Abstract
The study was designed to fulfill effective work-flow to fabricate three-dimensional mesh titanium scaffold for mandibular reconstruction. The 3D titanium mesh scaffold was designed based on a volunteer with whole mandible defect. (1) acquisition of the CT data; (2) design with computer aided design (CAD) and finite element analysis (FEA). The pore size and intervals with the best mechanic strength was also calculated using FEA. (3) fabrication of the scaffold using electron beam melting (EBM); (4) implantation surgery. The case recovered well, without loosening and rejection. Additionally, 12 mandibular defect model beagles were used to verify the results. The model was established via tooth extraction and mandibular resection surgeries, and the scaffold was designed individually based on CT data obtained at 2 weeks after extraction operation. Then scaffolds were fabricated using 3D EBM, and the implantation surgery was performed at 2 months after extraction operation. All the animals healed well after implantation, and the grafted mandibular recovered well with time. The relevant parameters of the grafted mandibular were nearly to the native mandibular at postoperative 12 months. It is feasible to fabricate mesh titanium scaffold for repairing mandibular defects individually using reverse engineering, CAD and EBM techniques.
Highlights
Reconstruction of mandibular defect should restore the anatomical height and contour of the missing part, optimal restoration of function involves mastication, deglutition and the management of oral secretions[1,2,3]
3D modeling reconstruction based on computerized tomography (CT) image
The example given in this paper was a whole mandible defect case, and the reconstructed scaffold occupied all the mandible area
Summary
Reconstruction of mandibular defect should restore the anatomical height and contour of the missing part, optimal restoration of function involves mastication, deglutition and the management of oral secretions[1,2,3]. To solve the too-low mechanical strength in early period of implanting loaded tissue engineering bones, our research group proposed a hypothesis of individualized functional repair of mandibular defects using a 3D porous internal tissue engineering titanium scaffold. The scaffolds require various special functions including improvement of mechanical strength to provide structural support and to guide tissue regeneration, shape recovering of defect tissues. It is very difficult and time-consuming to model, analyze and fabricate the whole mesh customized scaffold for all the different range of porosities and pore diameters. The aim of this study was to discuss the rational work-flow for engineering tissues and a 3D mesh internal titanium scaffold by combining 3D reconstruction with EBM technique to repair mandibular defect. 12 beagles were used to establish the mandibular defect animal model to verify the effect of 3D mesh titanium mandibular prosthesis scaffold
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