Dental Tribune USA

For jaw cancer patients, in-house 3-D printing allows quicker restoration of teeth

By Dental Tribune USA
September 28, 2020

In-house 3-D printing allows patients with malignant disease to more quickly receive immediate tooth restoration — treatment that had been regarded as low importance for these patients because of the severity of their disease, a new study found.

The 3-D digital workflow eliminates the wait in providing replacement teeth using the conventional approach and is less costly, according to the study published in the August issue of the Journal of Oral and Maxillofacial Surgery, the official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS).

For the study, 12 patients underwent virtual surgical planning (VSP) for a procedure called free fibula maxillofacial reconstruction, which replaces bone and soft tissues in the face removed to treat cancer with bone and soft tissue from the patient’s leg. A dental prosthesis was created for each patient to be placed at reconstruction. For five patients, a dental laboratory made the prostheses. For the other patients, a surgeon designed the prostheses and 3-D printed them in-house. Four of the patients who received a prosthesis from the in-house 3-D printing had malignant tumors.

Researchers found time and cost were less for developing the prostheses in-house than using a dental laboratory. Sending production of a prosthesis to dental laboratories leads to delays in the prosthesis being ready to give to the patient soon after cancer surgery, the study notes.

“Such a delay has limited the usefulness of this treatment to benign conditions,” researchers wrote. “With point-of-care 3-D printing, we have fabricated a dental prosthesis within 24 hours of the VSP session, eliminating any additional waiting period before surgery.”

For the in-house printing, the surgeon received digital files immediately after the VSP session. Within a day, the prosthesis was 3-D printed. The in-house prostheses were prepared for surgery one to two weeks before a plate and models from VSP arrived, so treatment was not delayed more than the standard duration for acquiring the plate and models from the vendor, according to the study.

By comparison, the offsite dental laboratory needed an additional two weeks to create the prostheses. On average, the prostheses created at the offsite dental laboratory cost $617 compared to $8.34 for resin for the in-house 3-D prosthesis, the study notes. However, the researchers cautioned that costs are associated with obtaining a 3-D printer and supplies (less than $3,000).

The small study did not compare prosthesis quality between the two settings.

“As point-of-care 3-D printing becomes available to more surgeons, we anticipate this will become a viable solution for many patients,” researchers wrote.

The authors of “Immediate Teeth in Fibulas: Planning and Digital Workflow With Point-of-Care 3D Printing” are Fayette C. Williams, DDS, MD; Daniel A. Hammer, DDS; Todd R. Wentland, DDS, MD; and Roderick Y. Kim, DDS, MD; from the Division of Maxillofacial Oncology and Reconstructive Surgery at John Peter Smith Health Network in Fort Worth, Texas.

Read the full article at JOMS.org/article/S0278-2391(20)30359-1/fulltext.

(Source: The American Association of Oral and Maxillofacial Surgeons)

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