Plastic Surgery Innovation with 3D Printing for Craniomaxillofacial Operations

Abstract

Plastic Surgery restores unique human qualities such as appearance, speech (palate), hands, to improve interaction with others and quality of life. Three-dimensional printing technology can be applied to Plastic Surgery craniomaxillofacial operations to change the bony skeleton of the skull, face, and jaws. Three-dimensional printing for patient-specific applications have four types: Type I contour models, Type II guides, Type III splints, Type IV implants. Plastic Surgery innovation in 3D printing clinical applications are described here and https://www.slucare.edu/newsroom/kmov-science-of-healing-faces-of-childhood.php.

Figure 1

3D-printed models from our in-house 3D-printer. The white mandible is the patient’s injured mandible from the gunshot. The blue mandible was made by taking the less injured left side of the white mandible, and mirroring it to create a theoretically perfect mandible. This predicted preinjury mandible can be used as our contour model. The patient’s maxilla is printed as the blue skull to demonstrate that the theoretical blue mandible’s condyles were seated within the TMJ joints, indicating the blue mandible has normal functional size and shape.

Figures 2 and 3

These images demonstrate the reconstruction plate being pre-bent to the 3D-printed predicted preinjury model.

Figure 4

Left, aerial view of a patient’s cranium with a significant skull defect, with the 3D-printed guide (blue) fitting perfectly in the cranial defect. This blue printed guide can be used during surgery to harvest a precisely shaped bone graft.

Figure 5

Right, posterior to anterior view of the cranium and cranial defects with a 3DP-guide in one of the two large cranial defects. A separate 3DP-guide was used for this second, distinct skull defect.

Figure 6

Patient with complex fronto-orbital craniofacial defect, with a 3DP yellow guide that is used to harvest autologous bone graft. This yellow guide not only captures the unpredictable shape of the skull defect, but also captures the complex 3D angulation of the lateral aspects of the human forehead where it sweeps into the temple region. This yellow 3D guide allows harvest of bone that has this congruent angle, ensuring an autologous bone graft that matches the patient’s specific forehead contour.