CAD/CAM fabrication of bone for guided bone regeneration : a narrative review of current principles, clinical applications, challenges and future perspectives

Abstract

Background The computer-aided design/computer-aided manufacturing (CAD/CAM) workflow is state of the art for a plethora of oral- and maxillofacial reconstruction procedures. The workflow is well implemented in alveolar ridge preservation and segmental bone regeneration. Guided bone or guided tissue regeneration (GBR/GTR) are essential in stabilising and regenerating the alveolar ridge height and width and the surrounding soft tissue in segmental deficient situations. CAD/CAM-assisted GBR minimises surgical time, optimises bone volume preservation and provides predictable results in implantology and reconstructive procedures. Besides, the technique is crucial in planning and executing free microvascular anastomosed tissue transfer for continuity defects.

Methods This review examines how CAD/CAM fabrication can further transform bony regeneration and reconstruction. Therefore, latest principles of CAD/CAM fabrication methods, manufacturing techniques in CAD/CAM bone fabrication, materials for CAD/CAM-fabricated bone in GBR, clinical applications of CAD/CAM bone in GBR, challenges and limitations as well as future perspectives are highlighted.

Results and Conclusions In conclusion, CAD/CAM is poised to become a standard approach not only for segmental but also continuity defect situations in regenerative maxillofacial surgery as technology evolves.

Clinical Relevance The application of CAD/CAM technology in guided bone regeneration holds the potential to significantly improve patient outcomes in oral and maxillofacial surgery. CAD/CAM-assisted GBR minimises surgical time, optimises bone volume preservation and provides predictable results. By allowing for precise, patient-specific bone grafts, this technology enhances reconstruction, leading to better integration with native bone and reduced complication rates. Shortcomings are the increased planning time and direct costs for the device. In the future, translation of newly developed optimised materials and methods into the clinical workflow will pave the way for the regeneration of continuity bony defects.