Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis

Abstract

This study aimed to perform a systematic review and meta-analysis to compare pre-shaped implants on a patient-specific 3D-printed (3DP) model to manual free-hand shaping (MFS) for orbital wall reconstruction. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42021261594). A search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Clinicaltrials.gov, Google Scholar, and the grey literature. Ten articles were included, and six outcomes were analyzed. In total, 281 patients were in the 3DP group and 283 were in the MFS group. The studies had an overall high risk of bias. 3DP models resulted in a better accuracy of fit, anatomical angle reproduction, and defect area coverage. The correction of orbital volume was also superior with statistical significance. There was a higher percentage of the correction of enophthalmos and diplopia in the 3DP group. Intraoperative bleeding and hospital stay were reduced in the 3DP group. The meta-analysis of operative time showed a reduction in the average operative time by 23.58 min (95% CI: −43.98 to −3.19), which was statistically significant (t(6) = −2.8299, p = 0.0300). The 3DP models appear advantageous for an accurate orbital wall reconstruction, with fewer complications than those for conventional free-hand-shaped implants.

Presurgical Virtual Planning and Intraoperative Navigation with 3D-Preformed Mesh: A New Protocol for Primary Orbital Fracture Reconstruction

“…As a result of this experience, we started applying preoperative planning and navigation systems to the reconstruction of orbital fractures. Although navigation-assisted orbital reconstructions offer many advantages, there are few cases described in the literature [20]. Several authors have raised the importance of anatomically precise reconstructions of the orbital walls, including the most posterior parts of the orbit [21].…”

A Meta-Review about Medical 3D Printing

“…Another author mentions transnasal sphenoid endoscopy, cerebrovascular, spinal functional surgery [38]. Oral and maxillofacial surgical procedures and plastic surgery procedures [47,48,[50][51][52][53][54][55][56]94] include orbital reconstruction surgery [48,53,54], jaw reconstruction [56] and cleft care [94]. Jacobs and colleagues [48] mention methods such as cranial defect repair, condylar head reconstruction and mandible fracture repair.…”

Advancements in Oral Maxillofacial Surgery: A Comprehensive Review on 3D Printing and Virtual Surgical Planning

“…For instance, research indicates that using 3D printed surgical guides can drastically reduce surgical time, simultaneously ensuring greater precision and thereby minimizing potential complications [34]. Another study accentuated the effectiveness of a patient-specific 3D printed implant, documenting its pivotal role in expediting postoperative recovery and optimizing aesthetic outcomes [35]. In a similar vein, the significance of 3D models in enhancing patient comprehension and subsequently obtaining informed consent was highlighted, marking a direct correlation with elevated patient satisfaction and confidence in the therapeutic approach [36].…”