Computer-aided designed 3D-printed polymeric scaffolds for personalized reconstruction of maxillary and mandibular defects: a proof-of-concept study

• DOI: 10.1007/s00405-023-08392-0
• Publication Date: 2024-01-03T07:02:32Z
• Authors: Davide Mattavelli; Vincenzo Verzeletti; Alberto Deganello; Antonio Fiorentino; Tommaso Gualtieri; Marco Ferrari; Stefano Taboni; William Anfuso; Marco Ravanelli; Vittorio Rampinelli; Alberto Grammatica; Barbara Buffoli; Roberto Maroldi; Ceretti Elisabetta; Rita Rezzani; Piero Nicolai; Cesare Piazza
• Keywords: Computers; Reproducibility of Results; Mandible; Plastic Surgery Procedures; 03 medical and health sciences; 0302 clinical medicine; 3D printing; Computer-aided design; Mandible; Maxillary; Maxillofacial reconstruction; Scaffold;; Printing, Three-Dimensional; Cadaver; Humans; Computer-Aided Design; Mandibular Reconstruction; Head and Neck

Abstract Purpose To investigate the potential reconstruction of complex maxillofacial defects using computer-aided design 3D-printed polymeric scaffolds by defining the production process, simulating the surgical procedure, and explore the feasibility and reproducibility of the whole algorithm.

Methods This a preclinical study to investigate feasibility, reproducibility and efficacy of the reconstruction algorithm proposed. It encompassed 3 phases: (1) scaffold production (CAD and 3D-printing in polylactic acid); (2) surgical simulation on cadaver heads (navigation-guided osteotomies and scaffold fixation); (3) assessment of reconstruction (bone and occlusal morphological conformance, symmetry, and mechanical stress tests).

Results Six cadaver heads were dissected. Six types of defects (3 mandibular and 3 maxillary) with different degree of complexity were tested. In all case the reconstruction algorithm could be successfully completed. Bone morphological conformance was optimal while the occlusal one was slightly higher. Mechanical stress tests were good (mean value, 318.6 and 286.4 N for maxillary and mandibular defects, respectively).

Conclusions Our reconstructive algorithm was feasible and reproducible in a preclinical setting. Functional and aesthetic outcomes were satisfactory independently of the complexity of the defect.