20 years of 3D printing in surgical planning of distraction osteogenesis

For 20 years, maxillofacial surgery has benefited from the use of 3D modeling and rapid prototyping techniques in the realization of physical replicas of the patient’s anatomy in the presurgical planning of complex mandibular distraction osteogenesis. It is known that the main disadvantages of distraction osteogenesis are the long surgical time and the complicated placement and manipulation of distractors during surgery. Furthermore, this treatment could be of high risk, especially in pediatric patients, as multiple postoperative complications can occur, and it is very important to preserve the integrity of the mandibular nerve during the operation. This chapter shows the extensive experience achieved by an Icelandic group in maxillofacial surgery and neurosurgery using 3D-printed models to improve the accuracy of distractor placement, thus reducing the operation time by at least 40–50minutes and improving patient education and compliance. Furthermore, a machine learning instance-based algorithm was used to understand how image-based variables could be helpful for two purposes: to predict the need for 3DP in DO, achieving an accuracy of 75%, and evaluating the quality of a 3DP model based on scanning parameters and self-reported assessment, achieving an accuracy of 70.4%.