Med Biol Eng Comput - Direct metal laser sintering (DMLS) of a customized titanium mesh for prosthetically guided bone regeneration of atrophic maxillary arches.

Tópicos

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Resumo

This study describes a protocol for the direct manufacturing of a customized titanium mesh using CAD-CAM procedures and rapid prototyping to augment maxillary bone and minimize surgery when severe atrophy or post-oncological deformities are present. Titanium mesh and particulate autogenous plus bovine demineralised bone were planned for patient rehabilitation. Bone augmentation planning was performed using the pre-op CT data set in relation to the prosthetic demands, minimizing the bone volume to augment at the minimum necessary for implants. The containment mesh design was used to prototype the 0.6 mm thickness customized titanium mesh, by direct metal laser sintering. The levels of regenerated bone were calculated using the post-op CT data set, through comparison with the pre-op CT data set. The mean vertical height difference of the crestal bone was 2.57 mm, while the mean buccal-palatal dimension of thickness difference was 3.41 mm. All planned implants were positioned after an 8 month healing period using two-step implant surgery, and finally restored with a partial fixed prosthesis. We present a viable and reproducible method to determine the correct bone augmentation prior to implant placement and CAD-CAM to produce a customized direct laser-sintered titanium mesh that can be used for bone regeneration.

Resumo Limpo

studi describ protocol direct manufactur custom titanium mesh use cadcam procedur rapid prototyp augment maxillari bone minim surgeri sever atrophi postoncolog deform present titanium mesh particul autogen plus bovin demineralis bone plan patient rehabilit bone augment plan perform use preop ct data set relat prosthet demand minim bone volum augment minimum necessari implant contain mesh design use prototyp mm thick custom titanium mesh direct metal laser sinter level regener bone calcul use postop ct data set comparison preop ct data set mean vertic height differ crestal bone mm mean buccalpalat dimens thick differ mm plan implant posit month heal period use twostep implant surgeri final restor partial fix prosthesi present viabl reproduc method determin correct bone augment prior implant placement cadcam produc custom direct lasersint titanium mesh can use bone regener

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