CAD-CAM-generated hydroxyapatite scaffold to replace the mandibular condyle in sheep: Preliminary results

Leonardo Ciocca, Davide Donati, Massimiliano Fantini, Elena Landi, Adriano Piattelli, Giovanna Iezzi, Anna Tampieri, Alessandro Spadari, Noemi Romagnoli, Roberto Scotti

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


In this study, rapid CAD-CAM prototyping of pure hydroxyapatite to replace temporomandibular joint condyles was tested in sheep. Three adult animals were implanted with CAD-CAM-designed porous hydroxyapatite scaffolds as condyle substitutes. The desired scaffold shape was achieved by subtractive automated milling machining (block reduction). Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Using the same technique, fixation plates were created and applied to the scaffold pre-operatively to firmly secure the condyles to the bone and to assure primary stability of the hydroxyapatite scaffolds during masticatory function. Four months post-surgery, the sheep were sacrificed. The hydroxyapatite scaffolds were explanted, and histological specimens were prepared. Different histological tissues penetrating the scaffold macropores, the sequence of bone remodeling, new apposition of bone and/or cartilage as a consequence of the different functional anatomic role, and osseointegration at the interface between the scaffold and bone were documented. This animal model was found to be appropriate for testing CAD-CAM customization and the biomechanical properties of porous, pure hydroxyapatite scaffolds used as joint prostheses.

Original languageEnglish (US)
Pages (from-to)207-218
Number of pages12
JournalJournal of Biomaterials Applications
Issue number2
StatePublished - Aug 1 2013


  • animal study
  • rapid prototyping
  • Regenerative medicine
  • scaffolding

ASJC Scopus subject areas

  • Biomedical Engineering
  • Biomaterials


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