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Review
. 2016 Jan 4;38(1):2.
doi: 10.1186/s40902-015-0048-7. eCollection 2016 Dec.

Computer-aided design/computer-aided manufacturing of hydroxyapatite scaffolds for bone reconstruction in jawbone atrophy: a systematic review and case report

Umberto Garagiola  1 , Roberto Grigolato  1 , Rossano Soldo  1 , Marco Bacchini  2 , Gianluca Bassi  1 , Rachele Roncucci  1 , Sandro De Nardi  2
Affiliations
Review

Computer-aided design/computer-aided manufacturing of hydroxyapatite scaffolds for bone reconstruction in jawbone atrophy: a systematic review and case report

Umberto Garagiola et al. Maxillofac Plast Reconstr Surg. .

Abstract

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments.

Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques.

Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity.

Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to 1200 μm had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

Keywords: Computer-aided design/computer-aided manufacturing; Hydroxyapatite; Review; Scaffold.

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Figures

Fig. 1
Fig. 1
CBCT with bone defect
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Fig. 2
3D volumetric reconstruction of the bone defect
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Fig. 3
Hydroxyapatite bone graft, built using CAD/CAM
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Fig. 4
Hydroxyapatite bone graft CAD/CAM inserted at the level of the bone defect
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Fig. 5
3D digital volumetric reconstruction of the mandibular defect
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Fig. 6
3D digital volumetric reconstruction of HA scaffold placed in the defect
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Fig. 7
3D digital volumetric reconstruction of HA scaffold placed in the defect
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Fig. 8
3D digital volumetric reconstruction of implant placement in regenerated bone
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Fig. 9
3D digital volumetric reconstruction of implant placement in regenerated bone
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Fig. 10
Intraoral radiography: the peri-implant defect
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Intraoral radiography: defect after implant removal
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Intraoral radiography: HA scaffold placement
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Fig. 13
Intraoral radiography: regenerated bone after 5 months
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Fig. 14
Intraoral radiography: implant placement
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Fig. 15
Clinical view: HA scaffold placement
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Clinical view: regenerated bone after 5 months
Fig. 17
Fig. 17
Clinical view: implant placement
See this image and copyright information in PMC

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