title: Custom-Made Synthetic Scaffolds for Bone Reconstruction: A Retrospective, Multicenter Clinical Study on 15 Patients.
abstract: Purpose. To present a computer-assisted-design/computer-assisted-manufacturing (CAD/CAM) technique for the design, fabrication, and clinical application of custom-made synthetic scaffolds, for alveolar ridge augmentation.Methods. The CAD/CAM procedure consisted of (1) virtual planning/design of the custom-made scaffold; (2) milling of the scaffold into the exact size/shape from a preformed synthetic bone block; (3) reconstructive surgery. The main clinical/radiographic outcomes were vertical/horizontal bone gain, any biological complication, and implant survival.Results. Fifteen patients were selected who had been treated with a custom-made synthetic scaffold for ridge augmentation. The scaffolds closely matched the shape of the defects: this reduced the operation time and contributed to good healing. A few patients experienced biological complications, such as pain/swelling (2/15: 13.3%) and exposure of the scaffold (3/15: 20.0%); one of these had infection and complete graft loss. In all other patients, 8 months after reconstruction, a well-integrated newly formed bone was clinically available, and the radiographic evaluation revealed a mean vertical and horizontal bone gain of 2.1 ± 0.9 mm and 3.0 ± 1.0 mm, respectively. Fourteen implants were placed and restored with single crowns. The implant survival rate was 100%.Conclusions. Although positive outcomes have been found with custom-made synthetic scaffolds in alveolar ridge augmentation, further studies are needed to validate this technique.
authors.affiliation: Private Practice, 00193 Rome, Italy.
authors.forename: Fabrizia
authors.identifier: 0000-0001-7998-613X
authors.initials: F
authors.lastname: Luongo
authors.affiliation: Department of Surgical and Morphological Science, Dental School, Insubria University, 21100 Varese, Italy.
authors.forename: Francesco Guido
authors.identifier: 0000-0001-5488-4268
authors.initials: FG
authors.lastname: Mangano
authors.affiliation: Department of Surgical and Morphological Science, Dental School, Insubria University, 21100 Varese, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Macchi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Federico II University, 80131 Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Luongo
authors.affiliation: Department of Dental Sciences, Vita Salute San Raffaele University, 20132 Milan, Italy.
authors.forename: Carlo
authors.identifier: 0000-0002-4419-4674
authors.initials: C
authors.lastname: Mangano
mesh_terms: D000539:Alveolar Process / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods; D001842:Bone and Bones / Q000473:pathology / Q000502:physiology* / Q000601:surgery; D017076:Computer-Aided Design; D015921:Dental Implants; D005260:Female; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D054457:Tissue Scaffolds / Q000737:chemistry*; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants