Department of Diagnosis and Surgery, School of Dentistry at Araraquara, UNESP - São Paulo State University(FOAr/UNESP), Araraquara, São Paulo, Brazil.
Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlândia - UFU, School of Dentistry, Uberlândia, MG, Brazil.
Braz Dent J. 2024 Oct 25;35:e246112. doi: 10.1590/0103-6440202406112. eCollection 2024.
This scoping review aimed to provide an overview of current advancements in virtual planning and custom-made 3D-printed bioresorbable scaffolds, and to evaluate their clinical outcomes in maxillofacial reconstructive surgeries. Electronic searches of PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were conducted for publications up to June 2024. Included in the review were reports evaluating patients who underwent maxillofacial bone defect reconstruction using virtual planning and custom-made 3D-printed bioresorbable scaffolds. Data on postoperative complications, new bone formation, scaffold resorption, dental implant success/survival, and patient satisfaction were collected. The electronic search found 5799 results (3438 unique citations). A total of 54 studies were evaluated for full-text reading, of which 41 were excluded based on the inclusion criteria. Thirteen studies (6 case reports, 5 case series, one prospective clinical study and one randomized clinical trial) were included. These studies assessed the effectiveness of 3D-printed scaffolds in reconstructing maxillofacial defects, bone augmentation for dental implant placement, and regeneration of periosseous defects. Most of the 3D-printed scaffolds were biocompatible and did not cause local or systemic adverse events. However, some postoperative complications were reported, including graft exposure, wound dehiscence, and local infection. Overall, the 3D-printed scaffolds demonstrated favorable dimensional compatibility with deformities, provided durable support, promoted bone formation, achieved adequate bone union with host bone tissues, and supported dental implant placement without additional guided bone regeneration. In conclusion, custom-made 3D-printed bioresorbable scaffolds, guided by virtual planning, present a promising option for maxillofacial reconstruction due to their accuracy, osteoconductivity, and biocompatible properties.
本范围综述旨在提供当前虚拟规划和定制 3D 打印可生物吸收支架方面的最新进展概述，并评估它们在颌面重建手术中的临床结果。对 PubMed、EMBASE、Web of Science、Scopus 和 Cochrane Library 数据库进行了截至 2024 年 6 月的文献电子检索。综述纳入了评估使用虚拟规划和定制 3D 打印可生物吸收支架进行颌面骨缺损重建的患者的报告。收集了术后并发症、新骨形成、支架吸收、牙种植体成功/存活率和患者满意度的数据。电子检索共发现 5799 项结果（3438 条独特引文）。对全文阅读进行了 54 项研究的评估，其中 41 项根据纳入标准被排除。纳入了 13 项研究（6 篇病例报告、5 篇病例系列研究、1 项前瞻性临床研究和 1 项随机临床试验）。这些研究评估了 3D 打印支架在重建颌面缺损、牙种植体放置的骨增量和牙周缺损再生方面的有效性。大多数 3D 打印支架具有生物相容性，不会引起局部或全身不良事件。然而，一些术后并发症被报道，包括移植物暴露、伤口裂开和局部感染。总体而言，3D 打印支架与畸形具有良好的尺寸兼容性，提供持久的支撑，促进骨形成，与宿主骨组织实现充分的骨结合，并支持牙种植体放置，而无需额外的引导骨再生。总之，定制的 3D 打印可生物吸收支架，通过虚拟规划引导，由于其准确性、骨传导性和生物相容性，成为颌面重建的有前途的选择。
