Self-Made Rapid Prototyping Technique for Orbital Floor Reconstruction: Showcases for Technical Description

Abstract

Background: Restoring the orbital cavity integrity in orbital floor defects is a challenging issue due to the anatomical complexity of the floor's surface. This is a showcase for technical description of a novel “in house” rapid prototyping protocol aimed to customize implant for orbital floor reconstruction. Methods: The authors present 4 cases to show our Computer-aided-design and Computer-aided-manufacturing digital workflow. The system was based on a 3D-printed press that; through a virtually designed mold, was used to conform a patient specific titanium mesh for orbital floor reconstruction. Results: The merging procedure analysis by iPlan Cranial 3.0 (Brainlab, Munich, Germany) highlighted a 0.71 ± 0.23 mm (P <0.05) discrepancy in a point-to-point superimposition between the digital planned reconstruction and the real in vivo result. Conclusions: The authors expect that this technique will reduce operative time and cost however further study and larger series may better define the applicability in everyday surgical practice.

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

“…3DP models can be printed on an inexpensive printer of a reasonable base size. With the advent of automated segmentation software, these models can be made available in every OR around the globe, thus allowing surgeons to use these anatomically accurate models to increase their precision during surgery and reduce patient complications [49]. When 3DP model-based orbital implants were compared with CAD-CAM-based PSIs for orbital defect reconstruction, there was no advantage offered by CAD-CAM PSIs over 3DP model-based implants regarding the ophthalmological outcomes; however, it improved the patient condition post-operatively, mainly due to less intraoperative time and bleeding [33].…”

Low-Cost Cranioplasty—A Systematic Review of 3D Printing in Medicine

“…FDM enables the design and production of bone scaffolds and implants, and takes part in drug development research [ 24 , 25 , 26 , 27 , 28 , 49 ]. Novel literature also presents numerous examples where it was used to prepare cranioplasty implants [ 29 , 30 , 31 , 32 ]. For example, Thakur et al used an FDM printer to prepare an ABS-made template for subsequent PMMA-implant fabrication, reporting high accuracy, precision, and excellent esthetics, which were obtained postoperatively [ 50 ].…”

“…In justified cases, print castings can be used to reconstruct a cranial base, for instance, in Arnold–Chiari syndrome [ 29 ]. Modern techniques for the repair of sphenoid dysplasia are also based on the pre-operative 3D-printing models of the skull base [ 32 , 124 ]. The use of 3D printing also contributes to the preparation of autologous transplants for craniofacial reconstruction surgeries in patients after severe burns [ 125 ].…”