Dr. Michele Jacotti
(Private practice, Brescia, Italy)
Title:
Abstract:
The use of bone grafts as a regenerating technique has taken on an ever increasing importance in the last few years and several authors have described bone grafts in alloplastic blocks.
With this technology one has the advantage of avoiding the necessity to make the patient undergo a further operation in order to get the graft and be able to use the quantity of material necessary for regeneration, since it is possible to get it from the store of adequate biomaterial. Histological research show that after 6 months since grafting the osteoblasts have colonized the material with consequent new bone formation. In implantology CT has by now become nearly a routine exam, as it is the only one that really can give significant data on bone quantity, anatomic structure morphology and maxillary three-dimensional vision. With adequate dedicated software the management of CT data gives the possibility to create 3D maxillary reconstruction; appropriate centres can transform these files into plastic material solid models that faithfully reproduce the real original anatomy.
From the data of a CT maxillary exam is thus possible to get three-dimensional models in heat resistant plastic material, that can be put in an envelope and sterilized. The 3D sterilized models are then used, with a sterile procedure, to model the bank bone (Tutogen) grafts which are then screwed onto the model. When the job is finished, the models with the grafts are put in sterile envelopes which will be reopened only when the patient is summoned for the surgical phase during which the premodelled grafts will be unscrewed from the model and screwed onto the receiving site. This technique drastically reduces the operation time on the patient, as a great part of the job is done on the 3D model; besides there is a better control of the graft precision as it is dry modelled and can be verified from different points of view, without the classical visual obstacles such as bleeding, flaps and limitations due to the oral cavity.