Establishment and Clinical Application of a Novel Design Protocol for Custom-made Titanium Devices in Alveolar Bone Augmentation for Dental Implants

For the patients with missing teeth, the restoration of masticatory function has been achieved by the prosthesis, such as a bridge or denture. In recent years, patients that dental implant are increasing, and recovered good the oral function. However, in the case with severe alveolar bone resorption, the application of the implant is very difficult as well as denture. For such cases, guided bone regeneration (GBR) is performed using an autogenous and artificial bone to increase the volume of jawbone. However, this treatment is difficult to construct the desired form, sometimes the results cannot be satisfied. Therefore, the therapies that can bone augmentation of an ideal form easily are desired. In the purpose of this study is to establish a design protocol for manufacturing custom-made devices and to reconstruct the jawbone that is applicable for implant treatment. This protocol was constructed by manipulating computed tomography-3-dimensional images of the jawbone by using implant placement simulation software and computer-aided design (CAD) software. We established a method involving CAD for the manufacturing a custom-made titanium mesh device were performed by the selected laser melting-rapid prototyping protocol. Based on this protocol, twenty custom-made devices were prepared. Three-dimensional accuracy of the device was good enough for GBR analyzed by 3-dimensional scanner, and the fitting to the replica model was also accurate. After the model surgery, clinical trial was performed. There is no gingival dehiscence and postoperative infection, good bone for implant insertion were augmented. Our results indicate that this novel device is capable of providing strong support in the cases of dental implant insertion with GBR that require bone augmentation.