Feasibility and efficiency of a rapid manufacturing workflow for patient-specific titanium implants in orbital floor...

Orbital floor fractures are common in maxillofacial trauma and may result in functional and aesthetic sequelae. Patient-specific orbital implants (PSI) improve anatomical reconstruction but are often limited by manufacturing delays, restricting their use in semi-urgent settings.

This study aimed to assess the feasibility of a rapid workflow for PSI fabrication and to evaluate its effectiveness in restoring orbital volume compared with conventional reconstruction using a manually contoured poly-p-dioxanone (PDS™) sheet.

A retrospective comparative study included 24 patients treated surgically for orbital floor fractures. Twelve patients received PSI produced through a rapid workflow based solely on post-traumatic computed tomography data, and twelve patients were treated using PDS™. Orbital volumes were measured preoperatively and postoperatively on the fractured and contralateral sides using 3D Slicer software. Postoperative residual error and correction gain were calculated. Operative time and delay between consultation and surgery were also compared. Statistical analysis was performed using the Mann-Whitney U test.

Postoperative residual error was significantly lower in the PSI group (p < 0.001). A non significant trend toward greater correction gain was observed with customized implants (p = 0.071). Operative time was significantly shorter in the PSI group (p = 0.029). No difference was found in the delay between consultation and surgery (p = 0.674).

Rapidly manufactured PSI allow accurate orbital volume restoration without delaying semi-urgent surgical management and represent an effective alternative to conventional PDS™ reconstruction.