Anatomical and functional custom made restoration techniques with Direct Metal Laser Forming technology: systematic workflow and CAD-CAM

Introduction Bone defects are usually repaired by the body’s healing process itself. If severe fracture, tumor or infection occur on large bones, it poses a serious challenge to the regeneration ability of the bones. One of the latest advancement in medical science is the rapid prototyping technologies. Therefore, the aim of the present study was the developing and testing of a reliable workflow to fabricate custom-made grafts in the field craniofacial surgery. Material and Methods In this study 14 patients with different cranio-facial bone defects were enrolled. Two evaluation methods were associated to test the results of the workflow. Surveys were given to patients undergone surgery and their surgeons to have a subjective analysis of the workflow. For each patient the produced prosthesis was superimposed on the original prosthesis design, the displacement between was evaluated. Results Significant level of discomfort at 4 weeks after surgery compared to 2 days after surgery, aesthetic improvement significant improved 1 year after surgery compared to 4 weeks after surgery. Aesthetic improvement 1 year after surgery and aesthetic improvement according to expectations showed correlation, aesthetic improvement 1 year after surgery and aesthetic improvement according to expectations showed correlation. The mean distance of the printed model was significant smaller than the virtual model, with a mean difference of -0.075 mm. Conclusion According to the results of the present study custom made bone graft made with laser sintering technique represents a valid alternative to traditional bone grafts with high clinical accuracy and the advantage to avoid morbidity of the donor site or of the patient due to animal grafting.