Methodology and Validation of 3D-Printed High-Fidelity Mandible Models for Surgical Simulation and Training

Mandibular bilateral sagittal split osteotomy (BSSO) is a common procedure used in orthognathic surgery. The greatest complication of BSSO is damage to the inferior alveolar nerve, resulting in facial numbness and poor quality of life. This study aimed to create a low-cost, biomechanically accurate 3D-printed mandible model for surgical training to prevent such complications.

A 3D mandible model was created from CT scans and printed using 12 different resin mixtures. Biomechanical testing was performed to determine percent elongation, tensile strength, yield strength, and Young's modulus. Four surgeons performed user testing to determine the most realistic model. The authors compared the osteotomy force profile of the best model to the human cadaveric mandible and commercially available model.

A mix of 45% Anycubic Colored UV and 55% Siraya Tech Tenacious resins was found to best mimic human bone. Surgeons reported feeling an accurate proprioceptive transition between cancellous and cortical bone. The osteotomy force profiles were similar across our 3D-printed (left: 2.66±1.67 N, right: 3.23±1.80 N), cadaveric (left: 3.18±1.81 N, right: 2.16±0.96 N), and commercial (left: 2.69±1.68 N, right: 3.10±1.88 N) mandibles. On maximal force testing, this model (left: 6.18 N, right: 6.80 N) closely resembled the cadaveric mandible (left: 6.59 N, right: 3.99 N) and commercially available model (left: 6.31 N, right: 6.39 N).

A low-cost 3D-printed mandible was developed and validated for surgical simulation in BSSO. Future applications include resident education and preoperative planning.