A semi-automated design workflow for patient-specific implants in orthognathic surgery using generative design

Patient-specific implants (PSIs) have demonstrated improved outcomes and have reduced the complexity of surgery in orthognathic surgery. However, the design process for PSIs is time-consuming and complicated, leading to high costs that hinder its widespread adoption. The aim of this study was to develop a novel workflow for designing PSIs using generative design (GD) techniques to streamline the process. The proposed workflow was implemented using GD-embedded software, Fusion (Autodesk Inc.), and tested by designing PSIs for one Le Fort I osteotomy case and one genioplasty case. The performance of the GD workflow was assessed through the time required for design and the basic properties of the GD PSIs. The hands-on time for the design was 94 min for the Le Fort I fixation plate and 45 min for the genioplasty plate. The maximum von Mises stress was 227.63 MPa for the Le Fort I fixation plate and 237.31 MPa for the genioplasty fixation plate. The GD-based workflow simplified and accelerated the design of PSIs for orthognathic surgery. Biomechanical analysis indicated the feasibility of generative designed patient-specific implants for clinical practice.