With the advent of computer-assisted design and computer-assisted manufacturing technology, 3D printing has found its way into the delivery of healthcare. From patient-specific surgical guides to 3D-printed anatomical models, 3D printing has endowed clinicians with greater precision in treatment of diseases. 3D bioprinting technology represents yet another advance in tissue engineering that aims to design constructs from biologically active cell-based bioinks. In the field of craniomaxillofacial and implant dentistry, 3D bioprinted constructs may hold promise for regeneration of orofacial defects and overcome the limitations of current management strategies. This article provides an overview of the concepts of 3D printing/bioprinting in craniomaxillofacial surgery and implant dentistry. The current concepts and their potential uses in these fields, together with future perspectives, will also be discussed.
3-dimensional (3D) printing has revolutionized medicine and dentistry since Chuck Hull invented stereolithography (SLA) in 1983. Advancements in 3D printing technology and reductions in manufacturing costs have significantly increased its adoption. This technology utilizes additive manufacturing where materials are joined layer upon layer to create objects (Hollister 2005). Initially, printed models were used for anatomical study guides but their application expanded to include oral and craniofacial prostheses, patient-specific cutting surgical guides and personalized dental implants (Dadhich et al. 2022).
Some challenges faced in the use of autologous graft reconstruction include limited availability and donor site morbidity. This is particularly so in large craniomaxillofacial defects and severe alveolar ridge deficiency where extensive grafting is required before dental implant placement. In addition, allografts and xenografts have limitations in clinical handling and the absence of osteogenic capacity (Ivanovski et al. 2023). Nonetheless, 3D bioprinting technology, which merges 3D printing with tissue engineering concepts, may address these concerns effectively.
3D bioprinting aims to produce regenerative tissues and organs through the precise layer-by-layer positioning of the living cells, biomaterials, and bioactive molecules tailored to specific patients and sites. This personalized treatment has the potential to mimic the complex inter- and intra-cellular interactions in large defect reconstructions, offering promising solutions for targeted tissue repair (Bartold & Ivanovski 2022; Obregon et al. 2015).
Beyond craniofacial defect reconstruction, there is growing interest in applying bioprinting to regenerative dentistry. Innovations in 3D bioprinting and stem cell technology have facilitated the reconstruction of dentin, gingiva, periodontal ligament, alveolar bone, and even whole tooth constructs (Ostrovidov et al. 2023). Given the high prevalence of peri-implant diseases (Derks & Tomasi 2015) and the unpredictability of successful peri-implantitis treatments (Herrera et al. 2023), bioprinting-based tissue and/or tooth regeneration may present a promising alternative for treating patients with diseased periodontium or edentulism.
This article will provide an overview of the concepts of 3D printing and bioprinting in craniomaxillofacial surgery and implant dentistry. The current concepts and their use in these field, together with future perspectives, will also be discussed.