The objective of this retrospective study is to verify the effectiveness and safety of patient-specific titanium implants on maxillofacial bones, with a long-term follow-up. Total 16 patients with various maxillofacial defects underwent reconstruction using patient-specific titanium implants. Titanium implants, manufactured by electron beam melting, selective laser sintering, or milling, were inserted into the maxilla, mandible, or zygoma. Long-term follow‐up (36.7 ± 20.1 months) was conducted after the surgery. Bone fusion of the titanium implant body, postoperative infection, implant malunion, functional results, patient satisfaction, subsidence, osteolysis around the implants, and complications were recorded and analyzed at the last follow-up. Of the 28 implants, only one failed to unite with the bone; therefore, revision surgery was performed. No osteolysis or subsidence around the titanium implants nor adverse events were observed; the mean VAS score for satisfaction was 9. All patients enrolled in this trial were esthetically and functionally satisfied with their surgical results, and fixation failure and esthetic dissatisfaction complications were well resolved. Patient-specific titanium showed satisfactory outcomes when used to treat various oral and maxillofacial defects. A 3D printed titanium implant can be effectively used in the reconstruction of the zygoma and mandible instead of autogenous bone without donor site morbidity.

The three-dimensional (3D) cell-printing technique has been identified as a new biofabrication platform because of its ability to locate living cells in pre-defined spatial locations with scaffolds and various growth factors. Osseointegrated dental implants have been regarded as very reliable and have long-term reliability. However, host defense mechanisms against infections and micro-movements have been known to be impaired around a dental implant because of the lack of a periodontal ligament. In this study, we fabricated a hybrid artificial organ with a periodontal ligament on the surface of titanium using 3D printing technology. CEMP-1, a known cementogenic factor, was enhanced in vitro. In animal experiments, when the hybrid artificial organ was transplanted to the calvarial defect model, it was observed that the amount of connective tissue increased. 3D-printed hybrid artificial organs can be used with dental implants, establishing physiological tooth functions, including the ability to react to mechanical stimuli and the ability to resist infections.

The purpose of this study was to evaluate the clinical efficacy and safety of patient-specific additive-manufactured CaOSiO₂-P₂O₅-B₂O₃ glass-ceramic (BGS-7) implants for reconstructing zygomatic bone defects at a 6-month follow-up. A prospective, single-arm, single-center, clinical trial was performed on patients with obvious zygoma defects who needed and wanted reconstruction. The primary outcome variable was a bone fusion between the implant and the bone evaluated by computed tomography (CT) at 6 months post surgery. Secondary outcomes, including implant immobilization, satisfaction assessment, osteolysis, subsidence of the BGS-7 implant, and safety, were assessed. A total of eight patients were enrolled in the study. Two patients underwent simultaneous reconstruction of the left and right malar defects using a BGS-7 3D printed implant. Cone beam CT analysis showed that bone fusion at 6 months after surgery was 100%. We observed that the average fusion rate was 76.97%. Osteolysis around 3D printed BGS-7 implants was not observed. The mean distance displacement of all 10 implants was 0.4149 mm. Our study showed no adverse event in any of the cases. The visual analog scale score for satisfaction was 9. All patients who enrolled in this trial were aesthetically and functionally satisfied with the surgical results. In conclusion, this study demonstrates the safety and promising value of patient-specific 3D printed BGS-7 implants as a novel facial bone reconstruction method.