Better outcomes come from virtual surgical planning

Dental Tribune International

Mon. 1. January 2024

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SEOUL, Korea: The rise of virtual surgical planning (VSP) and 3D printing signify the ongoing digital evolution in orthognathic and oral and maxillofacial surgery. Such advances that utilise custom aids such as surgical guides help ensure that surgical success no longer comes down to surgeons’ raw skill alone. That being said, a recent review has provided a comprehensive look into the clear benefits of adopting VSP workflows and 3D-printing solutions, in addition to noting that doing so involves substantial training and expenses.

VSP employs advanced imaging and software to enable surgeons to visualise and simulate surgeries before they occur. This boosts predictability and customisation, catering to each patient’s unique needs. Unlike traditional planning that relies on 2D images, VSP offers a 3D interactive approach, improving outcomes and efficiency.

3D printing has emerged as a transformative tool in orthognathic and oral and maxillofacial surgery. This technology has various applications, from advanced preoperative planning, in which tailored patient models are developed for detailed visualisation of surgical steps, to intra-operative guidance through custom surgical guides. Studies have illustrated the potential of 3D-printed surgical guides to significantly reduce surgical times and ensure precision, minimising complications. Besides their surgical advantages, 3D-printed models enhance patient understanding, serving as an essential tool for informed consent.

An additional benefit of 3D printing is the improvement of postoperative care, especially with custom implants and prostheses, optimising patient recovery. This is particularly true in cases of facial reconstruction, for which custom 3D-printed titanium implants with diverse applications have been introduced, offering both essential mechanical support and marked biocompatibility. In managing orbital blowout fractures, for example, these implants can be meticulously crafted based on the anatomy of the undamaged orbit, ensuring restoration of typical ocular movement.

When it comes to reconstructive efforts for maxillary and mandibular defects, tailored titanium devices have shown success. These devices encourage the migration of osteogenic cells from the remaining mandibular bone, promoting natural healing and bone regeneration. They also help in managing the challenges associated with the reconnection of mandibular bone segments after tumour removal.

In practice, VSP starts with patient-specific imaging data converted into 3D digital models. This helps the surgical team understand complex anatomies and perform virtual adjustments. Studies have proved VSP’s effectiveness, which leads to reduced operative time and improved postoperative results. When paired with 3D-printed surgical guides, VSP provides unparalleled surgical accuracy, reducing the complications often seen with traditional 2D-based planning and supporting advanced patient care.

However, despite the profound potential of VSP combined with 3D printing, challenges exist. Mastery of the necessary software for these technologies necessitates intensive training and can be financially taxing. The quality of 3D printing is contingent on high-resolution digital imaging, and various factors affect the precision of digital scans. Notably, the rapid evolution of 3D printing and VSP has superseded the establishment of standards and regulations, raising concerns over patient safety and procedural accountability.

Technological advancements integrating novel biomaterials and artificial intelligence such as machine learning will likely further refine these tools’ precision, affordability and usability. Simultaneously, regulatory bodies must devise clear guidelines to safeguard patient well-being while championing technological strides.

The study, titled “Advancements in oral maxillofacial surgery: A comprehensive review on 3D printing and virtual surgical planning”, was published on 1 September 2023 in Applied Sciences.