Ivanovski Sašo, Staples Reuben, Arora Himanshu, Vaquette Cedryck, Alayan Jamil
The University of Queensland, School of Dentistry, Herston, Queensland, Australia.
Centre for Orofacial Regeneration Reconstruction and Rehabilitation (COR3) Herston, Herston, Queensland, Australia.
Clin Oral Implants Res. 2024 Dec;35(12):1655-1668. doi: 10.1111/clr.14340. Epub 2024 Aug 7.
This case report demonstrates the effective clinical application of a 3D-printed, patient-specific polycaprolactone (PCL) resorbable scaffold for staged alveolar bone augmentation.
To evaluate the effectiveness of a 3D-printed PCL scaffold in facilitating alveolar bone regeneration and subsequent dental implant placement.
A 46-year-old man with a missing tooth (11) underwent staged alveolar bone augmentation using a patient-specific PCL scaffold. Volumetric bone gain and implant stability were assessed. Histological analysis was conducted to evaluate new bone formation and graft integration.
The novel approach resulted in a volumetric bone gain of 364.69 ± 2.53 mm, sufficient to reconstruct the original alveolar bone contour and permit dental implant placement. Histological analysis showed new bone presence and successful graft integration across all defect zones (coronal, medial, and apical), with continuous new bone formation around and between graft particles. The dental implant achieved primary stability at 35 Ncm, indicating the scaffold's effectiveness in promoting bone regeneration and supporting implant therapy. The post-grafting planned implant position deviated overall by 2.4° compared with the initial restoratively driven implant plan pre-bone augmentation surgery. The patient reported low average daily pain during the first 48 h and no pain from Day 3.
This proof-of-concept underscores the potential of 3D-printed scaffolds in personalized dental reconstruction and alveolar bone regeneration. It marks a significant step forward in integrating additive manufacturing technologies into clinical practice through a scaffold-guided bone regeneration (SGBR) approach. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000118707p).
本病例报告展示了一种3D打印的、患者特异性聚己内酯（PCL）可吸收支架在分期牙槽骨增量术中的有效临床应用。
评估3D打印的PCL支架在促进牙槽骨再生及后续牙种植体植入方面的有效性。
一名46岁缺失牙（11）患者使用患者特异性PCL支架进行分期牙槽骨增量术。评估骨体积增加量和种植体稳定性。进行组织学分析以评估新骨形成和移植物整合情况。
这种新方法使骨体积增加了364.69±2.53立方毫米，足以重建原始牙槽骨轮廓并允许植入牙种植体。组织学分析显示在所有缺损区域（冠部、中部和根尖部）均有新骨形成且移植物成功整合，移植物颗粒周围和之间有持续的新骨形成。牙种植体在35Ncm时实现了初期稳定性，表明该支架在促进骨再生和支持种植治疗方面的有效性。与骨增量手术前最初的修复驱动种植计划相比，移植后计划的种植体位置总体偏差2.4°。患者报告在术后48小时内平均每日疼痛程度较低，从第3天起无疼痛。
这一概念验证强调了3D打印支架在个性化牙齿重建和牙槽骨再生中的潜力。它标志着通过支架引导骨再生（SGBR）方法将增材制造技术整合到临床实践中向前迈出了重要一步。该试验已在澳大利亚新西兰临床试验注册中心（ACTRN12622000118707p）注册。
