Aplicabilidade dos enxertos impressos tridimensionalmente na reconstrução óssea: uma revisão de escopo

Abstract

The use of virtual planning and customized 3D-printed bioresorbable structures has been proposed as a solution to the challenges associated with obtaining and shaping grafts or implants for reconstructing complex geometric bone defects in the maxillofacial region. This scoping review provides an overview of the current advancements in virtual planning and custom-made 3D-printed bioresorbable scaffolds, along with their clinical outcomes in maxillofacial reconstructive surgeries. Electronic searches were conducted across five databases for publications up to January 2024. Included in the review were reports evaluating patients who underwent maxillofacial bone defect reconstruction using virtual planning and custom-made 3D-printed bioresorbable scaffolds. Data on postoperative complications, new bone formation, scaffold resorption, dental implant success/survival, and patient satisfaction were collected. Ten studies (5 case reports, 4 case series, 1 prospective clinical study) were included. These studies assessed the effectiveness of 3D-printed scaffolds in reconstructing maxillofacial defects, bone augmentation for dental implant placement, and regeneration of periosseous defects. Most of the 3D-printed scaffolds were found to be biocompatible and did not cause local or systemic adverse events. However, some postoperative complications were reported, including graft exposure, wound dehiscence, and local infection. Overall, the 3D-printed scaffolds demonstrated favorable dimensional compatibility with deformities, provided durable support, promoted bone formation, achieved adequate bone union with host bone tissues, and supported dental implant placement without the need for additional guided bone regeneration. In conclusion, custom-made 3D-printed bioresorbable scaffolds, guided by virtual planning, present a promising option for maxillofacial reconstruction due to their accuracy, osteoconductivity, and biocompatible properties.