Use of 3-D printing technologies in craniomaxillofacial surgery: a review

Three-dimensional (3-D) printing is a method of manufacturing in which materials like plastic or metal are deposited onto one another in layers to produce a 3-D object. Because of the complex anatomy of craniomaxillofacial structures, full recovery of craniomaxillofacial tissues from trauma, surgeries, or congenital malformations is extremely challenging. 3-D printing of scaffolds, tissue analogs, and organs has been proposed as an exciting alternative to address some of these key challenges in craniomaxillofacial surgery. There are four broad types of 3-D printing surgical applications that can be used in craniomaxillofacial surgery: contour models (positive-space models to allow preapplication of hardware before surgery), guides (negative-space models of actual patient data to guide cutting and drilling), splints (negative-space models of virtual postoperative positions to guide final alignment), and implants (negative-space 3-D printed implantable materials or 3-D printed molds into which nonprintable materials are poured). 3-D printing technology is being successfully used for surgeries for head and neck malignancies, mandibular reconstruction, orthognathic surgeries, for mandibulectomies after osteoradionecrosis, orbital floor fracture surgeries, nasal reconstruction, and cranioplasties. The excitement behind 3-D printing continues to increase and hopefully will drive improvements in the technology and its surgical applications, especially in craniomaxillofacial region. This present review sets out to explore use of 3-D printing technologies in craniomaxillofacial surgery.