Design and Development of Additive Manufacturing-Based Surgical Guides for Maxillofacial Surgery

Conventional bone replacement procedures are often associated with critical limitations, including challenges in cutting the bone, maintaining implant positioning and fixation accuracy. One of the most prominent issues in maxillofacial surgery is the misalignment or shifting of implants from their intended anatomical location. Surgical guides have emerged as valuable tools to enhance the precision of implant placement by replicating the intraoral anatomy of the patient. However, ensuring accurate fit and placement of prefabricated guides remains a clinical challenge. With recent advancements in Additive Manufacturing (AM), particularly in patient-specific design capabilities, new opportunities have arisen to address these limitations effectively. This study presents the development of a prototype surgical guide using Fused Filament Fabrication (FFF), followed by iterative assessment through trial-and-error methods. The final model, intended for real-time surgical use, was fabricated in cobalt-chromium due to its excellent biocompatibility and mechanical strength using Direct Metal Laser Sintering (DMLS). The results indicate that 3D-printed, additive-manufactured, patient-specific surgical guides significantly enhance surgical accuracy, minimize fixation issues, reduce operative time, and limit intraoperative blood loss. These findings support the clinical potential of AM-based surgical guides in improving outcomes in maxillofacial surgery.