Austria Achieves First with Ceramic 3D Printed Jaw Implant by Lithoz

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Surgeons at Austria’s Kepler University Hospital have successfully implanted a 3D printed ceramic jaw in a patient, marking the first use of ceramic material in this type of procedure. While 3D printed implants have been used in previous surgeries, primarily with titanium, this innovation offers unique benefits.

Jaw atrophy, a condition where the jawbone deteriorates due to tooth loss, making traditional dentures impossible to use, can affect not only elderly patients but also younger people with severe dental issues. With severe atrophy, conventional treatments often require multiple surgeries and bone grafting, which are not possible for many older patients due to health concerns. Instead, this new implant requires only one procedure, and on top of that, it reduces the healing time by 75% and minimizes trauma.

Made from biocompatible zirconia, this implant is tailored to the patient’s anatomy, ensuring a custom fit—a quality that conventional methods cannot achieve.

Zirconia subperiostal implants. Image courtesy of Lithoz.

Combining the efforts of 19 interdisciplinary partners, this project was led by Austrian automation and robotics specialist Profactor and funded by the European Union’s Horizon 2020 program. Aimed at developing 3D printed, patient-specific implants for different age-related pathologies, the project saw Austrian company Lithoz, known for its advanced ceramic 3D printing technology, play a crucial role in fabricating the implant.

In charge of the implant’s design was the Centre for Medical Physics and Biomedical Engineering at the Medical University of Vienna, with essential contributions from the BTI Biotechnology Institute in Spain and BioMed Centre Innovation in Germany. All of this diverse expertise was integrated to create medical solutions by the INKplant project, a European initiative that advances personalized healthcare through 3D printing.

Lithoz’s lithography-based ceramic manufacturing (LCM) technology was crucial in creating the high-precision, custom-fit implant. This method allows for a high degree of design freedom, making it possible to produce implants tailored to the specific needs of individual patients. What’s more, by using zirconia, a ceramic known for its strength and compatibility with the human body, Lithoz says the implant integrates seamlessly with the patient’s jawbone. Used in medical implants since the 1980s and in dental since the early 2000s, zirconia has proven its worth in medicine thanks to its durability and ability to bond well with bone tissue.

The First Patient

The patient who received the 3D printed ceramic implant had faced significant challenges. Due to compromised health, he had lost numerous dental implants and bone grafts, making further conventional treatments, including surgeries, impossible. After exhausting other options, and as a result of significant scarring issues, he received the new implant as a compassionate use case. He was referred to Christoph Staudigl, a medical and dental surgeon at Kepler University Hospital in Linz.

DDr. Christoph Staudigl and Dr.Michael-Malek. Image courtesy of Kepler University Clinic.

Staudigl decided to proceed with this innovative procedure. The customized design was pioneered by the Centre for Medical Physics and Biomedical Engineering at the Medical University of Vienna in collaboration with Staudigl. The operation was completed in a single session. Despite some expected wound healing issues, the implant showed clinical stability after 60 days and superior soft tissue compatibility of zirconia compared to titanium. Furthermore, it demonstrated its potential for broader applications.

While this is the first time a 3D printed ceramic subperiosteal jaw implant has been used, the medical field has seen other significant progress with 3D printed jaw implants typically using titanium. For example, in 2012,  an 83-year-old woman received a 3D printed titanium lower jaw implant in the Netherlands, marking the first operation of its kind for titanium implants. Numerous surgeries have since used 3D printed titanium implants for jaw reconstruction, particularly for patients with tumors or severe trauma. In 2017, Morriston Hospital in Wales performed the first jaw reconstruction surgery combining traditional bone grafts with 3D printed titanium implants. Then, in 2022, a patient with head and neck cancer received a custom 3D printed titanium lower jaw implant.

Zirconia subperiostal implants on surgical applicator. Image courtesy of Lithoz.

3D printed titanium jaw implants have been the standard in previous procedures. However, the successful surgery with a ceramic jaw implant marks a significant advancement in medical technology. It sets the stage for future advances in dental and maxillofacial surgery, eliminating the need for bone grafts and reducing recovery times. A clinical trial is being prepared to systematically validate the implant’s efficacy, which will be patented and adopted as a medical device. While the implant used in this surgery was developed and fabricated by Lithoz, future implants will be manufactured by Agensmed, a spin-off from BioMed Centre, using Lithoz 3D printers. This trial aims to ensure the implant’s reliability and safety for widespread clinical use.

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