Clinical evaluation of 3D printed nano-porous hydroxyapatite bone graft for alveolar ridge preservation: A randomized controlled trial

Abstract

Background/purpose Ridge resorption after tooth extraction may result in inadequate bone volume and unfavorable ridge architecture for ideal implant placement. The use of bone substitutes has been advocated to fill extraction sites and to enhance primary implant stability. This study was made to evaluate the clinical efficacy of novel 3D printed nano-porous hydroxyapatite (3DP HA, test group) in comparison to nano-crystalline bone graft (NanoBone®, control group) in alveolar ridge preservation prior to implant placement. Materials and methods Thirty patients were randomized into two groups following tooth extraction. All extracted sockets were filled with 3DP HA or NanoBone® and covered with a non-resorbable membrane. After four months, cone-beam computed tomography (CBCT) and intraoral scanner were used to measure dimensional changes of bone and soft tissue surface. Bone core specimens were harvested for histological analysis during implant osteotomy. Implant stability was assessed using a modified damping capacity analysis. Results At four months postoperatively, dimensional changes in soft tissue surface resorption were less in the test group than in the control group; however, alveolar bone resorption was the same in both groups. Histological analysis revealed new bone formation, residual graft and fibrous connective tissue in both groups. The average primary implant stability (IST) value for both groups was approximately 70. There was no statistically significant difference in all parameters between two groups (p > 0.05). Conclusion 3DP HA could potentially be used as an alternative bone graft material for alveolar ridge preservation.

Customized 3D printed nanohydroxyapatite bone block grafts for implant sites: A case series

“…The second layer of the 3DHA block graft, which is composed of xenogenic bone graft, may also slow down the resorption of 3DHA. It could also increase the volume of the graft area [17,51]. These findings agree with the hypothesis that xenografts added to autogenous block grafts lead to less resorption compared with autogenous block grafts alone [55].…”

“…At higher magnification, newly formed bone was observed around the graft particles and blood vessels. Histomorphometric analysis revealed that the percentages of bone tissue, new bone formation, residual graft, and connective tissue were similar to the results from our previous study [51]. At six months, 3DHA remained at the recipient site and was completely integrated into the graft site, which suggests that it could be a space maintainer and ideal material for alveolar bone augmentation.…”

“…No significant resorption or nonfixation of the graft was observed. The same method of measurement was used as in previous studies [51,52]. Mean maximum horizontal bone gain was 3.56 ± 0.45 mm.…”

Additive Manufacturing of Bioceramic Implants for Restoration Bone Engineering: Technologies, Advances, and Future Perspectives

“…Micro-CT analysis after 4 and 12 weeks of implantation indicated that the implant significantly stimulated new bone production (Figure f). Borvornwu et al verified the restoration effect of additively manufactured nano-HA in alveolar bone, where implants were filled with the new bone around both the root tip and crown after implantation and showed significant degradation and resorption after some time. The additive manufacturing technologies of HA are diverse and comparatively sophisticated.…”

Mechanism and application of 3D-printed degradable bioceramic scaffolds for bone repair

“…Encouragingly, several combinations of bioceramic and 3D printing technologies appear promising for clinical use, particularly 3D-printed TCP and HA scaffolds that have been successfully tested in humans, suggesting that biodegradable bioceramic scaffolds can be used as reliable bone graft materials to facilitate the bone repair and bone remodeling. 206,209 Researchers have demonstrated a digital approach for creating customized clinical-scale CP scaffolds that can be transplanted into alveolar bone defects using 3D imaging, design, and printing. In addition, a strong foundation for future studies to evaluate personalized medical approaches to treat alveolar bone defects was established.…”