Exploring the use of 3D-printed models, computer-aided designs, and 2D images in geoscience learning within a small-cohort introductory classroom

Use of 3D-printed animal models as a standard method to test avian behavioral responses toward nest intruders in the studies of avian brood parasitism

Evaluating the Use of Cleft Lip and Palate 3D-Printed Models as a Teaching Aid

Where Are We Now? To justify widespread adoption of any classification scheme, a high degree of inter- and intraobserver reliability must be demonstrated. The reliability of assessing proximal humerus fracture patterns using widely-held classification systems such as that of Neer and Hertel based on plain radiographs has been fairly low, though the addition of advanced imaging such as two-dimensional (2-D) and three-dimensional (3-D) CT scans appears to improve both inter- and intraobserver reliability [4]. More recently, using 3D printed models alone in the surgical planning process has been found to improve interobserver reliability over plain radiographs and both 2D and 3D CT scans using the Neer system, though the observed agreement with the printed models was only moderate [2]. In these studies, where the kappa values using the guidelines of Landis and Koch were reported as "substantial" and "moderate," respectively, we must recognize that a high proportion of cases will still be misclassified. As a consequence, clinical outcomes research based on these classifications may result in misleading results. A recent meta-analysis [7] based on randomized trials comparing fracture fixation of various anatomic sites both with and without the use of 3D-printed models determined that blood loss, surgical time, fluoroscopy use, clinical outcomes, and achievement of anatomic reduction all favored 3D modeling. A limitation of this study was the inclusion of multiple fracture types and the small number of patients in several included studies. Furthermore, the effect size for many of the surgical outcome measures could be quite small based on the reported 95% confidence intervals. The only included study involving complex three- and four-part proximal humerus fractures [8] found a reduction in operative time, blood loss, and fluoroscopy time, though the clinical outcomes at final follow-up were similar. It is not clear, however, whether the mean 15-minute decreased operative time and approximately 55 cc decreased blood loss with 3D models is clinically significant. A retrospective study [3] comparing conventional preoperative planning using plain radiographs and both 2D and 3D CT scans with both computer-assisted virtual planning and 3D-printed models found shorter operative time, less blood loss, and less fluoroscopy in the latter groups compared to the conventional group. Planning time was shorter in the computer-assisted planning group compared with the 3D model group. Once again, the reported differences in the surgical parameters were small. Whether these differences justify the direct and indirect costs of routine use of 3D models, including the creation (personnel, software, hardware), storage, and potential sterilization, remain unclear [5]. In their current study, Spek and colleagues [6] examined 20 adult patients with complex three- and four-part proximal humerus fractures that were deemed difficult to classify and determined that the addition of 3D-printed handheld models to a series of plain radiographs and both 2D and 3D CT scan images did not improve interobserver reliability for the majority of fracture characteristics being studied. Additionally, the handheld models did not improve fracture classification using either the Neer or Hertel system. There was also no difference in agreement between residents and attending orthopaedic surgeons as to whether the 3D models aided in fracture pattern classification. These findings suggest that the routine use of 3D-printed models may not be beneficial for classifying proximal humeral fracture patterns beyond the information gained from currently available imaging modalities. Specifically, use of these models as the sole determinant for recommending surgical intervention based on fracture displacement should probably be avoided at this time based on the results of the current study. What is particularly concerning about the findings of the current study is that the addition of the 3D-printed models did not improve the ability of attending surgeons to identify particular fracture characteristics and classify patterns above that of the surgeons in-training. This would seem to indicate that a level of subjectivity exists within the classification systems themselves. Based on the results of the study, we should invest fewer resources determining whether handheld models improve preoperative fracture classification. The answer, according to Spek et al. [6], is a resounding "no." Where Do We Need To Go? The current study raises some important questions that warrant further study, namely: (1) In what capacity does the use of the 3D-printed model provide benefit to care for patients with proximal humerus fractures who have already been indicated for surgery? (2) What is the potential role of preoperative computer-assisted virtual surgical planning for proximal humerus fractures both with and without 3D model printing? In the only published randomized study that I am aware of assessing the surgical utility of 3D modeling for three- and four-part proximal humerus fractures [8], patients underwent preoperative planning using either two orthogonal radiographs and a thin-cut 2D CT scan versus plain radiographs, a 3D CT reconstruction with simulated fracture reduction using specialized software, and a handheld 3D-printed model. The use of 2D CT images in the control group represents a difference from the current paper, though a prior study [1] found that the use of 3D CT did not offer improvement in classification or treatment recommendations over 2D CT, except among junior residents. Regardless, to fully demonstrate the positive influence of the handheld models independently, researchers should ensure that both study groups are provided with all of the imaging modalities generally available today, including 3D CT images. Furthermore, future studies should determine whether these improvements can be replicated among surgeons of all levels of experience or if those with less experience would demonstrate greater benefit. Finally, we need a better understanding of the costs associated with the computer-assisted software and the model creation in light of the minimal—14-minute—surgical time difference reported. Computer-assisted planning can involve virtual reduction of the fracture and selection/placement of implants even without the use of 3D handheld models. One study [3] reported improved operative parameters for the virtual planning and 3D model group compared to the conventional planning group, though it is not entirely clear whether the differences are clinically significant. From a cost perspective, more data are needed to determine whether the 30 minutes of virtual planning is cost-efficient with the 18 minutes of reduced operative time. Computer planning time may be even higher for surgeons performing a lower volume of proximal humerus fracture surgery. How Do We Get There? The primary potential advantage of 3D-printed models likely will be realized in more complex proximal humerus fracture patterns that have already been indicated for surgical intervention. Specifically, the 3D models can provide the surgeon with a tactile modality for planning fracture reductions and correct placement of hardware. Future studies for determining the utility of the 3D models in the clinical realm should be designed based on objective surgical parameters such as operative time, duration of fluoroscopy use, estimated blood loss, adequacy of fracture reduction, and perhaps most importantly, on patient outcomes. Given the dearth of available evidence, the utility of 3D models versus computer-assisted fracture planning alone needs to be validated. The reported differences in these parameters have been fairly small in the literature so far and, therefore, justification for utilizing either technology necessarily requires demonstrating larger, more clinically relevant differences. Furthermore, future studies must assess whether surgeons with extensive experience with proximal humerus fracture fixation will derive any meaningful benefit from these technologies. A comparative study of this type needs to be performed in a high-volume Level 1 trauma center to achieve sufficient patient numbers. Only three-part and four-part fractures should be included and should be randomized either to planning through the use of standard imaging including 2D and 3D CT or to planning with additional use of the 3D-printed model versus computer-assisted planning. To determine which surgeons would most benefit from either the 3D model or computer-assisted planning, surgical data need to be stratified for surgeon volume and/or clinical experience. There will be a learning curve for use of the planning software, which should be taken into account regarding planning time. Innovation can often be costly, and cost benefits with both of these technologies must be demonstrated, either by calculating operating time savings compared with increased planning time and/or by reduced intraoperative implant wastage. As there are no currently defined minimal clinically important differences for surgical parameters such as intraoperative blood loss, surgical time, and use of fluoroscopy, any potential benefit must be considered in light of a rigorous cost-benefit analysis. Finally, any comparison of patient-reported functional outcomes should be viewed in light of minimal clinically important differences.

Understanding the three-dimensional (3D) nature of the human form is imperative for effective medical practice and the emergence of 3D printing creates numerous opportunities to enhance aspects of medical and healthcare training. A recently deceased, un-embalmed donor was scanned through high-resolution computed tomography. The scan data underwent segmentation and post-processing and a range of 3D-printed anatomical models were produced. A four-stage mixed-methods study was conducted to evaluate the educational value of the models in a medical program. (1) A quantitative pre/post-test to assess change in learner knowledge following 3D-printed model usage in a small group tutorial; (2) student focus group (3) a qualitative student questionnaire regarding personal student model usage (4) teaching faculty evaluation. The use of 3D-printed models in small-group anatomy teaching session resulted in a significant increase in knowledge (P = 0.0001) when compared to didactic 2D-image based teaching methods. Student focus groups yielded six key themes regarding the use of 3D-printed anatomical models: model properties, teaching integration, resource integration, assessment, clinical imaging, and pathology and anatomical variation. Questionnaires detailed how students used the models in the home environment and integrated them with anatomical learning resources such as textbooks and anatomy lectures. In conclusion, 3D-printed anatomical models can be successfully produced from the CT data set of a recently deceased donor. These models can be used in anatomy education as a teaching tool in their own right, as well as a method for augmenting the curriculum and complementing established learning modalities, such as dissection-based teaching. Anat Sci Educ 11: 44-53. © 2017 American Association of Anatomists.

An 8-year-old girl, diagnosed with mid-aortic syndrome (MAS) at the age of 2 months and under antihypertensive therapy, presented with severe systemic hypertension (>200/120 mmHg). Computed tomography (CT) examination revealed aortic aneurysm between severe stenoses at pre- and infra-renal segments, and occlusion of principal splanchnic arteries with peripheral collateral revascularization. Based on CT imaging, preoperative three-dimensional (3D) anatomy was reconstructed to assess aortic dimensions and a dedicated in vitro planning platform was designed to investigate the feasibility of a stenting procedure under fluoroscopic guidance. The in vitro system was designed to incorporate a translucent flexible 3D-printed patient-specific model filled with saline. A covered 8-zig 45-mm-long Cheatham-Platinum (CP) stent and a bare 8-zig, 34-mm-long CP stent were implanted with partial overlap to treat the stenoses (global peak-to-peak pressure gradient > 60 mmHg), excluding the aneurysm and avoiding risk of renal arteries occlusion. Percutaneous procedure was successfully performed with no residual pressure gradient and exactly replicating the strategy tested in vitro. Also, as investigated on the 3D-printed model, additional angioplasty was feasible across the frames of the stent to improve bilateral renal flow. Postoperative systemic pressure significantly reduced (130/70 mmHg) as well as dosage of antihypertensive therapy. This is the first report demonstrating the use of a 3D-printed model to effectively plan percutaneous intervention in a complex pediatric MAS case: taking full advantage of the combined use of a patient-specific 3D model and a dedicated in vitro platform, feasibility of the stenting procedure was successfully tested during pre-procedural assessment. Hence, use of patient-specific 3D-printed models and in vitro dedicated platforms is encouraged to assist pre-procedural planning and personalize treatment, thus enhancing intervention success.

BackgroundThe two-dimensional (2D)-based left atrial appendage (LAA) occluder (LAAO) size determination by using transesophageal echocardiography (TEE) is limited by the structural complexity and wide anatomical variation of the LAA.ObjectiveThis study aimed to assess the accuracy of the LAAO size determination by implantation simulation by using a three-dimensional (3D)-printed model compared with the conventional method based on TEE.MethodsWe retrospectively reviewed patients with anatomically and physiologically properly implanted the Amplatzer Cardiac Plug and Amulet LAAO devices between January 2014 and December 2018 by using the final size of the implanted devices as a standard for size prediction accuracy. The use of 3D-printed model simulations in device sizing was compared with the conventional TEE-based method.ResultsA total of 28 cases with the percutaneous LAA occlusion were reviewed. There was a minimal difference [−0.11 mm; 95% CI (−0.93, 0.72 mm); P = 0.359] between CT-based reconstructed 3D images and 3D-printed left atrium (LA) models. Device size prediction based on TEE measurements showed poor agreement (32.1%), with a mean difference of 2.3 ± 3.2 mm [95% CI (−4.4, 9.0)]. The LAAO sizing by implantation simulation with 3D-printed models showed excellent correlation with the actually implanted LAAO size (r = 0.927; bias = 0.7 ± 2.5). The agreement between the 3D-printed and the implanted size was 67.9%, with a mean difference of 0.6 mm [95% CI (−1.9, 3.2)].ConclusionThe use of 3D-printed LA models in the LAAO size determination showed improvement in comparison with conventional 2D TEE method.

Introduction: The use of 3D-printed aortic models for the creation of surgeon-modified endoprostheses represents a promising avenue in aortic surgery. By focusing on the potential impact of sterilization on model integrity and geometry, this report sheds light on the suitability of these models for creating customized endoprostheses. The study presented here aimed to investigate the safety and viability of 3D-printed aortic models in the context of sterilization processes and subsequent remodeling. Methods: The study involved the fabrication of 3D-printed aortic models using patient-specific imaging data and established additive manufacturing techniques. Five identical aortic models of the same patient were printed. Two models were subjected to sterilization and two to disinfection using commonly employed methods, and one model remained untreated. The models were checked by in-house quality control for deformation (heat map analyses) after the sterilization and disinfection processes. Three models (sterilized, disinfected, and untreated) were sent for ex-house (Lufthansa Technik, AG, Materials Technologies and Central Laboratory Services, Hamburg, Germany) evaluation and subsequent quantification of possible structural changes using advanced imaging and measurement technologies (macroscopic and SEM/EDX examinations). After sterilization and disinfection, each aortic model underwent sterility checks. Results: Based on macroscopic and SEM/EDX examinations, distinct evidence of material alterations attributed to a treatment process, such as a cleaning procedure, was not identified on the three implants. Comparative material analyses conducted via the EDX technique yield consistent results for all three implants. Disinfected and sterilized models tested negative for common pathogens. Conclusions: The evaluation of 3D-printed aortic models’ safety after sterilization as well as their suitability for surgeon-modified endoprostheses is a critical step toward their clinical integration. By comprehensively assessing changes in model integrity and geometry after sterilization, this research has contributed to the broader understanding of the use of 3D-printed models for tailor-made endovascular solutions. As medical technologies continue to evolve, research endeavors such as this one can serve as a foundation for harnessing the full potential of 3D printing to advance patient-centered care in aortic surgery.

This study aimed to answer the following questions: do 3D-printed models lead to a more accurate recognition of the pattern of complex fractures of the elbow?; do 3D-printed models lead to a more reliable recognition of the pattern of these injuries?; and do junior surgeons benefit more from 3D-printed models than senior surgeons? A total of 15 orthopaedic trauma surgeons (seven juniors, eight seniors) evaluated 20 complex elbow fractures for their overall pattern (i.e. varus posterior medial rotational injury, terrible triad injury, radial head fracture with posterolateral dislocation, anterior (trans-)olecranon fracture-dislocation, posterior (trans-)olecranon fracture-dislocation) and their specific characteristics. First, fractures were assessed based on radiographs and 2D and 3D CT scans; and in a subsequent round, one month later, with additional 3D-printed models. Diagnostic accuracy (acc) and inter-surgeon reliability (κ) were determined for each assessment. Accuracy significantly improved with 3D-printed models for the whole group on pattern recognition (acc2D/3D = 0.62 vs acc3Dprint= 0.69; Δacc = 0.07 (95% confidence interval (CI) 0.00 to 0.14); p = 0.025). A significant improvement was also seen in reliability for pattern recognition with the additional 3D-printed models (κ2D/3D = 0.41 (moderate) vs κ3Dprint = 0.59 (moderate); Δκ = 0.18 (95% CI 0.14 to 0.22); p ≤ 0.001). Accuracy was comparable between junior and senior surgeons with the 3D-printed model (accjunior = 0.70 vs accsenior = 0.68; Δacc = -0.02 (95% CI -0.17 to 0.13); p = 0.904). Reliability was also comparable between junior and senior surgeons without the 3D-printed model (κjunior = 0.39 (fair) vs κsenior = 0.43 (moderate); Δκ = 0.03 (95% CI -0.03 to 0.10); p = 0.318). However, junior surgeons showed greater improvement regarding reliability than seniors with 3D-printed models (κjunior = 0.65 (substantial) vs κsenior = 0.54 (moderate); Δκ = 0.11 (95% CI 0.04 to 0.18); p = 0.002). The use of 3D-printed models significantly improved the accuracy and reliability of recognizing the pattern of complex fractures of the elbow. However, the current long printing time and non-reusable materials could limit the usefulness of 3D-printed models in clinical practice. They could be suitable as a reusable tool for teaching residents.Cite this article: Bone Joint J2023;105-B(1):56-63.

Advancements in three-dimensional (3D) printing have introduced innovative tools for medical and dental education. In dental surgery, 3D-printed simulation models offer valuable presurgical training. This review explores the scope, study types, key findings, limitations, and future research needs to enhance their application in dental education. A comprehensive literature search was conducted across seven major health and education databases for studies published up to June 2025. A structured search strategy was developed using a combination of MeSH terms and keywords related to dental and oral surgical procedures, educational interventions, and 3D printing. Two reviewers independently screened and evaluated the retrieved articles. Studies were included if they investigated the use of 3D-printed models as hands-on simulation tools for intraoral surgery education. Only peer-reviewed articles published in English were considered. A total of 3686 studies were identified, 34 of which met the inclusion criteria after screening. These studies, largely published within the past decade, evaluated the use of 3D-printed models as training tools across five core areas of intraoral surgery, with the greatest focus on minor oral surgery (32%) and maxillofacial related procedures: orthognathic procedures (26%), followed by cleft palate surgery (15%), implant surgery (15%), and periodontal interventions (12%). Various printers and materials were employed, with an emphasis on model fabrication and evaluation through trainee feedback. The models were widely accepted by trainees, who reported improved technical skills, increased confidence, and reduced procedure time. However, challenges remain, particularly the need for advanced soft tissue-replicating material to enhance anatomical realism. 3D-printed models are effective tools for pre-operative planning and hands-on training in oral surgery. Future research should focus on developing cost-efficient printing technologies and advanced materials to better replicate hard and soft tissues in these models. Furthermore, well-designed studies are needed to support changes to implementation into current curricula and enhance the delivery of surgical education.

Three-dimensional (3D) printing holds great potential for lateral skull base surgical training; however, studies evaluating the use of 3D-printed models for simulating transtemporal approaches are lacking. To develop and evaluate a 3D-printed model that accurately represents the anatomic relationships, surgical corridor, and surgical working angles achieved with increasingly aggressive temporal bone resection in lateral skull base approaches. Cadaveric temporal bones underwent thin-slice computerized tomography, and key anatomic landmarks were segmented using 3D imaging software. Corresponding 3D-printed temporal bone models were created, and 4 stages of increasingly aggressive transtemporal approaches were performed (40 total approaches). The surgical exposure and working corridor were analyzed quantitatively, and measures of face validity, content validity, and construct validity in a cohort of 14 participants were assessed. Stereotactic measurements of the surgical angle of approach to the mid-clivus, residual bone angle, and 3D-scanned infill volume demonstrated comparable changes in both the 3D temporal bone models and cadaveric specimens based on the increasing stages of transtemporal approaches (PANOVA<.003,<.007, and<.007, respectively), indicating accurate representation of the surgical corridor and working angles in the 3D-printed models. Participant assessment revealed high face validity, content validity, and construct validity. The 3D-printed temporal bone models highlighting key anatomic structures accurately simulated 4 sequential stages of transtemporal approaches with high face validity, content validity, and construct validity. This strategy may provide a useful educational resource for temporal bone anatomy and training in lateral skull base approaches.

Chapter 3 - From CT and MR Images to 3D Printed Models—Software Basics for the Surgeon

This study aimed to explore the role of the three-dimension (3D) printed models in orthopedic resident training of tibial plateau fractures. A total of 41 residents from our institution were divided into two groups. The intervention group, consisting of 20 residents, had access to 3D-printed models illustrating thirteen tibial plateau fractures. In contrast, the control group, comprising 21 residents, received digital images of thirteen identical tibial plateau fractures. Evaluation of learning outcomes included the accurate identification of tibial plateau fracture patterns, deduction of traumatic mechanisms, preoperative plan, assessment time, and subjective questionnaire responses. The participants with 3D printed models scored significantly higher in both the Schatzker classification and Luo three-column classification compared to those without 3D printed models. Residents in the intervention group performed better in accuracy in deducing traumatic mechanisms compared to the control group. In addition, the sum score of preoperative plan in the intervention group was significantly higher than that in the control group. Specifically, participants with 3D printed models scored higher in surgical approach choice and implants placement than these in the control group. Residents exposed to 3D printed models also spent less time to complete the assessment than those with access only to digital imaging. Subjective assessments indicated that 3D-printed models boosted confidence in fracture identification, improved preoperative plan for fracture management and enhanced the understanding in injury mechanism of tibial plateau fractures. Furthermore, residents agreed that the use of 3D-printed models heightened their interest in learning tibial plateau fractures. Therefore, the addition of 3D printed models significantly contributed to a comprehensive understanding of tibial plateau fractures, the improvement in fracture identification, inferring injury mechanisms and preoperative plan.

Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.

Aims and Objectives 3d-printed models (bio-models) have become a useful tool in the armamentarium of surgeons for improved surgical planning in the recent past. This study directs at reinforcing the incorporation of these bio-models as a handy tool in treatment planning, resident training, patient education and record maintenance. The aim of this empirical study was to compare the outcome in reconstructive maxillofacial surgery when planned using 3d-printed model and without 3d-printed model (conventional). The objectives were to assess and compare the intraoperative time taken during reconstruction, the immediate post-operative experience (pain, mouth opening and incidence of infection) and the quality of life using University of Washington (UW-QOL) questionnaire during follow up. Methods This retrospective comparative study was conducted in Department of Oral &amp; Maxillofacial Surgery, from March 2018 to March 2020. It included 50 cases consisting variety of pathologic and traumatic maxillofacial defects and they were grouped into with 3d-printed model (Group A) and without 3d-printed model (Group B). The groups were further subclassified based on maxillary (MR) and mandibular reconstruction [vascularized flaps (VFFF), non-vascularised grafts (NVG), reconstruction plate alone (RP)]. We compared intra operative time taken along with immediate post-operative parameters (pain, mouth opening and presence of infection) and patient’s quality of life using UW-QOL questionnaire. These values were taken for comparison and statistical analysis was done by unpaired t-test. Result There was 14.75% (35.26 minutes) mean reduction in operative time (* P = .029) and reduction in mean visual analogue score (VAS) (* P = .003) with statistically significant difference. However, increase in immediate post-operative mouth opening was not found to be statistically significant difference ( P =.471). The comparison of the social and functional domain of UW-QOL showed statistically significant P-value in saliva (*0.004) and mood (*0.002) with regard to NVG. In RP group, pain (*0.026), swallowing (*0.041) and taste (*0.008) was found to be statistically significant. In MR group, only pain (*0.037) showed statistically significant difference. Conclusion Use of 3d-printed model to guide and assist in surgical procedures have provided promising results. Based on this study, we found that there is decreased intraoperative time and post-operative pain score when 3d-printed model were used. The patient’s quality of life was also found to be better in terms of reduction in pain, salivary secretion and mood elevation. With increased success rate, the authors are of the strong opinion that it is time to revisit the surgical protocol used for reconstruction and include 3d-printed model as a primary tool or technology across the board for all patients notwithstanding the comparative cost, as the results offset the financial aspect.

ObjectiveTo investigate how accurately doctors estimated their performance on the General Medical Council's Tests of Competence pilot examinations.DesignA cross-sectional survey design using a questionnaire method.SettingUniversity College London Medical School.Participants524 medical...