In oral and maxillofacial procedures, pre-surgical planning allows surgeons to predefine surgical steps and develop detailed intervention plans. With many hospitals trying to speed up their surgical workflows and reduce costs, additive manufacturing (AM) can help by transforming anatomical modelling. Rob Pitts, sales manager at Tri-Tech 3D, UK provider of Stratasys 3D printing solutions, explores how.
Tri-Tech 3D
Traditionally, surgeons would perform surgical planning using 2D models based on CT or MRI scans of different areas of the patient’s body, like the skull or the temporomandibular joints. Though useful for pre-operative visualisations, 2D images don’t represent the 3D complexity of anatomical structures and also lack depth perception, making it difficult to accurately assess spatial relationships between structures and identify routes for intervention.
Now, hospitals can 3D print tactile, realistic models of the area that surgeons will operate on. This involves using 3D scanning to create a digital design — a CAD file — and then printing it. For example, by 3D printing a model of a cancerous jawbone, clinicians can identify a surgical approach and practice the procedure before entering the operating theatre — ensuring consistent, high-quality patient care.
By using realistic 3D-printed models for surgical planning, surgeons can improve patient safety by reducing the time spent under anaesthesia. One systematic review published in the Journal for Clinical Medicine found that over 50% of studies on 3D printing and preoperative planning noted a decrease in operation duration when hospitals used 3D printing technology.
The cost of running an operating theatre is approximately £1,200 an hour or £4,800 for a four-hour procedure, so minimising any delays is crucial. While a 3D printer carries an upfront investment, this technology can provide quick knock-on savings by helping to reduce operation times.
How is AM being used?
Many hospitals are now printing models of patients’ skulls, teeth and soft tissue, helping the surgical team identify any deformities or other patient-specific characteristics. For example, by printing a model of the patient’s skull before a cranioplasty procedure, surgeons can ensure that the cranial plate will fit the patient’s skull exactly.
Surgical implants are another area of interest. When installing an artificial hip or another implant, surgeons may not know what screws they need until they get into the operating theatre because the quality and thickness of the bone will vary depending on the patient. However, by producing a realistic 3D-printed model of the bone structure, surgeons can identify what type of screw is required and have it ready in advance. This is another way that 3D printing can help reduce operating time.
Selecting 3D printing technology
When selecting an AM system, hospitals typically specify an AM system that can support multiple materials and colours. Depending on the application, the material may need to be translucent, opaque or a particular colour. This will allow the operator to create vivid models that replicate an individual patient’s tissue and bone structure as well as surgical guides that accurately represent the surfaces of their intraoral setting.
There are machines and materials available designed specifically with medical applications in mind. For example, the Stratasys J5 MediJet is an all-in-one system that is compatible with a wide range of materials, including Biocompatible Opaque (MED615RGD IV), Elastico Clear (FLX934) and WSS150 — all offering different colours and properties. These materials are sterilisable and biocompatible in line with EN ISO 10993-1:2018 standards to ensure patient efficacy and safety.
Although many hospitals still use 2D scanning when planning oral or maxillofacial procedures, these lack the depth and accuracy to help surgeons fully prepare. Instead, surgeons can 3D print realistic models of the operating field, and use these to identify intervention routes and obstacles early.