Application of 3D Printing Technology in the Rahabilitation of Reconstructed Jaw by Implant supported Prosthesis following Ablative Surgery (GP03)

Ablative surgeries in the Oro Facial regions following Malignancies or SevereTrauma result in Resection of the Jaws, either Maxilla or Mandible or both.

These defects if not Reconstructed, lead to Oro Facial Cripple having limitations in Mastication, Degluttition, Aesthetics and Phoenitics often leading to Poor Quality of Life or Suicidal tendencies.

Earlier these defects were closed Primarily leading to all sorts of issues, later Reconstruction Plates were used to retain the facial forms. But these also did not withstand the test of time as they too were getting exposed over the thin and friable facial skin or mucosa.

Then the Era of Microvascular Reconstruction started where in the bony defects in the Oro Facial regions were reconstructed by Micro Vascular Free Fibula grafts.

Initially, there was a lot of learning curve as the first few reconstructions were only to place the Fibula grafts and give the Facial forms without giving due importance to the Mastication or Occlusion .

In the present Era, Three-dimensional (3D) printing technology, also referred as Additive Manufacturing or Rapid Prototyping or Solid freeform technology is used extensively in the medical field.

It was first demonstrated in 1986, since then this innovative technique has attracted significant attention, especially within the Head and Neck surgical specialities, Maxillofacial, Otorhinolaryngology and Plastic surgery and Implantology owning to its incredible ability to create complex constructs with high precision.

At present, this technology is made use in Reconstructive surgery and Implant surgery to precisely place the Osteotomies on a Fibula graft to get a good contour of the face and also to orient the Fibula grafts in the correct arch form so as to receive the Dental Implants and restore the Occlusion.

The Advantages of 3D Printing technology are:

A) To Obtain highly accurate Anatomic Prototype models and to ease preoperative planning and improve postoperative facial contour,
symmetry. This may help clinicians to inspect anatomy preoperatively and practice different techniques and consequently reduce
the operating time and minimise errors.

B) Virtually planning and printing pre-contoured grafts and plates to improve surgical outcomes and reduce operating time.

C) Offering high-accuracy prosthesis that can enhance the aesthetic and psychological status of patients suffering from significant
scarring, deformation and asymmetry.

D) 3D printing technology not only help in getting the correct Arch form of the Jaws but also aid in printing Surgical splints to correctly
and stratigically place implants in the Fibula and to restore the Occlusion.

E) Proposing cutting-edge simulation models to enhance surgical education at both undergraduate and postgraduate level.

With these innovations in the cutting edge Science and Technology, we are comfortably Resecting the Jaws, Reconstructing the defects with Micro Vascular Fibula Grafts and also Rehabilitating them with Dental Implants to finally restore Occlusion all by REVERSE ENGINEERING technique having the END IN MIND.

There by, the 3 cardinal principles of Facial Contouring viz: Resection, Reconstruction and Rehabilitation is fullfilled.

This presentation Aims to build interest in the usage of these 3D models to fullfill the objectives of Facial Recontouring and Implatology.