Osteogenesis ability of CAD-CAM biodegradable polylactic acid scaffolds for reconstruction of jaw defects

Reconstruction of alveolar bony defects is difficult using grafting materials in a powder form. A biodegradable scaffold material might simplify the procedure.

The purpose of this in vivo study was to evaluate osteogenesis ability of a biodegradable CAD-CAM-fabricated polylactic acid (PLA) scaffold enriched with calcium phosphate salts including hydroxyapatite (HA) and beta tricalcium phosphate (β-TCP) used to reconstruct mandibular defects in a dog model.

Surgical defects were made bilaterally in the mandible of male beagle dogs. Computerized tomography images were obtained for determination of the 3-dimensional shape of the defects after 3 months of healing. Porous PLA scaffolds were fabricated by milling custom-made CAD-CAM blocks into the desired shape. After milling, half of the scaffolds were prepared by filling the pores of the scaffolds by a mixture of HA and β-TCP. Scaffolds were inserted in the mandibular defects bilaterally. After a healing time of 8 weeks, the bone-scaffold interface was analyzed histomorphometrically to detect the amount of new bone formation. Stained histological sections were examined using a computer software and depth of new bone formation was assessed (n=14, α=.05).

Histomorphometric analysis revealed that enriched scaffolds with calcium phosphates had significantly (t=4.4, P<.001) higher amounts of new bone formation (1.3 ±0.33 mm) compared with the controls (0.7 ±0.39 mm). Average new bone growth in enriched scaffolds was 1.3 mm while almost half this value was observed in uncoated scaffolds, 0.7 mm.

Within the limitations of this animal study, HA and β-TCP enhanced osteogenesis ability of CAD-CAM-fabricated PLA scaffolds.