#7-3. Regulatory limitations of the 3D printing technology and future goals

Dr. Jung-whan Baek (H Plastic Surgery)

Image 4-1. This photograph was taken during her first visit at my practice. She presented with severe asymmetry of the mandible and abnormal indentation in the left mandible.Image 4-1. This photograph was taken during her first visit at my practice. She presented with severe asymmetry of the mandible and abnormal indentation in the left mandible.

Image 4-2. The panoramic image taken at the first visit showed severe bone defect in the gonial angle and the body of the mandible. Due to malocclusion, teeth have been lost and remaining teeth had become very loose. This patient had problems articulating and eating and required immediate reconstructive surgery. This patient, however, had given up on a treatment after visiting a university hospital where she was told that fibula free flap surgery and dental implants would be needed and the treatment would last over 6 months and cost KRW 40 million. It would be correct to recommend textbook remedies, however, patients often are deterred from choosing the treatment due to excessive financial burden, impractical treatment duration, and donor site complications, etc.

Image 4-3. Oral scanning examination of the occlusal contact area showed very poor alignment of the teeth. Normal ingestion of food was impossible and trismus and malocclusion were evident due to posterior mandible displacement.

Image 4-4. The patient experienced a traumatic accident about a decade ago but could not receive proper treatment. Based on history taking, the mandible as well as cheekbone may have been fractured from trauma. The cheekbone fracture could lead to bone integration due to little displacement but the mandible was not attached properly after complete fracture. Therefore, bone resorption occurred around the fracture, ultimately leading to loss of the left mandible.

I consulted an orthodontist and prosthodontist to plan reconstructive surgery using computer simulation and 3D printing. The final reconstructive surgery was planned to be carried out using customized titanium implant for recovering the bone defect. The reconstructive surgery was planned as follows.