Patient-Specific Implants in Maxillo-Facial Reconstruction: Current Practices and Way Forward-An Overview of Systematic Reviews.

Abstract

Background: Maxillofacial reconstruction has undergone a paradigm shift from conventional to digital workflows. The integration of Three Dimensional (3D) technology and patient-specific implants (PSIs) has revolutionized surgical planning and execution, particularly in complex procedures. This overview of systematic review (SR) aims to provide healthcare professionals with a comprehensive, evidence-based resource on current practices and future perspectives of maxillofacial reconstruction using 3D technology and PSIs.

Methods: A comprehensive literature search was conducted from inception 30th September 2023, using keywords such as "3D printing," "patient-specific implants," "maxillofacial reconstruction," and related terms. The search included PubMed, ScienceDirect, and Cochrane databases. Only SRs focusing on maxillofacial reconstruction with 3D technology were included. Article quality was assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) tool and Glenny et al. checklists.

Results: Out of 327 search results, fourteen articles met the inclusion criteria. Most reviews focused on reconstructing orbital, nasal, maxillary, mandibular, and temporomandibular joint defects. Notably, only one Cochrane review was identified, indicating a lack of high-quality randomized or cohort studies. Furthermore, only three reviews had a registered protocol.

Conclusion: While the literature supports the use of PSIs and 3D technology in maxillofacial reconstruction, the evidence quality remains moderate to poor. The heterogeneity of the data across studies has limited the ability to perform a meta-analysis. SRs emphasize the need for careful ethical considerations when using medical devices like PSIs. Although advanced technologies enhance surgical outcomes, they come with a steep learning curve and require rigorous clinical validation.