Analysis of Quality of Life With 3D-Printed Model vis-á-vis Conventional Procedure in Oral & Maxillofacial Surgery – An Empirical Study

Abstract

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 & 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.