Developing a Patient-Specific Maxillary Implant Using Additive Manufacturing and Design

Abstract

Maxillectomy is the surgical removal or resection of the maxilla or upper jaw bone. A total or partial maxillectomy can be performed depending on how far the tumour has spread. This paper will discuss a patient diagnosed with an aggressive tumour in half of the top jaw who had to undergo an operation to remove the hemi-maxilla and orbital floor. Due to the extent and complexity of the defect, it was decided to manufacture an anatomical model of the hard tissues for planning a possible laser-sintered titanium implant using Additive Manufacturing (AM). The CRPM had only two weeks to design and manufacture the titanium implant, due to the severity of the tumour. The anatomical model was sent to the surgeon to cut the nylon model where the bone resection was planned. Furthermore, the prosthodontist made a wax model of the planned titanium frame that was reverse- engineered and used as reference geometry in the design software.Materialise® design suite was used to design the patient-specific maxilla and cutting jig. The EOS M280 Direct Metal Laser Sintering (DMLS) system was instrumental in achieving the direct manufacturing of the bio-compatible titanium implant. The EOS P385 system was used to manufacture the pre-operation planning model as well as the cutting jig.The process chain followed to complete this case study will be discussed showing how this intervention improved the quality of life of a SA patient. Furthermore, the proposed paper and presentation will discuss the post-operation review of the patient showing the impact AM had in accelerating patient-specific implant manufacturing. The authors seek to claim a progressed level of maturity in the proposed manufacturing value chain. The claim is based on the successful completion of the analysis and synthesis of the problem , the validated proof-of-concept of the manufacturing process and the in-vivo implementation of the final product.