Jamil Alayan, Reuben Staples, Sašo Ivanovski
Patient-specific PCL scaffolds demonstrated predictable bone regeneration of moderate size defects with minimal complications, which facilitated precise implant placement, supporting scaffold-guided bone regeneration as a clinically viable and personalised approach in alveolar bone reconstruction.
AIM: To evaluate clinical feasibility of 3D-printed, patient-specific, polycaprolactone (PCL) resorbable scaffolds for staged alveolar ridge augmentation.
MATERIALS AND METHODS: Ten patients requiring staged bone augmentation underwent digital planning to virtually reconstruct the defect to its original contour. Patient-specific medical-grade PCL scaffolds were then fabricated using 3D printing and sterilised using γ irradiation. Following surgical access of the defect site, the scaffolds were loaded with a composite graft of autogenous bone, deproteinised bovine bone mineral and injectable platelet-rich fibrin, and covered with a resorbable collagen membrane. Clinical reviews were performed at 1, 3 and 8 weeks. Guided implant placement was carried out 6 months later. Primary outcome was volume gain. Secondary outcomes included linear ridge changes, surgical and postoperative parameters, implant feasibility and patient-reported outcomes.
RESULTS: Mean volumetric bone gain was 513.1 ± 321.4 mm3, or 112.0% ± 35.0% of the original defect. Mean linear bone gain was 2.2 mm horizontally and 4.7 mm vertically. All implants achieved primary stability with minimal additional augmentation or deviation from the initial digital plan. Surgically, there was one case of transient altered sensation and one case of wound dehiscence. Postoperative pain (worse pain) reached moderate levels that significantly declined to mild levels after Day 4; interference to daily activities significantly reduced by Day 6 and analgesic (NSAIDs) consumption by Day 8.
CONCLUSION: Patient-specific PCL scaffolds demonstrated predictable bone regeneration of moderate size defects with minimal complications, which facilitated precise implant placement, supporting scaffold-guided bone regeneration as a clinically viable and personalised approach in alveolar bone reconstruction.