Clinical Efficacy Assessment of Digitally Fabricated PEEK Barrier Membranes for Guided Bone Regeneration in Severe Bone Defects

Implantation of a PEEK biological barrier during guided bone regeneration in the area of severe bone deficiency

The cone beam computed tomography (CBCT) data from the two time points (on the day of the initial consultation (T0), and six-eight months after the first surgery (T2) ) were obtained and imported into Mimics Medical software. For each patient, the jaw models at T2 were aligned separately with the jaw model at T0 using point and global registration. After registration and cutting of the digital models, , a Boolean subtraction operation was conducted by subtracting the pre-operative bone segment from the bone segment at 6 months postoperatively to obtain a 6-month postoperative bone increment model. The volumes of the 6-month bone increment can be accessed from the properties menu.

The cone beam computed tomography (CBCT) data from the three time points (on the day of the initial consultation (T0), immediately after surgery (T1) and six months after the first surgery (T2) ) were obtained and imported into Mimics Medical software. For each patient, the jaw models at T1 and T2 were aligned separately with the jaw model at T0 using point and global registration. After registration and cutting of the digital models, , a Boolean subtraction operation was conducted by subtracting the pre-operative bone segment from the bone segment at 6 months postoperatively to obtain a 6-month postoperative bone increment model. V1 (volumes of the immediate bone increment) and V2 (volumes of the 6-month bone increment) can be accessed from the properties menu. The resorption rate of bone increment, denoted as RV, can be calculated by utilizing the formula (V1 -V2)/V1.

The STL files of the preoperative bone defect region, immediate postoperative augmented bone, and bone at 6 months postoperatively were imported into the E-3D implant design software with a unified coordinate system. These files were then registered to the CBCT datasets, and the implant site was planned. Using the long axis of the virtually designed implant, an inspection plane was created in the buccolingual direction, from which two-dimensional measurements were acquired. The STL models of bone contours at the three time points were visualized in 2D within the E-3D software. The linear distance between T0 and T2 was recorded as the augmented bone height (H1), and the linear distance between T1 and T2 was recorded as the bone height after six months of healing (H2). The difference between H1 and H2 represented the bone height resorption over the six-month healing period.

postoperative satisfaction through VAS assessment

A periodontal probe was used to measure the pseudo-periosteal thickness at the buccal, palatal, and alveolar crest sites around each implant.

Soft tissue healing condition recorded by oral scanning and photography in 2 weeks before and 2 weeks after surgery and 6-8 months after surgery.

The STL files of the preoperative bone defect, immediate postoperative augmented bone, and bone at 6 months postoperatively were imported into the E-3D implant design software under a unified coordinate system. These files were then registered to the CBCT datasets, and the implant site was virtually planned. Using the long axis of the designed implant, an inspection plane was generated in the buccolingual direction for two-dimensional measurement acquisition. The STL models of bone contours at the three time points were visualized in 2D within the E-3D software. For horizontal bone defects, a line perpendicular to the long axis of the designed implant was drawn at the level of the implant platform. Three segment lengths were captured to represent the bone width at baseline, immediately after surgery, and at 6 months postoperatively, respectively. Pairwise subtraction of these values yielded the immediate width gain, the width gain at 6 months, and the width resorption.

Logging PEEK barrier exposure, infection, bone Implantation Failure, etc.