Background Periodontally accelerated osteogenic orthodontics (PAOO) effectively increases alveolar bone volume and broadens orthodontic treatment options. However, bone grafting during PAOO faces challenges such as graft displacement, membrane collapse, and insufficient coronal bone regeneration. This study aimed to evaluate whether 3D-printed digital bone grafting guides could improve graft stability and alveolar bone regeneration compared with conventional PAOO. Methods In this retrospective cohort study, 10 patients who underwent PAOO surgery were evaluated. Patients were divided equally into GBG (digital guided bone grafting) and Control groups (conventional PAOO). Cone-beam computed tomography (CBCT) images and periodontal clinical parameters, including probing depth (PD), attachment loss (AL), keratinized gingival width (KW), and gingival biotype, were assessed preoperatively (T0), immediately postoperatively (T1), and at 12 months follow-up (T2). Changes in alveolar bone morphology were analyzed using Mimics software, with data statistically compared using SPSS 25.0. Results Immediately postoperatively, the GBG group exhibited significantly greater vertical bone augmentation and horizontal bone augmentation in crown and mid-root areas compared to the control group (<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12903_2025_6753_Article_IEq1.gif" Format="GIF" Height="14" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:P\)</EquationSource> </InlineEquation> < 0.05). At the 12-months follow-up, GBG maintained significantly superior vertical bone regeneration and coronal horizontal bone volume, particularly in the coronal third of the alveolar bone (<InlineEquation ID="IEq2"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12903_2025_6753_Article_IEq1.gif" Format="GIF" Height="14" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:P\)</EquationSource> </InlineEquation> < 0.05). Both groups demonstrated significant improvements in KW compared to baseline (<InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12903_2025_6753_Article_IEq1.gif" Format="GIF" Height="14" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:P\)</EquationSource> </InlineEquation> < 0.05), while PD and AL showed no significant intergroup differences. Conclusions The application of 3D-printed bone grafting guides significantly improves graft stability, reduces postoperative bone resorption, and enhances coronal alveolar bone regeneration after PAOO.

The osteogenic effect of 3D-printed bone grafting guides in PAOO: a retrospective cohort study

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2025年9月2日

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Han Bao,
Yiran Luo,
Qingfei He,
Yan Jiang,
Ling Chen,
Yun Wu

摘要

Background

Periodontally accelerated osteogenic orthodontics (PAOO) effectively increases alveolar bone volume and broadens orthodontic treatment options. However, bone grafting during PAOO faces challenges such as graft displacement, membrane collapse, and insufficient coronal bone regeneration. This study aimed to evaluate whether 3D-printed digital bone grafting guides could improve graft stability and alveolar bone regeneration compared with conventional PAOO.

Methods

In this retrospective cohort study, 10 patients who underwent PAOO surgery were evaluated. Patients were divided equally into GBG (digital guided bone grafting) and Control groups (conventional PAOO). Cone-beam computed tomography (CBCT) images and periodontal clinical parameters, including probing depth (PD), attachment loss (AL), keratinized gingival width (KW), and gingival biotype, were assessed preoperatively (T0), immediately postoperatively (T1), and at 12 months follow-up (T2). Changes in alveolar bone morphology were analyzed using Mimics software, with data statistically compared using SPSS 25.0.

Results

Immediately postoperatively, the GBG group exhibited significantly greater vertical bone augmentation and horizontal bone augmentation in crown and mid-root areas compared to the control group ( \(\:P\) < 0.05). At the 12-months follow-up, GBG maintained significantly superior vertical bone regeneration and coronal horizontal bone volume, particularly in the coronal third of the alveolar bone ( \(\:P\) < 0.05). Both groups demonstrated significant improvements in KW compared to baseline ( \(\:P\) < 0.05), while PD and AL showed no significant intergroup differences.

Conclusions

The application of 3D-printed bone grafting guides significantly improves graft stability, reduces postoperative bone resorption, and enhances coronal alveolar bone regeneration after PAOO.