Cost Comparison of Industry Versus In-House Three-Dimensional Printed Models for Microvascular Mandible Reconstruction.

Background: Computer-aided design and manufacturing can enhance microvascular mandible reconstruction, particularly in cases with preexisting segmental defects or exophytic tumors where precise in situ plate bending is difficult. However, its high cost may limit its use in high-volume academic centers. Objective: To compare the costs of industry-performed patient-specific milled locking mandibular reconstruction plates (LMRPs) and surgeon-performed plate bending using 3D-printed (3DP) models as measured by billing data. Methods: A retrospective study of patients who underwent mandibular reconstruction with either industry-performed milled plates or with surgeon-bent plates based on a 3DP model. Costs of patient-specific and stock plates were obtained from the hospital's financial database, along with surgical outcomes associated with each protocol. Results: The study included 25 patients (14 males and11 females) undergoing fibula free flap reconstruction for mandibular defects, averaging 6.4 cm in size. Groups were comparable in age, sex, defect size, number of osteosyntheses, and incidence of osseous union. The average cost of milled plates was $7,709, while 3DP models and standard reconstruction plates cost $1,453, a difference of $6,256. The 3D printer's initial investment was $18,998, but readily with models produced for about $10 per model. Conclusion: Surgeon-performed 3D printing for plate bending is less expensive than computer-aided, patient-specific plates for mandibular reconstruction.