Patient-specific 3D-printed four-part interlocking mold-assisted sticky bone graft shaping in late secondary alveolar bone grafting.

Accurate graft adaptation remains a major challenge in alveolar bone grafting, especially when particulate graft materials are used. This technical note presents a digital and surgical workflow for shaping a defect-matched sticky bone graft with a patient-specific three-dimensional (3D)-printed mold. Cone-beam computed tomography-based segmentation and volumetric planning were performed in 3D Slicer, and the cleft geometry was transferred to Meshmixer for mold design. A four-part mold was fabricated to allow controlled condensation of the graft material and retrieval without fragmentation. Autogenous symphyseal bone, xenogenic graft material, and platelet-rich fibrin were combined to form sticky bone, which was packed into the mold and then placed into the defect after setting. The proposed workflow integrates virtual planning, sticky bone preparation, and mold-assisted graft shaping into a single process. This technique may improve graft adaptation, simplify intraoperative handling, and support more standardized graft preparation in alveolar cleft reconstruction.