A Systematic Approach for Making 3D-Printed Patient-Specific Implants for Craniomaxillofacial Reconstruction

Craniomaxillofacial reconstruction implants, which are extensively used in head and neck surgery, are conventionally made in standardized forms. During surgery, the implant must be bended manually to match the anatomy of the individual bones. The bending process is time-consuming, especially for inexperienced surgeons. Moreover, repetitive bending may induce undesirable internal stress concentration, resulting in fatigue under masticatory loading in vivo and causing various complications such as implant fracture, screw loosening, and bone resorption. There have been reports on the use of patient-specific 3D-printed implants for craniomaxillofacial reconstruction, although few reports have considered implant quality. In this paper, we present a systematic approach for making 3D-printed patient-specific surgical implants for craniomaxillofacial reconstruction. The approach consists of three parts: First, an easy-to-use design module is developed using Solidworks (R) software, which helps surgeons to design the implants and the axillary fixtures for surgery. Design engineers can then carry out the detailed design and use finite-element modeling (FEM) to optimize the design. Second, the fabrication process is carried out in three steps: (1) testing the quality of the powder; (2) setting up the appropriate process parameters and running the 3D printing process; and (3) conducting post-processing treatments (i.e., heat and surface treatments) to ensure the quality and performance of the implant. Third, the operation begins after the final checking of the implant and sterilization. After the surgery, postoperative rehabilitation follow-up can be carried out using our patient tracking software. Following this systematic approach, we have successfully conducted a total of 41 surgical cases. 3D-printed patient-specific implants have a number of advantages; in particular, their use reduces surgery time and shortens patient recovery time. Moreover, the presented approach helps to ensure implant quality. (C) 2020 THE AUTHORS. Published by Elsevier LTD on behalf of Chinese Academy of Engineering and Higher Education Press Limited Company.