The New Paradigm in Medical Modeling: Utilizing Consumer-Level Desktop 3D Printers

Introduction: 3D stereolithographic models are shown to be accurate for patient anatomy_,¹ significantly enhancing the predictability of clinical outcomes in complex oral and maxillofacial surgical procedures. It has been demonstrated that the use of stereolithographic models positively affects patient care by reducing anesthesia and operating room time_² and improving preoperative planning and surgical simulation. It is also useful as an educational tool for resident training and patient demonstration. Prohibitive costs of commercial stereolithography have been a barrier to frequent utilization. The aim of this study is to assess the feasibility and use of low cost 3D desktop printed model technology in complex maxillofacial surgical procedures.

Materials and Methods:A prospective study was designed at the Nova Southeastern University Department of Oral and Maxillofacial Surgery from March 2015 to February 2016. A fifth generation MakerBot Replicator was used to produce a cohort of fifty polylactic acid (PLA) models in the following categories: trauma, pathology, orthognathics and reconstruction. Modeling software permitted digital manipulation of models including mirroring, supports and segmentation. Models were then used for reference, patient education, implant customization, and resident training. On 15 of the CT scans, three points were digitally measured and corresponding locations were compared to the 3D printed model. Five commercial sterolithographic models were manufactured by 3DSystems and were compared to the desktop printed 3D models at three corresponding measurements. Resident and attending surgeons reviewed each model preoperatively. Patient surveys were completed utilizing survey questionnaires.

Results:The use of 3D desktop models improved surgical outcomes comparably to previously demonstrated clinical advantages of 3D stereolithographic models. At 1/100 of the cost of commercial sterolithographic models, 3D printed models were found to be beneficial for diagnosis, surgical planning and reference during surgery, and an understanding of extensive pathological and traumatic defects. Printed models were found to be accurate to one tenth of a millimeter compared to CT and commercially available printed models except in the areas where supports were applied. All surveyed patients reported increased understanding of their proposed surgery and more confidence in their surgeon.

Conclusion: Low cost 3D desktop printed models can be successfully used in oral and maxillofacial surgery for a variety of indications and diverse clinical procedures that rival more expensive Stereolithographic models.

1. Chopra K: Complex craniofacial reconstruction using stereolithographic modeling. Annals of plastic surgery Volume: 72 Issue: 1 Date: 2014

2. Kermer C: Preoperative stereolithographic model planning for primary reconstruction in craniomaxillofacial trauma surgery journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. Volume: 26 Issue: 3 Date: 1998