Reconstruction of maxillofacial bone defects using patient-specific long-lasting titanium implants

Abstract

The objective of this retrospective study is to verify the effectiveness and safety of patient-specific titanium implants on maxillofacial bones, with a long-term follow-up. Total 16 patients with various maxillofacial defects underwent reconstruction using patient-specific titanium implants. Titanium implants, manufactured by electron beam melting, selective laser sintering, or milling, were inserted into the maxilla, mandible, or zygoma. Long-term follow‐up (36.7 ± 20.1 months) was conducted after the surgery. Bone fusion of the titanium implant body, postoperative infection, implant malunion, functional results, patient satisfaction, subsidence, osteolysis around the implants, and complications were recorded and analyzed at the last follow-up. Of the 28 implants, only one failed to unite with the bone; therefore, revision surgery was performed. No osteolysis or subsidence around the titanium implants nor adverse events were observed; the mean VAS score for satisfaction was 9. All patients enrolled in this trial were esthetically and functionally satisfied with their surgical results, and fixation failure and esthetic dissatisfaction complications were well resolved. Patient-specific titanium showed satisfactory outcomes when used to treat various oral and maxillofacial defects. A 3D printed titanium implant can be effectively used in the reconstruction of the zygoma and mandible instead of autogenous bone without donor site morbidity.

An innovative additively manufactured implant for mandibular injuries: Design and preparation processes based on simulation model

“…Subsequently, the patient-specific titanium plates utilized to reconstruct maxillofacial bone defects were of great interest. Lim et al (2022) conducted a long-term follow-up of 16 patients who underwent reconstruction using patient-specific titanium plates. Albeit this customized-plates reduced fixation failure and aesthetically unsatisfactory complications, it cannot rehabilitate the masticatory function, which remains a deficiency.…”

A Novel Method to Reconstruct the Upper and Lower Jaws Using 3D-Custom-Made Titanium Implants

“… 1 – 9 Reviewing the literature several reports were published on the use of 3D printing techniques to reconstruct the mandible. 6 – 10 However, few studies were reported on the use of 3D-custom-made implants to reconstruct the maxilla. These mainly focused on the use of 3D subperiosteal implants to reconstruct the atrophic maxilla.…”

“…Rather than reconstructing large bony defects of the maxilla after ablative tumor surgery. 1 – 6 Mastication and pronunciation are important functions of the mandible and maxilla that can be restored with dental rehabilitation. The use of 3D-custom-made implants for occlusal rehabilitation is limited in that dental implants cannot be installed into the custom-made implant body itself during the fabrication process.…”

“… 1 – 6 The advantage of 3D-custom-made titanium implants is that they can be accurately designed according to the defect size and morphology. 1 – 6 This will reduce the operative time and also recover the original contour of the mandible and maxilla achieving an optimal facial symmetry. Also, the placement of 3D implants after ablative cancer surgery is an advantage, especially when the oncology treatment requires postoperative radiotherapy for disease control because it avoids the issue of secondary surgery in irradiated tissues.…”

Recent Advancements and Trends in 3D Printing for Biomedical Applications

“…35 Titanium/Ti6Al4V are involved in bone tissue remodeling, bone defect repair, knee implant, etc. 34,36,37 Gold nanotubes or nanowires can be combined with decellularized extracellular matrix to form hydrogel for tissue engineering 38 or directly used for medical implant 39 .…”