Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation—A New Method for Regeneration

Abstract

For sinus grafting, different methods and materials are available. One possible shortcoming of particulate bone grafts is either overfilling or augmenting the planned implant area insufficiently. To overcome this risk and to determine the implant position prior augmentation, we present an approach using three-dimensional printed scaffolds. A patient with a remaining anterior dentition and bilateral severely atrophied posterior maxilla was seeking oral rehabilitation. The cone beam computed tomography (CBCT) showed residual bone heights between one and two millimeters. Following the three-dimensional reconstruction of the CBCT data, the positions of the implants were determined in areas 16 and 26. Three-dimensional scaffolds adapted to the topography of the sinus were virtually designed and printed using a calcium phosphate cement paste. Bilateral sinus floor augmentation applying the printed scaffolds with an interconnecting porosity followed. After nine months, a satisfying integration of the scaffolds was obvious. At the re-entry, vital bone with sufficient blood supply was found. One implant could be placed in positions 16 and 26, respectively. After five months, the implants could be uncovered and were provided with a temporary denture. The application of three-dimensionally printed scaffolds from calcium phosphate cement paste seems to be a promising technique to graft the severely atrophied posterior maxilla for the placement of dental implants.

Additive manufacturing of individual bone implants made of bioresorbable calcium phosphate cement using the example of large skull defects

“…The work in this paper is based on a process consisting primarily of six steps, which has been established for the development of customized medical implants (Pendzik et al, 2021;Schulz et al, 2023). The process chain primarily takes into account data acquisition, data preparation, planning, design, preprocessing and manufacturing (Figure 2).…”

Further Development of the Design Process for Hybrid Individual Implants

“…There are also customisable implants made of lattice-like titanium bearing structures and biocompatible matrix (OssDesign AB, 2021). In contrast, there exist pasty calcium phosphate preparations (CPC) that allow the near-net-shape production of cellular shaped bodies without additional post-processing by means of 3D printing processes (INNOTERE GmbH, 2021;Heinemann et al, 2013;Schulz et al 2019;Kilian et al, 2021). By using filling structures made of biocompatible plastics, complex near-net-shape implants can be manufactured (Holtzhausen et al 2019).…”

CBCT-Based Design of Patient-Specific 3D Bone Grafts for Periodontal Regeneration

“…On the other hand, both grafts created using the proposed workflow are patient-specific bone grafts, exactly fitted to the hard tissues of the patient's periodontal defect. In spite of the fact that a few limited research articles tackle the issue of patient-specific scaffolds using CBCT data, such as [46][47][48], they do not reveal any technical details of the scaffold-designing process, which our article emphasizes, with the aim to establish an optimal workflow that may be followed for patient-specific scaffold design. What is more, the novelty of our design relies on the fact that with the reported workflow, one is able to represent with a great deal of detail osseous defects fine in dimensions and, thus, to design scaffolds that match the defects with high accuracy.…”

“…Favorable results were obtained up to 12 months after the scaffold was placed on the patient. The generation of scaffolds using CBCT data has also been proposed in [46][47][48] for the reconstruction of alveolar bone defects. However, the research conducted so far on the 3D design of periodontitis scaffolds using CBCT data is very limited.…”