Computer-assisted bone augmentation, implant planning and placement: An in vitro investigation

Area of Science:

• Biomaterials and Regenerative Medicine
• Dental Implantology
• Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM)

Background:

• Alveolar ridge defects pose challenges for dental implant placement.
• Traditional augmentation techniques can be unpredictable.
• Advancements in 3D printing and computer-assisted technologies offer potential solutions.

Purpose of the Study:

• To evaluate the in vitro accuracy of customized 3D printed block grafts for alveolar ridge augmentation.
• To assess the integration of simultaneous computer-assisted implant planning and placement with this workflow.

Main Methods:

• Cone beam computed tomography (CBCT) scans of mandible models with defects were used for digital planning.
• Customized resin block grafts and stereolithographically produced surgical guides were 3D printed.
• Grafts were placed, stabilized, and implants were inserted using guided surgery.
• Optical scans and superimposition techniques were employed to measure deviations between planned and achieved positions.

Main Results:

• The mean deviation of block graft position from the virtual plan was 0.79 ± 0.13 mm.
• The precision of block graft fixation demonstrated a mean deviation of 0.47 ± 0.2 mm, considered clinically acceptable.
• Guided implant placement resulted in a minimal mean shift of 0.16 ± 0.06 mm in block graft position.

Conclusions:

• Customized 3D printed block grafts, planned via CBCT and CAD, achieve predictable and reproducible alveolar ridge augmentation in vitro.
• Simultaneous computer-assisted implant planning and placement alongside block grafting is feasible.
• The workflow leads to clinically insignificant displacement of block grafts, supporting its potential clinical application.