing complication rate, surgical complication rate, implant survival, and success rate.

CONCLUSIONS

The primary findings of the meta-analysis, based on the changes between final and baseline values, showed that the peri-implant bone loss could be influenced by the type of intervention but there is a need to evaluate in RCTs the behavior of the peri-implant bone levels after long-term follow-up for all techniques.

Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review

Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.

Polymeric Scaffolds for Dental, Oral, and Craniofacial Regenerative Medicine

Dental, oral, and craniofacial (DOC) regenerative medicine aims to repair or regenerate DOC tissues including teeth, dental pulp, periodontal tissues, salivary gland, temporomandibular joint (TMJ), hard (bone, cartilage), and soft (muscle, nerve, skin) tissues of the craniofacial complex. Polymeric materials have a broad range of applications in biomedical engineering and regenerative medicine functioning as tissue engineering scaffolds, carriers for cell-based therapies, and biomedical devices for delivery of drugs and biologics. The focus of this review is to discuss the properties and clinical indications of polymeric scaffold materials and extracellular matrix technologies for DOC regenerative medicine. More specifically, this review outlines the key properties, advantages and drawbacks of natural polymers including alginate, cellulose, chitosan, silk, collagen, gelatin, fibrin, laminin, decellularized extracellular matrix, and hyaluronic acid, as well as synthetic polymers including polylactic acid (PLA), polyglycolic acid (PGA), polycaprolactone (PCL), poly (ethylene glycol) (PEG), and Zwitterionic polymers. This review highlights key clinical applications of polymeric scaffolding materials to repair and/or regenerate various DOC tissues. Particularly, polymeric materials used in clinical procedures are discussed including alveolar ridge preservation, vertical and horizontal ridge augmentation, maxillary sinus augmentation, TMJ reconstruction, periodontal regeneration, periodontal/peri-implant plastic surgery, regenerative endodontics. In addition, polymeric scaffolds application in whole tooth and salivary gland regeneration are discussed.

Effectiveness of xenogeneic and synthetic bone-block substitute materials with/without recombinant human bone morphogenetic protein-2: A preclinical study using a rabbit calvarium model

AIM

To investigate new bone (NB) formation by using bone-block substitute materials with/without recombinant human bone morphogenetic protein-2 (rhBMP-2).

MATERIALS AND METHODS

Three synthetic bone-block substitute materials [biphasic calcium phosphate (BCP); nanostructured hydroxyapatite (NH); 3D-printed tricalcium phosphate/hydroxyapatite (3DP)] and one xenogeneic deproteinized bovine bone mineral (DBBM) block substitute were affixed to rabbit calvarium using osteosynthesis screws, either with rhBMP-2 (n = 12) or without rhBMP-2 (n = 16). At 2 or 12 weeks (n = 6 with rhBMP-2 and n = 8 without rhBMP-2 for each week), histologic, histomorphometric and microcomputed tomography analyses were performed.

RESULTS

The application of rhBMP-2 increased NB formation in all experimental groups at both weeks. DBBM resulted in a greater area of NB compared with synthetic blocks either with or without rhBMP-2 at 2 weeks (2.8 ± 0.9 vs. 1.4 ± 0.5-1.9 ± 1.4 mm² ; 1.4 ± 1.0 vs. 0.6 ± 0.3-0.9 ± 0.5 mm² ) and without rhBMP-2 at 12 weeks (3.0 ± 0.8 vs. 1.7 ± 0.7-2.6 ± 1.5 mm² ) (p > 0.05). NB formation did not differ significantly for DBBM and the three types of synthetic block with rhBMP-2 at 12 weeks (4.5 ± 2.0 vs. 3.8 ± 0.7-5.1 ± 1.1 mm² ; p > 0.05).

CONCLUSIONS

rhBMP-2 enhanced NB in all blocks. DBBM blocks yielded more NB than synthetic blocks without rhBMP-2. The application of rhBMP-2 appears to compensate for differences in late healing.

Mineralized Plasmatic Matrix for Horizontal Ridge Augmentation in Anterior Maxilla with and without a Covering Collagen Membrane

Background:

Mineralized Plasmatic Matrix [MPM] is a unique form of platelet rich fibrin that contains mineralized bone graft particles within a fibrin network.

Aim:

This study was conducted to evaluate horizontal ridge augmentation using MPM with and without a coverage membrane.

Materials and Methods:

Sixteen edentulous spaces were randomly divided into 2 equal groups. MPM was used for horizontal ridge augmentation with and without a covering collagen membrane (group 1 and 2, respectively). Cone Beam CT images were obtained preoperatively as well as 1 week and 4 months postoperatively to evaluate alveolar ridge and the resorption of the grafting material at 3 predetermined points along with the site where the future dental implant will be placed.

Student’s t-test (Unpaired) was used for comparing two different groups with quantitative parametric data and student’s t-test (Paired) was used for comparing two related groups with quantitative parametric data while repeated measures ANOVA (Analysis of variance) followed by post-hoc Bonferroni was used for comparing more than two related groups with quantitative parametric data.

Student’s t-test (Unpaired) was used for comparing two different groups with quantitative parametric data and student’s t-test (Paired) was used for comparing two related groups with quantitative parametric data while repeated measures ANOVA (Analysis of variance) followed by post-hoc Bonferroni was used for comparing more than two related groups with quantitative parametric data.

Results:

There was no statistically significant difference between the gained bone width in both groups. More but not statistically significant resorption was recorded in group 2.

Conclusion:

MPM can be successfully used for horizontal ridge augmentation without a barrier membrane.

Allogeneic cortical struts and bone granules for challenging alveolar reconstructions: An innovative approach toward an established technique

OBJECTIVE

The shell technique is a well-established procedure for GBR with which extensive osseous defects can be predictably restored by using cortical bone struts harvested from various intraoral aspects. Recent publications have demonstrated comparable results for autologous and allogeneic bone grafts, whereas the evidence on allogeneic cortical struts remains limited.

CLINICAL CONSIDERATIONS

In this case series, we demonstrate the regeneration of five complex alveolar bone defects in four patients with subsequent insertion of fixed dental implants. In all cases, cortical struts made from human donor bone were applied in combination with allogeneic bone granules and collagen membranes.

CONCLUSIONS

Similar to autologous cortical shells, the allogeneic struts functioned by creating an immobile container with which the osseous defects in all patients could be successfully restored, enabling placement of dental implants in accordance with the treatment plan. Even when the containers were solely filled with allogeneic granules, vascularized healthy tissue was present at re-entry, demonstrating the vast potential of these materials for applications in dentistry.

CLINICAL SIGNIFICANCE

Especially when it comes to regeneration of complex alveolar bone defects, autologous bone grafts are often outlined as the only treatment modality. Here we show that innovative biomaterials like allogeneic bone grafts hold the potential to mimic the functions of autologous bone transplants and provide excellent clinical results without the requirement of a second surgical side for bone harvesting and no risk of donor-site morbidity.

Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts: A systematic review and meta-analysis

BACKGROUND

This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis.

MATERIAL AND METHODS

An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates.

RESULTS

Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts.

CONCLUSIONS

Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings.

Platelet-rich fibrin and collagen membrane in the preservation of the alveolar bone: Feasibility of the elemental inorganic composition and scanning electron microscopy analysis

The success of dental implants is related to the amount, quality, and composition of the alveolar bone. The placement of platelet-rich fibrin (PRF) clot associated with a resorbable collagen membrane (RCM) in a postextraction alveolus is a technique used for ridge preservation. This case report study analyzed the ultrastructural characteristics of cross-sectioned alveolar bone that received PRF and RCM using scanning electron microscopy and the inorganic composition using "energy dispersive X-ray spectrometry," in order to explore the feasibility of this method to clinical studies. Three alveolar bone samples from two male patients (37 and 58 years old), obtained in the procedure of placing the dental implant, were analyzed. Two bone samples previously received PRF and RCM (M37 and M58), the third sample represented a physiological bone formation without treatment (M37-control). The bone sample M37 showed irregularly shaped islets of calcified material intermingled with connective tissue. The other samples, from the 58-year-old patient with PRF and RCM (M58); and the other untreated bone sample from the same 37-year-old patient (M37-control) showed similar ultrastructural morphology with trabecular conformation without islets agglomerations. The inorganic composition analysis showed higher concentrations of calcium and phosphorus in both samples treated with PRF and RCM in comparison to the untreated bone sample. The Ca/P ratio was higher in the M37 sample compared to the others samples. The results showed morphology and inorganic composition differences among the treatments used, suggesting that this method is feasible to analyze parameters of the alveolar bone tissue.

Dental alloplastic bone substitutes currently available in Korea

As dental implant surgery and bone grafts were widely operated in Korean dentist, many bone substitutes are commercially available, currently. For commercially used in Korea, all bone substitutes are firstly evaluated by the Ministry of Health and Welfare (MOHW) for safety and efficacy of the product. After being priced, classified, and registration by the Health Insurance Review and Assessment Service (HIRA), the post-application management is obligatory for the manufacturer (or representative importer) to receive a certificate of Good Manufacturing Practice by Ministry of Food and Drug Safety. Currently, bone substitutes are broadly classified into C group (bone union and fracture fixation), T group (human tissue), L group (general and dental material) and non-insurance material group in MOHW notification No. 2018-248. Among them, bone substitutes classified as dental materials (L7) are divided as xenograft and alloplastic bone graft. The purpose of this paper is to analyze alloplastic bone substitutes of 37 products in MOHW notification No. 2018-248 and to evaluate the reference level based on the ISI Web of Knowledge, PubMed, EMBASE (1980–2019), Cochrane Database, and Google Scholar using the criteria of registered or trademarked product name.

Marginal and internal fit of 3D printed resin graft substitutes mimicking alveolar ridge augmentation: An in vitro pilot study

Recent improvements in additive manufacturing technologies may facilitate the use of customized 3D printed grafts for horizontal and vertical augmentation of the atrophic alveolar ridge. The accurate fit of such grafts could reduce the clinical treatment time and contribute optimal bone regeneration. The aim of this in vitro study was to evaluate the marginal and internal fit of 3D printed resin grafts as they could be used for alveolar ridge augmentation. Alveolar ridge morphologic data were derived from the Cone Beam Computed Tomography (CBCT) scans of six patients with alveolar bone defects. These data were transferred to a segmentation program to produce virtual 3D reconstructions of the alveolar ridge models. Using a Computer Aided Design (CAD) program, the alveolar bone defects were defined and customized grafts were designed and both the defects as well as the grafts generated (CAM) as 3D projects. These projects were imported into a 3D printer and were manufactured in resin. Hereafter, the grafts were fitted to the defect sites of the corresponding models and new CBCT scans were performed. Based on these scans, measurements were made at the marginal and internal part of the fitted grafts to evaluate the marginal and internal fit, respectively. The statistical analysis revealed that the mean marginal fit was significantly better (P < 0.05) than the mean internal fit. The fit of the grafts was dependent on the shape and on the size of the grafts. Specifically, the total void surface between the fitted graft and the corresponding defect site was significantly larger in the large-defect grafts than the small-defect grafts (P < 0.05). Within the limitations of the study, it could be demonstrated that it is possible to fabricate 3D printed resin grafts with acceptable fit in customized shapes, when combining CBCT scans and computer aided design and 3D printing techniques.

A New Method for Partial Breast Reconstruction: 3-Year New Zealand Experience

In New Zealand, oncoplastic surgery is common, but partial breast reconstruction presents challenges for radiation therapy targeting. Tissue rearrangement creates ambiguity when targeting the tumor bed, with resultant overestimation of treatment volumes. Thus, adoption of advanced methods of radiation therapy have been hindered. This pilot study describes use of a novel three-dimensional implant that provides a scaffolding for tissue ingrowth during partial breast reconstruction and delineates the tumor bed more precisely to assist radiation planning and mammographic surveillance. After informed consent, 15 women were implanted with the three-dimensional bioabsorbable implant. The device was sutured to the tumor bed during lumpectomy, and tissue flaps were mobilized and attached to the implant. Visualization of the marker and radiation treatment volumes were recorded and compared. The implant provided volume replacement and helped to maintain breast contour. Cosmetic outcomes were excellent; no device- or radiation-related complications occurred. One patient had a postoperative hematoma that resolved after percutaneous drainage; there were no postoperative infections. Three-year follow-up shows no tumor recurrences and no untoward effects. When compared to conventional radiation targeting, use of the implant showed that a greater than 50 percent reduction in treatment volume was possible in some cases. Three-year mammograms show no significant artifact, normal tissue ingrowth, and minimal fibrosis. This study describes a method of oncoplastic breast reconstruction using an implantable device that marks the site of tumor excision and provides for volume replacement with tissue ingrowth. Patients tolerated it well, and radiation therapy planning, positioning, and treatment were facilitated.

Nasal Dorsal Augmentation with Freeze-Dried Allograft Bone: 10-Year Comprehensive Review

Supplemental Digital Content is available in the text.

Background:

The aim of this study was to evaluate freeze-dried cortical allograft bone for nasal dorsal augmentation. The 42-month report on 18 patients was published in 2009 in Plastic and Reconstructive Surgery with 89 percent success at level II evidence, and this article is the 10-year comprehensive review of 62 patients.

Methods:

All grafts met standards recommended by the American Association of Tissue Banks, the U.S. Food and Drug Administration, and the Centers for Disease Control and Prevention. Objective evaluation of the persistence of graft volume was obtained by cephalometric radiography, cone beam volumetric computed tomography, and computed tomography at up to 10 years. Vascularization and incorporation of new bone elements within the grafts were demonstrated by fluorine-18 sodium fluoride positron emission tomography at up to 10 years. Subjective estimation of graft volume persisting up to 10 years was obtained by patient response to a query conducted by an independent surveyor.

Results:

The authors report objective proof of persistence of volume alone or combined with proof of neovascularization in 16 of 19 allografts. The authors report the patient’s subjective opinion of volume persistence in 37 of 43 grafts. The dorsal augmentation was assessed overall to be successful in 85 percent of 62 patients evaluated between 1 and 10 years, with a mean of 4.7 years.

Conclusions:

Freeze-dried allograft bone is a safe and equal alternative for dorsal augmentation without donor-site morbidity. Further studies are needed to (1) confirm these findings for young patients needing long-term reconstruction, and (2) partially demineralize allograft bone to allow carving with a scalpel.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.

Bilateral maxillary augmentation using CAD/CAM manufactured allogenic bone blocks for restoration of congenitally missing teeth: A case report

OBJECTIVE

Various biomaterials have been successfully applied in alveolar bone regeneration, however, the reconstruction of extensive osseous defects remains challenging and is often unfeasible with granular grafting materials. Several studies have outlined allogenic bone blocks as valid alternative to autologous block grafting.

CLINICAL CONSIDERATIONS

In this report, we demonstrate the regeneration of two large osseous defects in the maxilla with allogenic bone blocks made from human donor bone. The bone blocks were customized using the CAD/CAM technology in order to enable the insertion of four dental implants.

CONCLUSIONS

Both blocks perfectly matched the defect geometry, showed limited resorption, led to the formation of sufficient amounts of mineralized bone in both horizontal and vertical dimensions and enabled the installation of implants according to the treatment plan. The implementation of innovative technologies for individualization of allogenic bone blocks simplifies the restoration of complex and extensive osseous defects and poses great benefits for both practitioners and patients.

CLINICAL SIGNIFICANCE

The here presented procedure demonstrates the successful regeneration of two extensive osseous defects in a patient suffering from hypodontia using two CAD/CAM manufactured allogenic bone blocks, rendering the procedure far less invasive as compared to guided bone regeneration carried out with autologous transplants. Furthermore, to the best of our knowledge, this is the first case report that radiographically demonstrates the new formation of a cortical bone layer following block grafting with solely cancellous bone blocks.

Comparative Investigation of Cutting Devices on Bone Blocks: An SEM Morphological Analysis

Background: Bone regeneration is a reliable technique when the bone volume is insufficient to provide a functional and aesthetic outcome in surgery and implantoprosthesis procedures. When bone blocks are used but do not match the shape of the defect, the block must be adapted. The aim of our research was to evaluate, by Scanning Electron Microscopy (SEM) morphological observation, how different cutting devices modify the bone surface. Method: Four equine bone blocks were divided into 15 cubic shape samples with ultrasonic and sonic tips, as well as diamond, tungsten carbide, and Lindemann burs. The uncut surface of the obtained bone block was used as a control. Two observers independently analyzed the SEM observation recording, including cut precision, depth of incision, thermal damages, and presence of bone debris. For each group, sharpness, depth, carbonization, and bone debris were expressed as mean values. Results: The osteotomy performed with an ultrasonic tip shows the best results, preserving the bone morphology in both quantitative and qualitative analyses. The bone surface appeared sufficiently clean from debris and showed a reduced presence of carbonization. Conclusion: The shaping of the bone block as in vivo osteotomy respects the bone morphology and allows it to achieve the relevant biological and clinical outcome.

Additive Manufacturing for Guided Bone Regeneration: A Perspective for Alveolar Ridge Augmentation

Three-dimensional (3D) printing has become an important tool in the field of tissue engineering and its further development will lead to completely new clinical possibilities. The ability to create tissue scaffolds with controllable characteristics, such as internal architecture, porosity, and interconnectivity make it highly desirable in comparison to conventional techniques, which lack a defined structure and repeatability between scaffolds. Furthermore, 3D printing allows for the production of scaffolds with patient-specific dimensions using computer-aided design. The availability of commercially available 3D printed permanent implants is on the rise; however, there are yet to be any commercially available biodegradable/bioresorbable devices. This review will compare the main 3D printing techniques of: stereolithography; selective laser sintering; powder bed inkjet printing and extrusion printing; for the fabrication of biodegradable/bioresorbable bone tissue scaffolds; and, discuss their potential for dental applications, specifically augmentation of the alveolar ridge.