Page 92 - IJB-9-2

International Journal of Bioprinting Steam-sterilized and degradable FFF-printed PLA/PHA surgical guides

there are different methods by which the surgical guide’s cofunded by the European Funds for Regional Development
accuracy can be assessed. The assessment of the post- (EFRE) and the German state Rhineland-Palatinate.
operative implant position requires either CBCT scan or an
intraoral scan. The CBCT scan could be imprecise because Conflict of interest
of beam hardening effects, which can negatively impact The authors declare that they have no competing interests.
the matching of the image to the pre-operative planned
position of the implant. Intraoral scan on the other side Author contributions
may be affected by the registration process itself, especially
when reference points are scarce. Conceptualization: Matthias Gielisch, Christoph Boesing,
Bilal Al-Nawas, Peer W. Kämmerer
Furthermore, the length of the used implant could also Data curation: Matthias Gielisch, Marc Krumpholtz
have an effect on the measured deviation. For example, for Investigation: Matthias Gielisch, Daniel G.E. Thiem, Marc
the same deviation at implant base and the same angular Krumpholtz, Peer W. Kämmerer
deviation, a longer implant has a higher deviation at the apex Methodology: Matthias Gielisch, Christoph Boesing, Marc
than a shorter one. For various long implants, the implant Krumpholtz, Bilal Al-Nawas, Peer W. Kämmerer
length has no effect on the accuracy after static navigation, Supervision: Bilal Al-Nawas, Peer W. Kämmerer
while a long distance between the sleeve and the bone has a Validation: Matthias Gielisch, Diana Heimes, Daniel G. E.
negative effect . To the knowledge of the authors, no data Thiem, Christoph Boesing, Marc Krumpholtz, Bilal
[36]
comparing short implants versus longer implants regarding Al-Nawas, Peer W. Kämmerer
the accuracy after static navigation is available. Visualization: Matthias Gielisch, Diana Heimes
In this study, we used the sterilization protocol that is Writing – original draft: Matthias Gielisch, Diana Heimes,
regularly used in the sterilization department. The effect Daniel G. E. Thiem, Peer W. Kämmerer
of other protocols with longer or shorter cycles, higher or Writing – review & editing: Matthias Gielisch, Diana
lower temperatures, and other pressure settings was not Heimes, Daniel G. E. Thiem, Christoph Boesing, Marc
investigated in the present study. Using lower temperatures Krumpholtz, Bilal Al-Nawas, Peer W. Kämmerer
could result in less deformation, but the protocols with the
lower temperatures require longer durations of sterilization Ethics approval and consent to participate
process, so the material changes are not necessarily lesser. Not applicable.
A question, regarding this topic, remains as to whether
a less accurate implantation with PLA/PHA guides can Consent for publication
be justified with the benefits of degradation or recycling Not applicable.
capabilities of the material, even if the existing materials
without those capabilities can attain better results. This Availability of data
topic must be further studied and discussed. Data can be obtained on reasonable request from the

5. Conclusion corresponding author.
The studied PLA/PHA printing material showed high, References
significant deviations in angle and 3D accuracy at the 1. Gibson I, David R, Stucker B, 2015, Additive Manufacturing
implant base after steam sterilization in comparison to Technologies: 3D Printing, Rapid Prototyping, and Direct
non-sterile PLA/PHA guides and guides printed with Digital Manufacturing. Berlin: Springer.
MED610. However, short implants with a length of 5.5 mm https://doi.org/10.1007/978-1-4939-2113-3
could be placed with a sterilized PLA/PHA guide with a
comparable accuracy as implants placed with guides made 2. Goetze E, Gielisch M, Moergel M, et al., 2017, Accelerated
of materials already used in clinical practice. workflow for primary jaw reconstruction with microvascular
fibula graft. 3D Print Med, 3: 3.
Acknowledgments https://doi.org/10.1186/s41205-017-0010-7

None. 3. Goetze E, Kämmerer PW, Al-Nawas B, et al., 2020,
Integration of perforator vessels in CAD/CAM free fibula
Funding graft planning: A clinical feasibility study. J Maxillofac Oral

The presented results are partially part of the ongoing Surg, 19: 61–66.
InnoProm-project “3D Biopolymer” (Grant No: 84003603) https://doi.org/10.1007/s12663-019-01215-y

Volume 9 Issue 2 (2023) 84 https://doi.org/10.18063/ijb.v9i2.655