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Computed Tomographic Evaluation Of Novel Custom-made Artificial Bones, “CT-BONE”, Applied For Maxillofacial Reconstruction

Authors: Yuki Kanno, Takashi Nakatsuka, Hideto Saijo, Yuko Fujihara, Hikita Atsuhiko, Ung-il Chung, Tsuyoshi Takato, Kazuto Hoshi

Abstract:

Introduction

We fabricated custom-made artificial bones using three-dimensionally layered manufacturing (3D printing) process, and have applied them to patients with facial deformities. We termed this novel artificial bone the “CT-bone”. The aim of the present study was to evaluate the middle- and long-term safety and effectiveness of the CT-bones after transplantation.

Methods

The subject areas involved were 23 sites of 20 patients with facial bone deformities due to congenital abnormality, tumor, or trauma. The CT-bones were used for augmentation; they were evaluated by CT images, minimally for 1 year and maximally for 7 years and 3 months (3 years and 1 month on average) after transplantation.

Results

No serious systemic events due to the CT-bone graft were found during the observation period (1 year postoperatively). In 4 sites of 4 patients, the CT-bones were removed due to local infection of the surgical wounds at 1–5 years postoperatively. Compatibility of the shapes between the CT-bone and the recipient bone was confirmed to be good during the operation in all of the 20 cases, implying that the CT-bones could be easily installed onto the recipient sites. During the CT evaluation (<7 years and 3 months), no apparent chronological change was seen in the shape of the CT-bones. Sufficient bone union was confirmed in 19 sites. The inner CT values of the CT-bones increased in all the sites. The longer the postoperative period, greater increases in the CT values of the CT-bones tended to be observed.

Keywords

Custom-made; Artificial bones; Tricalcium phosphate; Inkjet printing; Maxillofacial reconstruction; Hydroxyapatite

Citation: Yuki Kanno, Takashi Nakatsuka, Hideto Saijo, Yuko Fujihara, Hikita Atsuhiko, Ung-il Chung, Tsuyoshi Takato, Kazuto Hoshi Computed Tomographic Evaluation Of Novel Custom-made Artificial Bones, “CT-BONE”, Applied For Maxillofacial Reconstruction http://dx.doi.org/10.1016/j.reth.2016.05.002

Received: 26 February 2016, Revised: 6 May 2016, Accepted: 18 May 2016, Available online: 1 July 2016

Copyright: © 2016, The Japanese Society for Regenerative Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Conclusions

The CT-bone showed maintenance of the original shape and good bone replacement, based on the middle- and long-term follow-ups. In the future, we would make an intelligent type of artificial bones in which bone regeneration is induced by gradually releasing angiogenesis-inducing factors and/or bone-regeneration-inducing factors at the three-dimensionally controlled positions.

Abbreviation

TCP, tricalcium phosphate; CT, computed tomography; HA, hydroxyapatite; IPCAB, inkjet-printed custom-made artificial bone; DICOM, digital imaging and communications in medicine; STL, stereolithography; MRSA, methicillin-resistant Staphylococcus aureus; CAD, computer aided design.

Conflict of interest

All authors declare no conflict of interest.

Acknowledgments

This study was approved by the Ethical Committee of the Faculty of Medicine at the University of Tokyo (approval no. 1310) and Clinical Research Support Center at the University of Tokyo (approval code: 3DB-01/CT-1). A part of this study was performed as the clinical trial of NEXT21 K.K.

The authors wish to acknowledge Dr Shigeki Suzuki, CEO of NEXT21 K.K.