From Computed Tomography Imaging to Reconstructive Surgery: A Comprehensive Review of the Role of Three-dimensional Printing in Maxillofacial Reconstruction

Abstract

Maxillofacial reconstruction remains challenging because of the complex regional anatomy and the demanding surgical techniques required to restore function and aesthetics. Recent advances in 3D printing technology enable the production of patient-specific surgical guides and implants based on medical data obtained from computed tomography (CT) scans. The purpose of this review is to provide a comprehensive evaluation of the application of CT-based 3D printing in maxillofacial reconstruction, including its workflow, uses, advantages, disadvantages, and future perspectives. The medical 3D printing process involves the acquisition of high-resolution CT images, Digital Imaging and Communications in Medicine (DICOM) data manipulation, anatomical segmentation, three-dimensional modelling, generation of stereolithography (STL) files, and additive manufacturing processes. These procedures enable the production of accurate patient-specific anatomical models, bone-cutting guides, drill guides, and other customised implants used for preoperative surgical planning and intraoperative guidance. Current evidence describes numerous applications of 3D printing technologies in mandibular reconstruction, fibula free flap (FFF) procedures, orbital reconstruction, surgical guide production, and patient-specific implants. Various clinical studies demonstrate improved preoperative visualisation, increased surgical precision, reduced operative time, and greater predictability of outcomes following the introduction of 3D printing technologies into surgical practice. Patient-specific implants and customised guides have become additional approaches for personalising treatment and restoring anatomy. Although these methods provide several benefits, issues associated with cost-effectiveness, segmentation expertise, process standardisation, and implant-related complications remain obstacles to wider application. Future innovations in artificial intelligence-assisted segmentation, on-demand manufacturing, biomaterials, and personalised implant design may enhance the clinical utility of 3D printing in maxillofacial surgery. In conclusion, CT-based 3D printing is a promising and rapidly developing technology that is changing the landscape of modern maxillofacial reconstruction surgery.