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Cirugía Plástica Ibero-Latinoamericana

On-line version ISSN 1989-2055Print version ISSN 0376-7892

Abstract

MANTRANA, Gustavo; JACOBO, Oscar; HARTWING, Denisse  and  GIACHERO, Virginia. Three-Dimensional printing models in the preoperative planning and academic education of mandible fractures. Cir. plást. iberolatinoam. [online]. 2018, vol.44, n.2, pp.193-200.  Epub Feb 08, 2021. ISSN 1989-2055.  https://dx.doi.org/10.4321/s0376-78922018000200012.

Background and Objective

The constant advances of science have allowed materializing images for the creation of three-dimensional physical objects in a range of diverse applications. Its use in Medicine has been rapidly disseminated with unimaginable results, with the creation of real anatomical models. The high cost and little access to stereolithographic printers forces us to look for other lower cost alternatives for the printing of three-dimensional models of good quality and definition. The emergence of the printers with fused deposition modeling (FDM) technology has allowed incorporating the use of models of lower cost, more accessible and more available for the medicine field.

We present and evaluate the use of three-dimensional printing with FDM technology in the manufacture of models in three dimensions (3D) that can be used in the preoperative planning of mandible fractures and in the residents training.

Methods

We studied 8 patients with mandible fractures. The initial assessment included computed tomography imaging study, and the digital file was processed into stereo lithography format. After this, the model was printed in polylactic acid using an open source fused deposition modeling (FDM) technology printer manufactured in Uruguay. The resulting models were carefully evaluated and used for academic training. Different pre-operatory approaches were studied, analyzing fracture patterns and enabling a precise selection of osteosynthesis plates and screws according to the characteristics of each patient.

Results

We achieved a real scale with a 1:1 proportion models. All measurements were concordant, pre-bended plates were perfectly adapted to the patient during surgery, and the screws had an accurate longitudinal measure. Total operative time was 20% reduced. Plastic Surgery teachers and residents were satisfied using the models for preoperative clinical discussion and planning, emphasizing the advantage of manipulating real scale models compared to three-dimensional imaging.

Conclusions

We have created models of low cost, high quality and accuracy, for the pre-operatory planning of mandible fracture reconstruction, accomplishing to reduce surgical time and improving the academic learning of the plastic surgery residents.

Keywords : Mandible; Mandible fracture; Fracture fixation; Internal fixation devices; Three dimensional image.

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