Digital technologies and biomaterials in customised therapies for bone reconstruction
DUBAI, UAE: Augmentation of an insufficient bone volume is indicated before or in conjunction with implant placement to gain long-term functioning and an aesthetic outcome. Autogenous bone block grafting is the accepted standard of care. These tissue transplants, however, have limited availability and require an additional procedure, posing the risk of morbidities. A variety of bone substitute materials, such as allogeneic or xenogeneic materials, are available for ridge augmentation, but the risk of disease transmission needs to be considered. In modern implant dentistry or maxillofacial surgery, priority should be given to those interventions that are simpler, are less invasive, involve less risk of complications, and reach their goal within the shortest time frame.
The ideal bone substitutes should have biocompatibility, excellent osteoconductive properties and appropriate strength, and they should be able to form a suitable shape easily and to replace the bone completely within a short period. Calcium phosphate-based materials have been considered for use as bone graft substitutes in the treatment of bone defects for over 30 years, in orthopaedic, dental and maxillofacial surgery. In the last several years, the application of digital technology in dentistry has become widespread, and considerable progress has been made in the development of CAD/CAM techniques. More recently, attempts have been made to fabricate custom-made scaffolds, allowing bone grafts to be tailored for specific applications or even for individual patients, using computer-assisted methods.
The same concepts are applied to produce dental or maxillofacial implants by direct laser metal forming, an additive manufacturing procedure. It is a time-saving procedure in which a high-power laser beam is directed on to a metal powder bed and fuses particles according to a program in a CAD file. Apposition of subsequent layers gives shape to a 3D form that requires minimal post-processing. It is now possible to fabricate dental, maxillofacial and orthopaedic implants directly from CAD models.
The presentation describes new protocols for the manufacture of custom-made calcium phosphate or titanium scaffolds using 3D printing procedures to augment or repair bone defects and minimise surgery when severe atrophy is present.
About the author
Dr Carlo Mangano is a top expert in the field of implantology and, besides working in his private practice in Italy, he is an adjunct
professor at the Gabriele d’Annunzio University of Chieti–Pescara and Vita-Salute San Raffaele University in Italy. He frequently contributes to publications and presents lectures at international congresses. As a member of the Italian Academy of Osseointegration, Mangano participates in many educational extracurricular activities, and from 2020 to 2021, he will serve as the president of the Digital Dentistry Society. In the last 15 years, he has focused on 3D printing of biomaterials.
What? “Digital technologies and biomaterials in customized therapies” by Dr Carlo Mangano
When? 6 February, 9:45–10:30
Where? DDS Forum, Hall A