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In-House 3D-Printed Occlusal Splints: A Cost-Effective and Scalable Workflow for Maxillofacial Surgery
Thomas Ren
*, Anahita Nimbalkar, Richard Redett, Robin Yang, Pasha Shakoori
Plastic Surgery, Johhs Hopkins School of Medicine, Hopewell Junction, NY
Introduction: Occlusal splints stabilize the jaws intraoperatively to facilitate occlusal correction and improve mastication. However, commercially manufactured splints are often costly and time-consuming. This study aimed to develop and validate a complete in-house workflow for the design and fabrication of 3D-printed occlusal splints. Methods: An in-house workflow was developed utilizing open-source software for the extraction of maxillofacial computed tomography (CT) data and voxel-based segmentation of mandibular/maxillary segments. A novel fracture reduction technique was established within a 3D modeling environment (Blender), utilizing semi-automated segmentation and a custom digital occlusogram to achieve precise alignment. Following virtual reduction, splints were designed and fabricated using a commercial resin-based 3D printer and biocompatible resin. Engineering duration and manufacturing costs were analyzed across a cohort of seven users (2 experts, 5 novices). Statistical analysis utilized Mann-Whitney U-tests for continuous variables. Results: The mean workflow time was 100.4±29.2 minutes. Initial design time of occlusal splint was statistically similar between experts and novices (111.4±11.8 vs72.9±4.2 minutes; p=0.095). However, both groups demonstrated improvement in learning curve upon a single repetition; novices achieved a mean time reduction of 48.4±33.5 minutes, while experts demonstrated a mean reduction of 41.1±12.0 minutes (p=0.329). The in-house reduction and fabrication process cost approximately $3.50 per unit in materials, with a batch manufacturing time of 4 hours for four splints. Conclusion: This study validates the feasibility of a custom, in-house fracture reduction and splint fabrication workflow. The rapid learning curve observed among novices suggests that this internal VSP platform is highly translatable to surgical residency programs. By shifting from commercial vendors to point-of-care manufacturing, surgical teams can maintain high-fidelity reconstruction while significantly reducing the economic burden.
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