Feasibility study of low-dose computed tomography (CT) technology for maxillofacial bone three-dimensional (3D) printing in skeletal class III malocclusion.

BACKGROUND

Skeletal class III malocclusion is among the most common dental and maxillofacial malformations. Three-dimensional (3D) printing technology has become widely applied in orthopaedics. The data source for 3D printing of maxillofacial bones is computed tomography (CT). The issue of the CT radiation dose caused by maxillofacial bone 3D printing has attracted increasing attention. This study aimed to explore the feasibility of low-dose CT technology in maxillofacial bone 3D printing and the clinical value of low-dose maxillofacial bone 3D printing.

METHODS

Ninety patients with class III malocclusion who planned to undergo maxillofacial bone 3D printing and 3D-CT were prospectively enrolled and randomly divided into the conventional CT dose 3D printing group (Group A, n=28), low-CT dose 3D printing group (Group B, n=32) and 3D-CT control group (Group C, n=30). The quality of maxillofacial bone 3D printing was subjectively evaluated, and a Likert-scale questionnaire was used to assess the clinical value of maxillofacial bone 3D printing.

RESULTS

No significant differences in the general demographic characteristics were detected among Groups A, B, and C. Compared with that in Group A (0.8±0.1 mSv), the radiation effective dose (ED) in Group B (0.3±0.1 mSv) was reduced by approximately 63%. There were no significant differences between Groups A and B in 3D printing quality indices (including clarity, integrity, accuracy or artefacts) (all P>0.05). There were significantly higher subjective scores for the clinical value of maxillofacial bone 3D printing (Group A=4.1±0.5, 4.0±0.5, 4.0±0.4 and 4.1±0.5; Group B=4.0±0.5, 4.0±0.4, 4.0±0.5 and 4.0±0.5) than for 3D-CT (Group C=3.1±0.5, 3.1±0.4, 2.9±0.4 and 3.0±0.4) in diagnosing and classifying, formulating the surgical plan, simulating the surgical process, and predicting postoperative recovery (all P<0.05).

CONCLUSIONS

Low-dose CT technology can be effectively applied for maxillofacial bone 3D printing, reducing the radiation dose without affecting the 3D printing quality. Maxillofacial bone 3D printing technology is superior to 3D-CT in class III malformations.