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Evaluation of structured training in osteotomy and splitting for BSSO using a 3D-printed mandibular model
Leonhard Gerich1,2, Yao Li1,2, Oliver-Costin Vladu1
1Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.
BMC Medical Education
|July 10, 2026
Summary
This study demonstrates that a cost-effective, 3D-printed mandibular model significantly enhances surgical skills for bilateral sagittal split osteotomy (BSSO) training. The realistic model improved trainee performance and reduced complications, offering a valuable tool for surgical education.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Education
- 3D Printing Technology
Background:
- Bilateral sagittal split osteotomy (BSSO) training requires practical methods to optimize outcomes and prevent complications like nerve damage.
- Traditional training methods may not fully prepare surgeons for the complexities of BSSO.
- Developing realistic and cost-effective simulation tools is crucial for improving surgical education.
Purpose of the Study:
- To evaluate a structured training program using a 3D-printed mandibular model for BSSO.
- To assess the model's effectiveness in improving osteotomy and splitting performance.
- To determine the cost-effectiveness and realism of the 3D-printed training model.
Main Methods:
- A cost-effective 3D-printed mandibular model, including a flexible inferior alveolar nerve, was created.
- Twenty participants performed BSSO osteotomy and splitting steps twice, with feedback.
- Surgical performance was assessed using the OSATS questionnaire, nerve proximity, and bad split counts.
Main Results:
- Surgical skills, measured by OSATS scores, significantly improved from 23.7 to 27.2 (p < 0.001).
- The distance between the inferior alveolar nerve and the fracture surface increased significantly (0.2 mm to 1.12 mm, p = 0.012).
- The number of bad splits decreased from 15 to 4 (p = 0.044), with a material cost of approximately $4.
Conclusions:
- A realistic, cost-effective 3D-printed mandibular model can be effectively used in structured BSSO training.
- This training model is associated with improved surgical performance and reduced complications.
- Further research is needed to validate the simulator's impact on real-world surgical outcomes.
