Maxillary ridge augmentation with custom-made CAD/CAM scaffolds. A 1-year prospective study on 10 patients.
Several procedures have been proposed to achieve maxillary ridge augmentation. These require bone replacement materials to be manually cut, shaped, and formed at the time of implantation, resulting in an expensive and time-consuming process. In the present study, we describe a technique for the design and fabrication of custom-made scaffolds for maxillary ridge augmentation, using three-dimensional computerized tomography (3D CT) and computer-aided design/computer-aided manufacturing (CAD/CAM). CT images of the atrophic maxillary ridge of 10 patients were acquired and modified into 3D reconstruction models. These models were transferred as stereolithographic files to a CAD program, where a virtual 3D reconstruction of the alveolar ridge was generated, producing anatomically shaped, custom-made scaffolds. CAM software generated a set of tool-paths for manufacture by a computer-numerical-control milling machine into the exact shape of the reconstruction, starting from porous hydroxyapatite blocks. The custom-made scaffolds were of satisfactory size, shape, and appearance; they matched the defect area, suited the surgeon's requirements, and were easily implanted during surgery. This helped reduce the time for surgery and contributed to the good healing of the defects.
1  Dental School, University of Varese, Italy.
Francesco
F
Mangano
Aldo
A
Macchi
Jamil Awad
JA
Shibli
Giuseppe
G
Luongo
Giovanna
G
Iezzi
Adriano
A
Piattelli
Alberto
A
Caprioglio
Carlo
C
Mangano
D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods*; D001284:Atrophy; D017076:Computer-Aided Design; D003442:Crowns; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010012:Osteogenesis / Q000502:physiology; D010347:Patient Care Planning; D011446:Prospective Studies; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D023822:Tissue Engineering / Q000295:instrumentation; D054457:Tissue Scaffolds / Q000145:classification*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface
D015921:Dental Implants
Alveolar ridge augmentation; CT; computer-aided design/computer-aided manufacturing (CAD/CAM); custom-made scaffolds