How 3D printing is used to create patient-specific jaw restorations

Gautam Gupta – vice president, global GTM, healthcare, 3D Systems, explains how it uses 3D printing technology to design patient specific implants, run virtual surgical planning, and to minimise how invasive dental surgery is.

Creating and placing jaw restorations or implants for dental patients can be extremely time-intensive, with the need for manual model shaping, bone grafts and titanium meshes – to name just a few of the challenges.

3D Systems has been able to develop a design process to produce patient-specific implants (PSIs). The creation of individualised implants for complex surgical procedures is aided by utilising the advanced processes and enhanced flexibility that 3D printing enables.

Due to the highly customised nature of this process, its DICOM to PRINT (D2P) and Geomagic Freeform 3D design software allows the creation of PSIs more meticulously than ever before. Geomagic Freeform, for example, takes advantage of touch-based haptic devices, the Touch and Touch X, to help make the process extremely natural. Transforming traditional techniques into digital design with precision at the core.

But, how are the 3D Systems innovations used in real-world scenarios? To highlight how this process works, I’d like to go through the typical use case of a patient in need of a PSI from a partner of 3D Systems, Graft3D Healthcare Solutions, who create prosthetics using our technology.

The first step is for a cone-beam computed tomography scan of the patient, the data from which can be rendered in DICOM, before being converted by the 3D Systems D2P software into an STL file. For reference, D2P can also be used by surgeons, radiologists, lab technicians, and device designers for the quick realisation of digital 3D models, but here we would use it to extract the exact amount of bone exposed during a CBCT.

This provides precise information about such elements as bone density and soft tissues. The net result is a minimally invasive osteotomy, with the enhanced accuracy potentially forming less discomfort for the patient.

Implants designed to specific measurements, customised to each and every individual, can then be created. The STL file previously converted by the D2P software is now imported into our Geomagic Freeform software – which combined with our haptic-feedback devices – is used to formulate the particular location, length, depth and angles for the prosthetic replacement.

Again, here we are looking at a specific use case for Geomagic Freeform, but the flexibility of the platform means that it could also be used for different projects such as turning the hand fabrication of orthoses and prostheses (O&P) into a digital workflow or establishing functional cages for applications such as custom medical implants.

By this point, you can hopefully see the improvements in accuracy and patient comfort, and that’s before we discuss the savings in time and changes in surgical procedure.

When formulating customised PSIs, speed of creation is an important factor. The use of the Geomagic Freeform software facilities the impressions of the patient’s mouth to be overlaid with the proposed new prosthetic design, the effect being an assessment period up to 50-60% faster thanks to the eradication of multiple patient visitations.

Once the elements are created using a combination of plastic and metal additive manufacturing (AM), the surgical procedure can commence. Here, adopting our 3D printing and AM processes creates millimetre-perfect prosthetics catered to the individual’s mouth, reducing bone scraping and lessening repetitive drills during surgery.

The net result is a reduction in time, an increase in accuracy and a less inconvenienced patient. Plus, the use of 3D-printed PSIs helps reduce the chances of periodontal disease further down the line.

Clinicians being able to work interactively with patient-specific interactive models thanks to 3D Systems’ D2P and Geomagic Freeform software is truly a game-changing revelation for subperiosteal implants and we continue to work tirelessly to find new technological-breakthroughs to assist medical professionals.