The use of 3D-printed bone scaffold in comparison to autogenous graft for atrophics maxilla reconstruction: randomized clinical trial

• Grant number: 21/07443-1
• Support Opportunities: Regular Research Grants
• Start date: July 01, 2022
• End date: September 30, 2024
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Elcio Marcantonio Junior
• Grantee: Elcio Marcantonio Junior
• Host Institution: Faculdade de Odontologia (FOAr). Universidade Estadual Paulista (UNESP). Campus de Araraquara. Araraquara , SP, Brazil
• Associated researchers: Carolina Mendonça de Almeida Malzoni ; Fábio Renato Manzolli Leite ; Jamil Awad Shibli ; Juliana Possari ; Rubens Spin Neto ; Victor Gonçalves

Abstract

Bone graft procedures are essential to rehabilitation of regions with bone insufficiency for implant placement. Among the grafts used, the autogenous stands out for presenting osteogenic, osteoinductive and osteoconductive properties. However, it also offers disadvantages such as longer surgical time, greater postoperative morbidity and limited amount of available tissue. For this, bone substitutes have been used. With the advancement of CAD / CAM technology (computer aided design / computer aided manufacturing), ceramic bone grafts can be customized. This technology provides precision and agility to the surgical procedure, and also eliminates the disadvantages of using an autogenous graft. However, the literature still lacks randomized clinical studies to assess the real effect of these customized bone grafts on bone neoformation. Thus, this clinical study aims to compare bone neoformation in the anterior region of the maxilla when the customized ceramic graft in block is used in comparison to the use of autogenous graft. For this, 20 patients with bilateral defects in the anterior region of the maxilla will be selected. The defects will be randomly divided into a test group and a control group, with the control group grafted with autogenous bone en bloc and the test group with a customized graft by CAD / CAM technology. After 8 months of the surgical procedure, biopsies from the bone graft region will be obtained and implants will be installed in the region. The analysis of the resonance frequency (RFA) will be measured to evaluate the primary and secondary stability of the implants. In addition, the biopsies will be processed for micro-tomographic, histomorphometric and immunohistochemistry analyzes using osteocalcin, VEGF, alkaline phosphatase and BMP-2 proteins. Tomographic analyzes regarding the change in graft volume and the adaptation of the graft to the native bone will also be performed. (AU)