Customised 3D Printed Guides for Mandibular Fracture Management- A Report of Two Cases

Abstract

In treating mandibular fractures, accurate anatomical reduction and reconstruction remains quite challenging and arduous for the oral maxillofacial surgeon using traditional devices and methods. Therefore, advanced techniques have become essential to simplify and achieve safe and desirable anatomical reduction with lesser operative time. Introduction of 3 Dimensional (3D) printed guides helps to achieve bony consolidation in the correct anatomic position to facilitate standard mouth opening and restore the pretrauma occlusion. In the following case reports (7-year-old male, 35-year-old male), the preoperative surgical planning began with the construction of 3D imaging in both the cases after radiographic examination. For virtual reconstruction, the images from the multiplanar Computed Tomography (CT) scan were converted into Digital Imaging and Communications in Medicine (DICOM) format. The present reports have proposed using an inexpensive customised 3D printed cast metal surgical guide in the treatment of two cases of mandibular fracture. A customised 3D printed surgical guide and an occlusal stent were designed and fabricated to assist in placing screws and plates for approximation of fractured segments and to guide the occlusion during surgery. They also highlight the efficacy and functionality of a customised 3D printed cast metal surgical guide in increasing the reduction accuracy, reducing surgical difficulties, and improving clinical outcomes with a lesser operative time in treating mandibular fractures.

Keywords

• additive manufacturing
• cast metal guide
• mandibular trauma
• occlusal splint
• virtual surgery