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Abstract
<p class="first" id="P1">Craniomaxillofacial congenital anomalies comprise approximately
one third of all congenital
birth defects and include deformities such as alveolar clefts, craniosynostosis, and
microtia. Current surgical treatments commonly require the use of autogenous graft
material which are difficult to shape, limited in supply, associated with donor site
morbidity and cannot grow with a maturing skeleton. Our group has demonstrated that
3D-printed bio-ceramic scaffolds can generate vascularized bone within large, critical-sized
defects (defects too large to heal spontaneously) of the craniomaxillofacial skeleton.
Furthermore, these scaffolds are also able to function as a delivery vehicle for a
new osteogenic agent with a well-established safety profile. The same 3D printers
and imaging software platforms have been leveraged by our team to create sterilizable
patient-specific intraoperative models for craniofacial reconstruction. For microtia
repair, the current standard of care surgical guide is a two-dimensional drawing taken
from the contralateral ear. Our laboratory has used 3D-printers and open source software
platforms to design personalized microtia surgical models. In this review, we report
on the advancements in tissue engineering principles, digital imaging software platforms
and 3D printing that have culminated in the application of this technology to repair
large bone defects in skeletally immature transitional models and provide in-house
manufactured, sterilizable patient-specific models for craniofacial reconstruction.
</p>
Osteoinduction is the process by which osteogenesis is induced. It is a phenomenon regularly seen in any type of bone healing process. Osteoinduction implies the recruitment of immature cells and the stimulation of these cells to develop into preosteoblasts. In a bone healing situation such as a fracture, the majority of bone healing is dependent on osteoinduction. Osteoconduction means that bone grows on a surface. This phenomenon is regularly seen in the case of bone implants. Implant materials of low biocompatibility such as copper, silver and bone cement shows little or no osteoconduction. Osseointegration is the stable anchorage of an implant achieved by direct bone-to-implant contact. In craniofacial implantology, this mode of anchorage is the only one for which high success rates have been reported. Osseointegration is possible in other parts of the body, but its importance for the anchorage of major arthroplasties is under debate. Ingrowth of bone in a porous-coated prosthesis may or may not represent osseointegration.
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