The 5-Minute Splint (5MS): In-House 3D Printing of an Orthognathic Splint for Single-Jaw Cases

Abstract

The benefits of computer-assisted surgical simulation (CASS) have been proven, including visualization of the osteotomies and interferences, increasing intra-operative efficiency, and producing reliable and accurate outcomes.1 However, the manual fabrication of orthognathic splints for single-jaw surgery using acrylic is still common today, despite being vulnerable to intrinsic inaccuracies.2 The purpose of this study was to demonstrate a novel, rapid, simple CASS protocol for in-house 3D-printing of orthognathic splints for use during single-jaw orthognathic surgery. A specific protocol, the 5 Minute Splint (5MS) protocol, was performed for consecutive patients requiring single-jaw orthognathic surgery. Using an intraoral scanner and computer-aided surgical simulation, computer-designed splints were fabricated by a rapid prototyping machine in-house. The primary outcome variable was the time associated with the design, manufacturing, and processing of the splints. The secondary outcome variable was the cost associated with the rapid prototyping of the splints. The 5 Minute Splint (5MS) protocol was utilized for 33 consecutive patients (21 female and 12 male; mean age 28.1 years) requiring single-jaw orthognathic surgery between January 2019 and February 2020. Of these patients, 10 underwent a Le Fort I osteotomy procedure and 23 a bilateral sagittal split osteotomy (BSSO) (both regardless of genioplasty). The mean time for each case was between 5 to 9 hours, including 3 minutes for scanning of models, 4.5 minutes for development of the splint, and 4-8 hours for rapid prototyping and post-processing. This time varied based on the complexity of the design and the number of splints printed simultaneously. The average cost for each splint was $0.73 Canadian dollars (CAD). The average time and cost for producing each splint using the 5MS protocol is significantly less than that seen in the literature. An average total cost of $2380.26 U.S. dollars (USD) reported in 1 study for a virtual surgical planning (VSP) session and fabrication of splints with an external company.3 The results of this study confirm that the design and rapid prototyping of orthognathic splints for single-jaw surgery can be performed in an efficient, cost-effective manner in-house using the 5MS protocol.