Dimensional Accuracy and Clinical Fitness of Customized 3D-Printed Hydroxyapatite Bone Block Grafts in Alveolar Ridge Augmentation

Abstract

Objective This article evaluates the feasibility of manufacturing customized three-dimensional (3D)-printed hydroxyapatite (3DHA) bone block grafts using binder jetting for alveolar ridge augmentation prior to implant placement. Materials and Methods Cone-beam computed tomography (CBCT) scans of the alveolar ridge from eight patients with horizontal ridge defects were converted to STL files to generate 3D models. These models were used to design and fabricate patient-specific 3DHA bone block grafts using binder jetting. The 3D-printed grafts underwent micro-CT (μCT) scanning, generating μSTL files, which were compared with the original computer-aided design models using inspection software. Dimensional accuracy in three axes (x, y, z) and discrepancies between the 3DHA grafts and ridge defect geometries were assessed. The 3DHA grafts were clinically evaluated for effectiveness in augmenting alveolar ridge defects. Results Percentage relative differences between the original STL files and those from μCT were -2.72, -7.24, and -3.26% for width, length, and height, respectively. Root mean square deviation was 0.19 ± 0.04 mm overall, -0.22 ± 0.25 mm for the margin area, -0.08 ± 0.18 mm for the inner area, and 0.03 ± 0.11 mm for the contour. Mean gap distances at the defect site were 0.19 ± 0.22 mm (marginal) and 0.37 ± 0.12 mm (internal), which are within clinical acceptable ranges. Clinical application showed no need for intraoperative graft adjustment. At 6 months postaugmentation, bone volume increased from 164.4 ± 37.87 mm 3 (initial μCT) to 169.2 ± 39.38 mm 3 (follow-up CBCT), though this change was not statistically significant (p = 0.0538). The mean dimensional change was 0.30 ± 0.14 mm. Conclusion In this pilot study, 3DHA bone block grafts demonstrated acceptable dimensional accuracy and were successfully used for alveolar ridge augmentation, indicating their potential for patient-specific applications. © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.