Abstract
Purpose of Review
CAD/CAM and 3D-printing are emerging manufacturing technologies in dentistry. In the field of alveolar ridge augmentation, graft customization utilizing these technologies can result in significant reduction of surgical time. A review of the literature on materials, techniques, and applications of CAD/CAM and 3D-printing available for alveolar ridge augmentation was performed.
Recent Findings
CAD/CAM applications for milling of customized block grafts of allogeneic, xenogeneic, and alloplastic origins have been reported, and currently only limited products are commercially available. 3D-printing applications are limited to alloplastic graft materials and containment shells, and have been mostly used in animal studies for optimizing biomaterials’ properties.
Summary
While current data support the potential use of CAD/CAM and 3D-printing for graft customization for alveolar ridge augmentation procedures, additional research is needed on predictability and long-term stability of the grafted sites.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Wang H-L, Boyapati L. “PASS” principles for predictable bone regeneration. Implant Dent. 2006;15:8–17.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment. Cochrane Oral Health Group, editor. Cochrane Database Syst Rev. John Wiley & Sons, Ltd; 2009; 105:CD003607.
Bernstein S, Cooke J, Fotek P, Wang H-L. Vertical bone augmentation: where are we now? Implant Dent. 2006;15:219–28.
Urban IA, Jovanovic SA, Lozada JL. Vertical ridge augmentation using guided bone regeneration (GBR) in three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after loading. Int J Oral Maxillofac Implants. 2009;24:502–10.
Urban IA, Lozada JL, Jovanovic SA, Nagursky H, Nagy K. Vertical ridge augmentation with titanium-reinforced, dense-PTFE membranes and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 19 patients. Int J Oral Maxillofac Implants. 2014;29:185–93.
Urban IA, Monje A, Lozada JL, Wang H-L. Long-term evaluation of peri-implant bone level after reconstruction of severely atrophic edentulous maxilla via vertical and horizontal guided bone regeneration in combination with sinus augmentation: a case series with 1 to 15 years of loading. Clin Implant Dent Relat Res. 2017;19:46–55.
Johnson FP, Coppins DA, Brook IM. Fabrication of custom made tissue spacers for use in tissue augmentation. Br J Oral Maxillofac Surg. 1991;29:282–3.
•• Jacotti M. Simplified onlay grafting with a 3-dimensional block technique: a technical note. Int J Oral Maxillofac Implants. 2006;21:635–9. First case report utilizing 3D-printed defect models to manually mill a customized block pre-operatively.
Venet L, Perriat M, Mangano FG, Fortin T. Horizontal ridge reconstruction of the anterior maxilla using customized allogeneic bone blocks with a minimally invasive technique—a case series. BMC Oral Health. 2017;17:146.
Draenert FG, Gebhart F, Mitov G, Neff A. Biomaterial shell bending with 3D-printed templates in vertical and alveolar ridge augmentation: a technical note. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123:651–60.
Eufinger H. Individual augmentation of the atrophic mandible based on CAD/CAM-manipulated computed tomography data—in vitro results. Int J Oral Maxillofac Surg. 1994;23:399–402.
•• Schlee M, Rothamel D. Ridge augmentation using customized allogenic bone blocks: proof of concept and histological findings. 2013;Implant Dent, 22:212–8. Proof-of-concept case series utilizing CAD/CAM milled allogeneic cancellous bone blocks for vertical and horizontal ridge augmentation.
Figliuzzi M, Mangano FG, Fortunato L, De Fazio R, Macchi A, Iezzi G, et al. Vertical ridge augmentation of the atrophic posterior mandible with custom-made, computer-aided design/computer-aided manufacturing porous hydroxyapatite scaffolds. J Craniofac Surg. 2013;24:856–9.
Mangano F, Macchi A, Shibli JA, Luongo G, Iezzi G, Piattelli A, et al. Maxillary ridge augmentation with custom-made CAD/CAM scaffolds. A 1-year prospective study on 10 patients. J Oral Implantol. 2014;40:561–9.
Mangano F, Zecca P, Pozzi-Taubert S, Macchi A, Ricci M, Luongo G, et al. Maxillary sinus augmentation using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Int J Med Robot. 2013;9:331–8.
Mangano FG, Zecca PA, van Noort R, Apresyan S, Iezzi G, Piattelli A, et al. Custom-made computer-aided-design/computer-aided-manufacturing biphasic calcium-phosphate scaffold for augmentation of an atrophic mandibular anterior ridge. Case Rep Dent. 2015;2015:941265–11.
Luongo F, Mangano FG, Macchi A, Luongo G, Mangano C. Custom-made synthetic scaffolds for bone reconstruction: a retrospective, multicenter clinical study on 15 patients. Biomed Res Int. 2016;2016:5862586–12.
Mirkovic S, Budak I, Puskar T, Tadic A, Sokac M, Santosi Z, et al. Application of modern computer-aided technologies in the production of individual bone graft: a case report. Vojnosanit Pregl. 2015;72:1126–31.
De Stavola L, Fincato A, Bressan E, Gobbato L. Results of computer-guided bone block harvesting from the mandible: a case series. Int J Periodontics Restorative Dent. 2017;37:e111–9.
• Tamimi F, Torres J, Gbureck U, Lopez-Cabarcos E, Bassett DC, Alkhraisat MH, et al. Craniofacial vertical bone augmentation: a comparison between 3D printed monolithic monetite blocks and autologous onlay grafts in the rabbit. Biomaterials. 2009;30:6318–26. Animal study showing that 3D-printed monolithic monetite block grafts have the potential to be used as an alternative to autogenous block grafts.
Torres J, Tamimi F, Alkhraisat MH, Prados-Frutos JC, Rastikerdar E, Gbureck U, et al. Vertical bone augmentation with 3D-synthetic monetite blocks in the rabbit calvaria. J Clin Periodontol. 2011;38:1147–53.
• Tamimi F, Torres J, Al-Abedalla K, Lopez-Cabarcos E, Alkhraisat MH, Bassett DC, et al. Osseointegration of dental implants in 3D-printed synthetic onlay grafts customized according to bone metabolic activity in recipient site. Biomaterials. 2014;35:5436–45. 3D-printed alloplastic blocks utilized to show that different macrogeometry designs can influence the bone formation pattern.
Mangano C, Barboni B, Valbonetti L, Berardinelli P, Martelli A, Muttini A, et al. In vivo behavior of a custom-made 3D synthetic bone substitute in sinus augmentation procedures in sheep. J Oral Implantol. 2015;41:240–50.
•• Ciocca L, Ragazzini S, Fantini M, Corinaldesi G, Scotti R. Work flow for the prosthetic rehabilitation of atrophic patients with a minimal-intervention CAD/CAM approach. J Prosthet Dent. 2015;114:22–6. First case report of 3D-printed Ti-mesh
Connors CA, Liacouras PC, Grant GT. Custom titanium ridge augmentation matrix (CTRAM): a case report. Int J Periodontics Restorative Dent. 2016;36:707–14.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Digital and Esthetic Dentistry
Rights and permissions
About this article
Cite this article
Yen, H.H., Stathopoulou, P.G. CAD/CAM and 3D-printing Applications for Alveolar Ridge Augmentation. Curr Oral Health Rep 5, 127–132 (2018). https://doi.org/10.1007/s40496-018-0180-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40496-018-0180-4