Vertical and Horizontal Ridge Augmentation Using Customized Three-Dimensionally Printed Polycaprolactone Mesh in Atrophic Posterior Maxillae: A Case Report.

Abstract

Polycaprolactone has exhibited expediency as a biomaterial for bone regenerative procedures preclinically. The present report of the 2 clinical cases in the posterior maxilla is the first to describe clinical application of a customized 3D-printed polycaprolactone mesh for alveolar ridge augmentation. Two patients needing extensive ridge augmentation procedures for dental implant therapy were selected. Polycaprolactone meshes were virtually designed, 3D printed, and applied in combination with a xenogeneic bone substitute. Cone-beam computerized tomography was taken preoperatively, immediately after the surgery, and 1.5-2 years after the delivery of implant prostheses. The serial cone-beam computerized tomography images were superimposed to measure the augmented height and width at 1-mm increments from the implant platform to 3 mm apically. After 2 years, the mean [maximum, minimum] bone gain was 6.05 [8.64, 2.85] mm vertically and 7.77 [10.03, 6.18] mm horizontally at 1 mm below the implant platform. From immediately postoperative to 2 years, there was 14% reduction of augmented ridged height and 24% reduction of augmented width at 1 mm below the platform. All implants placed in augmented sites were successfully maintained until 2 years. The customized polycaprolactone mesh might be a viable material for ridge augmentation in the atrophic posterior maxilla. This needs to be confirmed through randomized controlled clinical trials in future studies.