Precision In Practice: The Evolution Of Patient-Specific Implants In Modern Surgery"

Abstract

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.