On-Site 3-Dimensional Printing and Preoperative Adaptation Decrease Operative Time for Mandibular Fracture Repair.

PURPOSE

The purpose of this study was to compare the intraoperative time and operating room costs between patients with mandibular fractures treated with traditional adaptation and fixation and patients treated with preadapted plates created with on-site 3-dimensionally printed models.

PATIENTS AND METHODS

We designed a prospective comparative cohort study for patients with mandibular fractures. The control group received traditional open reduction and internal fixation of their mandibular fractures. For the patients in the experimental group, a 3-dimensional (3D) model of the fractured mandible was made using an on-site 3D printer. The model then underwent osteotomy, if needed, and the plate was adapted to the model, submitted to sterilization, and implanted in the patient. The primary outcome variable was intraoperative plating time, and the secondary outcome variable was operating room cost. The groups were compared by the Wilcoxon signed rank test.

RESULTS

The 38 patients included in the study had a mean age of 39.6 years, and male patients comprised 81.6%. The mean time for intraoperative plate adaptation was 22.8 ± 2.1 minutes in the control group and 6.9 ± 0.3 minutes in the experimental, 3D printed group (P < .0001). In the experimental group, 4 patients (21%) required a single intraoperative corrective bend. The calculated average cost per patient based on the average operating costs at our institution was $2,306.45 in the control group and $698.00 in the experimental group.

CONCLUSIONS

This study shows that the use of 3D printers for fabrication of models to prebend maxillofacial reconstruction plates is associated with decreased operating room time and costs. Using an on-site 3D printer requires minor start-up and use costs and results in a significant reduction in operating room time, which remains one of the most expensive aspects of facial trauma care.