Precision in Practice: The Evolution of Patient-Specific Implants in Modern Surgery
Keywords:
Three-dimensional printing, patient specific implantsAbstract
Background: Patient-specific implants (PSIs), represent an advanced method for reconstructive and aesthetic surgery, especially in complex areas like maxillofacial surgery. These implants are specifically made to match the unique three-dimensional contours of a patient's anatomy, addressing challenges that standard implants may not adequately resolve. Over the last decade, considerable advancements have been made in the development and production of PSIs for maxillofacial applications.
Aim: This narrative review was conducted to understand the indications of patient specific implants in the rehabilitation of different congenital and acquired maxillofacial defects, along with their benefits, drawbacks, fabrication process, manufacturing method and future perspectives.
Methods: An electronic search was performed on EBSCO, Medline/Pubmed and Cochrane Library databases for the articles published from April 2012 to February 2024 was used.
Results: A total of 22 articles were collected and they were used to formulate this review. Despite constraints, the design of patient-specific implants (PSIs) ensured accurate placement due to their intricate shape matching the anatomy of reconstructed areas and the inclusion of retention features. There were no significant complications during the postoperative phase.
Discussion: Craniomaxillofacial reconstruction, essential for treating conditions like tumors and trauma, addresses both functional and aesthetic concerns. It encompasses trauma, pathology, neoplasia, esthetics, gunshot injuries, and congenital anomalies. The alternative options for synthetic reconstruction has grown to facilitate single-stage procedures, avoiding donor site issues. Patient-specific implants (PSI) are pivotal, widely utilized in various oral and maxillofacial surgeries, including TMJ reconstruction, trauma, and orthognathic procedures. The adoption of 3D printed PSIs in craniomaxillofacial surgery has surged recently.
Conclusion: Maxillofacial surgery is difficult due to intricate anatomy and issues with conventional implants. Yet, patient-specific implants (PSIs) enabled by 3D printing have transformed the discipline. They bypass the need for donor sites, ensuring accurate reconstruction and stability, especially in challenging areas like cranioplasty and orbital fractures. Despite being costly and requiring specialized resources, PSIs reduce adjustments, and optimize results, making them invaluable despite some accessibility challenges
Downloads
References
Alasseri N, Alasraj A. Patient-specific implants for maxillofacial defects:challenges and solutions. Maxillofac Plast Reconstr Surg. 2020 May;42(1):15.
Goswami R, Trivedi A, Kumar A. Evaluation of short and ultra-short dental implants in challenging clinical situations of resorbed ridges: A narrative review. SRM Journal of Research in Dental Sciences. 2024 Jan 1;15(1):45-9.
Huang MF, Alfi D, Alfi J, Huang AT. The Use of Patient-Specific Implants in Oral and Maxillofacial Surgery. Oral Maxillofac Surg Clin North Am. 2019 Nov;31(4):593-600.
Bhat M, Nandini V. The Realm of Patient Specific Implants In Maxillofacial Prosthodontics: A Review. J Dent Med Sciences. 2020 Nov;19(11):13-9.
Kotecha S, Ferro A, Harrison P, Fan K. Orbital reconstruction: a systematic review and meta-analysis evaluating the role of patient-specific implants. OralMaxillofac Surg. 2023 Jun;27(2):213-26.
Owusu JA, Boahene K. Update of patient-specific maxillofacial implant. CurrOpin Otolaryngol Head Neck Surg. 2015 Aug;23 (4):261-4.
Gander T, Essig H, Metzler P. Patient specific implants (PSI) in reconstruction of orbital floor and wall fractures. J Craniomaxillofac Surg 2015; 43:126-30.
Mertens C, Lo ̈wenheim H, Hoffmann J. Image data based reconstruction of the midface using a patient-specific implant in combination with a vascularizedosteomyocutaneous scapular flap. J Craniomaxillofac Surg 2013; 41:219-25.
Theworld’sfirstAMmandibleimplant.http://www.layerwise.com/the-worlds- firstpatient-specific-am-lower-jaw/. [Accessed 22 February 2015]
Binder WJ. Custom-designed facial implants. Facial Plast Surg Clin North Am 2008;16:133–146.
Guevara-RojasG,FiglM,SchichoK,etal.Patient-specificpolyetheretherke- tone facial implants in a computer-aided planning workflow. J Oral Maxillofac Surg2014; 72:1801 – 1812.
ParthasarathyJ.3Dmodeling,custom implants and its future perspectives in craniofacial surgery. Ann Maxillofac Surg 2014; 4:9–18.
Du R, Su Y, Yan Y, Choi, Yang W, Zhang C, Chen X, Curtin J, Ouyang J, Zhang BA. Systematic Approach for Making 3D- Printed Patient-Specific Implants for Craniomaxillofacial Reconstruction.Eng. 2020Sep;6(11):1291-301.
Moiduddin K, Mian SH, Umer U, Alkhalefah H, Ahmed F, Hashmi FH. Design, Analysis and 3D Printing of a Patient- Specific Polyetheretherketone Implant for the Reconstruction of ZygomaticDeformities. Polymers. 2023 Sep;15(4):886.
Lethaus B, Bloebaum M, Koper D, Poort-Ter Laak M, Kessler P. Interval cranioplasty with patient-specific implants and autogenous bone grafts Success and cost analysis. J Cranio Maxillofacial Surg.2014;42(8):1948–51.
Mazzoni S, Bianchi A, Schiariti G, et al. Computer-aided design and computer-aided manufacturing cutting guides and customized titanium plates are useful in upper maxilla waferless repositioning. J Oral Maxillofac Surg. 2015;73:701–7.
Gander T, Essig H, Metzler P, Lindhorst D, Dubois L, Rücker M, et al. Patient-specific implants (PSI) in the reconstruction of the orbital floorand wall fractures. J Cranio-Maxillofacial Surg. 2015;43(1):126–30.
Stoor P, Suomalainen A, Mesimäki K, Kontio R. Rapid prototyped patient-specific guiding implants in critical mandibular reconstruction.JCranio-Maxillo-Facial Surg. 2016.
Rotaru H, Schumacher R, Kim S-G, Dinu C. Selective laser melted titanium implants: a new technique for the reconstruction of extensive zygomatic complex defects. Maxillofac Plast Reconstr Surg.2015;37(1):1–6.
Johnson NR, Roberts MJ, Doi SA, Batstone MD. Total temporomandibular joint replacement prostheses: a systematic review and bias-adjusted meta-analysis. Int J Oral Maxillofac Surg.2017;46:86–92.
Trivedi A. Rehabilitation of mandibular defects using customized implants. J Indian Prosthodont Soc. 2020 Dec;20(Suppl 1):S29.
Ciocca L, Mazzoni S, Fantini M, Persiani F, Baldissara P, Marchetti C, et al. A CAD/CAM-prototyped anatomical condylar prosthesis connected to a custom-made bone plate to support a fibula free flap. Med Biol EngComput. 2012;50(7):743–9.
Suojanen J, Leikola J, Stoor P. The use of patient-specific implants in orthognathic surgery: a series of 30 mandible sagittal split osteotomy patients. J Craniomaxillofac Surg. 2017;45:990–4.
Kumar PR, Kalavathy N, Shetty MM, Sanketh AK, Tidke R. 3D Bioprinting: The Imminent Future of Maxillofacial Rehabilitation. J DentSci. 2021 May;13(3):109-20..
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.