CAD–CAM-generated hydroxyapatite scaffold to replace the mandibular condyle in sheep: Preliminary results

Author:

Ciocca Leonardo1,Donati Davide2,Fantini Massimiliano3,Landi Elena4,Piattelli Adriano5,Iezzi Giovanna5,Tampieri Anna4,Spadari Alessandro6,Romagnoli Noemi6,Scotti Roberto1

Affiliation:

1. Department of Oral Science, Alma Mater Studiorum University of Bologna, Bologna, Italy

2. Laboratory of Bone Tissue Regeneration, Alma Mater Studiorum University of Bologna, Bologna, Italy

3. Virtual Reality and Simulation Laboratory, Alma Mater Studiorum University of Bologna, Forlì, Italy

4. Institute of Science and Technology for Ceramics, National Research Council, Faenza (RA), Italy

5. Department of Oral Sciences, University of Chieti, Chieti, Italy

6. Faculty of Veterinary Medicine, Alma Mater Studiorum University of Bologna, Ozzano Emilia, Italy

Abstract

In this study, rapid CAD-CAM prototyping of pure hydroxyapatite to replace temporomandibular joint condyles was tested in sheep. Three adult animals were implanted with CAD-CAM-designed porous hydroxyapatite scaffolds as condyle substitutes. The desired scaffold shape was achieved by subtractive automated milling machining (block reduction). Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Using the same technique, fixation plates were created and applied to the scaffold pre-operatively to firmly secure the condyles to the bone and to assure primary stability of the hydroxyapatite scaffolds during masticatory function. Four months post-surgery, the sheep were sacrificed. The hydroxyapatite scaffolds were explanted, and histological specimens were prepared. Different histological tissues penetrating the scaffold macropores, the sequence of bone remodeling, new apposition of bone and/or cartilage as a consequence of the different functional anatomic role, and osseointegration at the interface between the scaffold and bone were documented. This animal model was found to be appropriate for testing CAD-CAM customization and the biomechanical properties of porous, pure hydroxyapatite scaffolds used as joint prostheses.

Publisher

SAGE Publications

Subject

Biomedical Engineering,Biomaterials

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