title: Direct metal laser sintering (DMLS) of a customized titanium mesh for prosthetically guided bone regeneration of atrophic maxillary arches.
abstract: This study describes a protocol for the direct manufacturing of a customized titanium mesh using CAD-CAM procedures and rapid prototyping to augment maxillary bone and minimize surgery when severe atrophy or post-oncological deformities are present. Titanium mesh and particulate autogenous plus bovine demineralised bone were planned for patient rehabilitation. Bone augmentation planning was performed using the pre-op CT data set in relation to the prosthetic demands, minimizing the bone volume to augment at the minimum necessary for implants. The containment mesh design was used to prototype the 0.6 mm thickness customized titanium mesh, by direct metal laser sintering. The levels of regenerated bone were calculated using the post-op CT data set, through comparison with the pre-op CT data set. The mean vertical height difference of the crestal bone was 2.57 mm, while the mean buccal-palatal dimension of thickness difference was 3.41 mm. All planned implants were positioned after an 8 month healing period using two-step implant surgery, and finally restored with a partial fixed prosthesis. We present a viable and reproducible method to determine the correct bone augmentation prior to implant placement and CAD-CAM to produce a customized direct laser-sintered titanium mesh that can be used for bone regeneration.
authors.affiliation: Section of Prosthodontics, Department of Oral Science, Alma Mater Studiorum, University of Bologna, via S. Vitale 59, 40125 Bologna, BO, Italy. leonardo.ciocca@unibo.it
authors.forename: L
authors.initials: L
authors.lastname: Ciocca
authors.forename: M
authors.initials: M
authors.lastname: Fantini
authors.forename: F
authors.initials: F
authors.lastname: De Crescenzio
authors.forename: G
authors.initials: G
authors.lastname: Corinaldesi
authors.forename: R
authors.initials: R
authors.lastname: Scotti
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000295:instrumentation* / Q000379:methods; D001861:Bone Regeneration / Q000502:physiology*; D016025:Bone Transplantation / Q000379:methods; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000379:methods; D004867:Equipment Design; D006801:Humans; D008297:Male; D008437:Maxilla / Q000502:physiology / Q000601:surgery*; D008439:Maxillary Diseases / Q000601:surgery*; D008875:Middle Aged; D013526:Surgical Mesh; D014025:Titanium
chemical_list: D014025:Titanium