Polylactic Acid-Based In-house Three-Dimensional-Printed Intraoperative Surgical Model is a Time- and Cost-efficient Approach for Mandibular Reconstruction

Abstract

Abstract Background The advanced development of computer-assisted design/manufacturing (CAD/CAM) technology aids in the process of producing patient-specific template for intraoperative dissection and fixation guide. To date, CAD/CAM technology has been greatly used in reconstructive mandibular cases to enhance accuracy, reduce operation time, and minimize possible complications. However, this technology was believed to be cost- and time-inefficient, limiting widespread use in several institutions. Methods This study displayed five case series incorporating in-house three-dimensional (3D)-printed models. 3D imaging was retrieved from computed tomography scan Digital Imaging and Communications in Medicine files, which was processed to STL (Stereo-lithography) format to recreate a symmetrical postoperative design. The rendered 3D file was then printed with the in-house printer using polylactic acid (PLA) material. A sterilized 3D-printed model was used as intraoperative guidance for plate bending and positioning. The process, time, and cost of each 3D model production were documented. Results A total of 100% success rate was observed in processing 3D-printed model in all cases, with no fail in printing. The printing time on average took 7 hours, 39 minutes (ranging from 5 hours 59 minutes up to 9 hours 43 minutes) and cost spent on average was approximately $1.83 on each print (ranging from $1.69 up to $2.10). The in-house 3D printer costs approximately $750, which is compact and can be easily purchased online. Conclusion CAD/CAM technology is a cost- and time-efficient approach, in addition to its renowned benefits in increasing surgical accuracy, reducing operation time, improving postoperative look, and minimizing complications. We suggest the implementation of in-house printed PLA-based 3D surgical guide for mandibular reconstructions.