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Form Fitting Prosthetics Using DICOM Data

June 2011, the Netherlands. A revolutionary jaw prosthesis operation is carried out at the Orbis Medisch Centrum Sittard-Geleen facility. A woman's lower jaw was replaced with a new one made out of titanium, and created using analysis of her own medical scans, then created by 3D printing to be an absolute perfect match for her face.

The surgery itself – the jaw transplant – was, although rare, nothing new. The use of the patient's mediucal data to create the framework for a perfectly fitting prosthetic, is also not new. However, mixing the two elements, is most definitely a new wrinkle. A prosthetic of this complexity and for such continual use has never before been created from medical data, tailored to a single individual.

In addition to creating the jawbone, a dental prosthesis was also created, designed to insert into the artificial jawbone, and dental bridges placed on top of that to give the patient a fully functional chewing jaw and artificial tooth set. The implant integrates multiple functions, including dimples increasing the surface area, cavities promoting muscle attachment, and sleeves to lead mandible nerves. In short, the idea is to make the result look and feel as natural as possible.

On top of all that, because it was created by 3D printing methods, specifically by chemical metal deposition, no special manufacturing technology was required, and any 3D printer capable of working with metal powder to build up layer by layer, could complete another jaw. This opens up the possibility of using the basic method in a far wider range of procedures. This specific jaw was made from powdered titanium 'ink' fused together in layers with a heat laser, thus removing the need for any glue.

It took just four hours to print, using the CT data as a guide, and as a bonus, the patient was able to regain basic speech within hours of recovery from the surgery, because of the way the new jaw so closely fit what her body expected from the old one, and it was coated with a bioceramic coating so that the body would not detect it as a foreign invader.

The 83 year old patient lost her original jaw due to a severe infection, osteomyelitis, which destroyed most of the original bone. Surgeons were left with no choice but to remove it, an action which also removed her ability to chew food, or speak, as well as destroying the lower half of her face.

The artificial jaw that replaced it, weighs in at 107 grams, made out of a solid piece of titanium as it is, which is heavier than her original jaw by one third – and it is as deeply fixed as her original jaw was.

Follow-up surgery will remove the temporary attachment screws, and prepare the site for the dental bridge implant that will give the patient back her teeth.

Further Reading

Large Image Display: Making a Bespoke Jaw

Large Image Display: Prosthetic Jaw Hinging

Large Image Display: The Layerwise Jaw

VR Hardware: Layerwise Jaw

Large Image Display: Teeth Designed for Prosthetic Jaws

Large Image Display: Connecting Teeth to Artificial Bone



Layerwise Specs

Rob Snoeijs, press communications at LayerWise

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