Abstract
Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood–Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy.
Highlights
While endosseous implants are known to achieve osseointegration with a high that time, cast frameworks and analogue radiographical imaging often led to inaccurate gree of predictability, their placement and longevity are dependent on sufficient bone designs
The clinical use of subperiosteal implants was largely abandoned over time with or neoplasia, which can render installation of endosseous implants risky or sometimes the advent of screw-type endosseous titanium implants
Progression of alveolar bone resorption may continue following placeWhile endosseous implants are known to achieve osseointegration with a high degree ment of screw-type implants, both in instances of placement into native alveolar bone and of predictability, their placement and longevity are dependent on sufficient bone quality placement into regenerated bone following grafting procedures [5,6]
Summary
The concepts of oral biology and stress shielding were not well understood at These factors contributed to patient discomfort and a rather high complication. DeAt. While endosseous implants are known to achieve osseointegration with a high that time, cast frameworks and analogue radiographical imaging often led to inaccurate gree of predictability, their placement and longevity are dependent on sufficient bone designs. ConceptsAvailability of oral biology and stress shielding weremay not be well understood by at quality and of an ideal osseous support compromised that time. These factors contributed to patient discomfort and a rather high complication excessive resorption or loss of the alveolar processes secondary to disuse atrophy, trauma, rate [2]. Progression of alveolar bone resorption may continue following placeWhile endosseous implants are known to achieve osseointegration with a high degree ment of screw-type implants, both in instances of placement into native alveolar bone and of predictability, their placement and longevity are dependent on sufficient bone quality placement into regenerated bone following grafting procedures [5,6]
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