Three-dimensional printed immediate surgical obturator before maxillectomy: A pilot study

Abstract

Purpose: Surgical obturators improve patients’ quality of life after maxillectomy by maintaining oral functions. As digital workflows are commonly used for planning maxillofacial surgeries and prostheses, the hypothesis of this study was that the fabrication of the immediate surgical obturator could benefit from the currently available open-source software. The aim of this study was to develop a protocol for fabricating before the surgery a prefabricated, personalized, and lightweight immediate surgical obturator with open-source software and limited amount of relining material. Materials and methods: The protocol steps consisted of digital simulation of maxillectomy defect based on CBCT segmentation of cadavers’ heads according to the surgical planning. Design of immediate surgical obturator by boolean subtraction tools using open-source software, scaling down the final designed immediate surgical obturator to 90%, and then 3D-printing it layer by layer in biocompatible resin to be relined and fitted intraorally after surgery. Results: The developed protocol was successfully achieved. Maxillectomy defect interest areas were successfully segmented using open-source software. Immediate surgical obturator was also successfully designed and 3D printed using biocompatible resin materials. The immediate surgical obturator was thus adapted to the defect with limited amount of relining material. Conclusions: This innovative method could give the patient an opportunity to benefit from a personalized, biocompatible and lightweight immediate surgical obturator. (Int J Maxillofac Prosthetics 2021;4:18-24)