Customized 3D-printed surgical templates for maxillary repositioning: a systematic review

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Medical Device Design

Background:

• Three-dimensional (3D) surgical templates enhance precision in orthognathic surgery, specifically for maxillary repositioning.
• Inconsistent terminology and a wide variety of available templates hinder comparison of outcomes and practices.
• Selecting the most suitable template for specific orthognathic surgery cases remains challenging.

Purpose of the Study:

• To systematically review the literature on 3D-printed surgical templates used in orthognathic surgery.
• To map existing approaches and designs of these templates.
• To propose a classification system for 3D-printed surgical templates based on design and outcomes.

Main Methods:

• A systematic literature search was conducted in PubMed, Embase, and Cochrane Library, adhering to PRISMA guidelines.
• Data extracted included template design, accuracy, operative time, complications, and reported advantages/limitations.
• Thirty-five studies met the inclusion criteria for analysis.

Main Results:

• A classification framework is proposed, categorizing templates into bone-borne and tooth-bone-borne types with three subtypes based on integration with implants, fixation plates, or intraoperative plate bending.
• Most reviewed templates demonstrated acceptable accuracy (≤2 mm) with minimal reported complications.
• Variations in surgical workflow, instrumentation, and intraoperative flexibility were observed across different template types.

Conclusions:

• The proposed classification system effectively categorizes the diverse range of 3D-printed surgical templates found in the literature.
• This framework can aid clinicians in understanding and selecting appropriate templates for orthognathic surgery.
• Further standardization in reporting may improve comparability of outcomes in future research.