Computer-aided design/computer-aided manufacturing (CAD/CAM) technologies may improve application of titanium scaffolds, onlay techniques and guided bone regeneration. In this study, the clinical outcome of DICOM-based individualized CAD/CAM-produced titanium scaffolds (iCTSs) was analyzed in grafted defects, particularly with regard to relation of dehiscence to demographic and surgery-related factors.
Materials and methods: In 100 patients, 115 defects of the alveolar crest were reconstructed with an iCTS covered with a native bilayer collagen membrane or left uncovered. The volume was mostly grafted with a mixture of autogenous bone and deproteinized bovine bone mineral. The healing process was documented. Office records were analyzed for association of dehiscence with demographic and surgical parameters.
Results: Uneventful healing was observed in 82 defects. Infection of the surgical area was documented in 11 cases, 10 were resolved by medication. One defect had to be regrafted. Dehiscence was reported in 26 defects. Premature removal of exposed iCTSs was not necessary. All of the cases showed sufficiently grafted volume for implant placement with presurgical 3-D planning. The grafted volume in the defects with dehiscence did not differ from that in sites without dehiscence. Statistical analysis revealed no significant association of dehiscence with demographic or surgical parameters, but a tendency to higher prevalence of dehiscence with mesiodistal width of the defect.
Conclusion: Combination of an iCTS with guided bone regeneration offers a reliable grafting technique with low sensitivity to dehiscence. Dehiscence did not correlate with demographic or surgical factors. In addition, it did not affect the final outcome, as implant insertion was possible simultaneously or staged in all of the cases..
Editorial note: The full article was published in the 1/2018 issue of the Journal of Oral Science and Rehabilitation.
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