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Review
. 2017 Jun;10(2):89-98.
doi: 10.1055/s-0036-1594277. Epub 2017 Jan 3.

Three-Dimensional Printing: Custom-Made Implants for Craniomaxillofacial Reconstructive Surgery

Mariana Matias  1 , Horácio Zenha  2 , Horácio Costa  2
Affiliations
Review

Three-Dimensional Printing: Custom-Made Implants for Craniomaxillofacial Reconstructive Surgery

Mariana Matias et al. Craniomaxillofac Trauma Reconstr. 2017 Jun.

Abstract

Craniomaxillofacial reconstructive surgery is a challenging field. First it aims to restore primary functions and second to preserve craniofacial anatomical features like symmetry and harmony. Three-dimensional (3D) printed biomodels have been widely adopted in medical fields by providing tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. Craniomaxillofacial reconstructive surgery was one of the first areas to implement 3D printing technology in their practice. Biomodeling has been used in craniofacial reconstruction of traumatic injuries, congenital disorders, tumor removal, iatrogenic injuries (e.g., decompressive craniectomies), orthognathic surgery, and implantology. 3D printing has proven to improve and enable an optimization of preoperative planning, develop intraoperative guidance tools, reduce operative time, and significantly improve the biofunctional and the aesthetic outcome. This technology has also shown great potential in enriching the teaching of medical students and surgical residents. The aim of this review is to present the current status of 3D printing technology and its practical and innovative applications, specifically in craniomaxillofacial reconstructive surgery, illustrated with two clinical cases where the 3D printing technology was successfully used.

Keywords: 3D printing; craniomaxillofacial defects; implants; prosthesis; rapid prototyping; reconstructive surgery.

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Figures

Fig. 1
Fig. 1
Virtual planning using 3D reconstruction software (Anatomics Pro, Anatomics TM, Melbourne, Australia) based on 3D CT scan data.
Fig. 2
Fig. 2
Clinical image of the patient before surgery (a), right maxilla specimen (b), and 3D biomedical model and surgical guides to dissect the iliac crest (c).
Fig. 3
Fig. 3
Subtotal maxillectomy with resection of greater than 50% of the palate. (a and b) Chimeric in muscle and bone flap. (c and d) Myosseous iliac crest flap implantation.
Fig. 4
Fig. 4
One-year postoperative images: (a and b) 3D virtual reconstructions; (c and d) inside and lateral views.
Fig. 5
Fig. 5
(a and b) Preoperative images of the patient, frontal view. (c–e) Preoperative CT scan data with 3D reconstruction.
Fig. 6
Fig. 6
Virtual preoperative planning by 3D biomodeling technique with definition of exact bone defect and generation of a patient-specific surgical guide for bone and osteosynthesis plate modeling.
Fig. 7
Fig. 7
(a) Preoperative iliac crest free flap planning; (b–d) 3D biomodel of patient anatomy and custom fitting surgical guides; (e) free flap tailored in accordance with patient's defect morphology, volume, length, and angle; (f) Iliac crest free flap implantation.
Fig. 8
Fig. 8
(a and b) Before and 9 months after reconstructive surgery.
See this image and copyright information in PMC

References

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