Surgeons Use 3D Planning and Printing for Jaw Reconstruction Surgeries

When Jack Sage started having jaw pain, he did what most would do, he went to see a dentist. He didn’t think it would lead to a jaw cancer diagnosis that would land him at Moffitt Cancer Center.

When a patient has oral cancer that involves the bone, surgeons have to remove part of the jaw and reconstruct it using a piece of the patient’s fibula or scapula bone. Because the jaw bone is curved and no one’s jaw structure is the same, the hardware used in the reconstruction has to be tailor made for each patient.

Moffitt has partnered with surgical innovation company KLS Martin to make custom made titanium plates.

Caitlin McMullen, MD, Head and Neck Oncology Program

“We custom design the hardware for what the patient needs and to account for the new bone that is being transplanted into their mandible,” said otolaryngologic surgeon Dr. Caitlin McMullen. “This way the plate fits perfectly and decreases the risk of complications.”

All KLS Martin needed to make the hardware for Sage was his scan. The scan is put into a computer planning program, which makes a 3D model of the skull. After margins have been established, the surgeon sets the resections on a video call with a KLS Martin engineer. The surgeon then analyzes the shape of the jaw, both preoperative and post reconstruction to design the custom titanium plate. Once the surgeon reviews the plan and makes any necessary modifications, the plate is 3D printed, using titanium powder and a laser beam in a high-pressure chamber.

McMullen had the proper plate for surgery before Sage even entered the operating room.

“If we didn’t have it custom made preoperatively, we would have to design the plates in the operating room during surgery,” said McMullen. “That can involve trial and error, bending and sometimes re-bending the plate until it fits perfectly. That takes more time and there is a higher risk for complications the longer a patient is in surgery.”

To shape the fibula or scapula bone to the jaw, surgeons need to cut it multiple times. A patient’s scan can also be used to make a special cutting guide to ensure the bone is cut at the most accurate angles.