Feasibility study of low-dose computed tomography (CT) technology for maxillofacial bone three-dimensional (3D) printing in skeletal class III malocclusion

Qian Miao; Guan Li; Yì Xiáng J Wáng; Jinbao Wang; Haopeng Wang; Wei Chen; Yang Shao

doi:10.21037/qims-22-1266

Feasibility study of low-dose computed tomography (CT) technology for maxillofacial bone three-dimensional (3D) printing in skeletal class III malocclusion

Quant Imaging Med Surg. 2024 Dec 5;14(12):8238-8248. doi: 10.21037/qims-22-1266. Epub 2024 Oct 17.

Authors

Qian Miao¹, Guan Li², Yì Xiáng J Wáng³, Jinbao Wang⁴, Haopeng Wang⁴, Wei Chen⁵, Yang Shao⁶

Affiliations

¹ Department of Anesthesiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
² Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
³ Department of Imaging and Interventional Radiology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
⁴ Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.
⁵ Department of Stomatology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
⁶ Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China.

Abstract

Background: Skeletal class III malocclusion is among the most common dental and maxillofacial malformations. Three-dimensional (3D) printing technology has become widely applied in orthopaedics. The data source for 3D printing of maxillofacial bones is computed tomography (CT). The issue of the CT radiation dose caused by maxillofacial bone 3D printing has attracted increasing attention. This study aimed to explore the feasibility of low-dose CT technology in maxillofacial bone 3D printing and the clinical value of low-dose maxillofacial bone 3D printing.

Methods: Ninety patients with class III malocclusion who planned to undergo maxillofacial bone 3D printing and 3D-CT were prospectively enrolled and randomly divided into the conventional CT dose 3D printing group (Group A, n=28), low-CT dose 3D printing group (Group B, n=32) and 3D-CT control group (Group C, n=30). The quality of maxillofacial bone 3D printing was subjectively evaluated, and a Likert-scale questionnaire was used to assess the clinical value of maxillofacial bone 3D printing.

Results: No significant differences in the general demographic characteristics were detected among Groups A, B, and C. Compared with that in Group A (0.8±0.1 mSv), the radiation effective dose (ED) in Group B (0.3±0.1 mSv) was reduced by approximately 63%. There were no significant differences between Groups A and B in 3D printing quality indices (including clarity, integrity, accuracy or artefacts) (all P>0.05). There were significantly higher subjective scores for the clinical value of maxillofacial bone 3D printing (Group A=4.1±0.5, 4.0±0.5, 4.0±0.4 and 4.1±0.5; Group B=4.0±0.5, 4.0±0.4, 4.0±0.5 and 4.0±0.5) than for 3D-CT (Group C=3.1±0.5, 3.1±0.4, 2.9±0.4 and 3.0±0.4) in diagnosing and classifying, formulating the surgical plan, simulating the surgical process, and predicting postoperative recovery (all P<0.05).

Conclusions: Low-dose CT technology can be effectively applied for maxillofacial bone 3D printing, reducing the radiation dose without affecting the 3D printing quality. Maxillofacial bone 3D printing technology is superior to 3D-CT in class III malformations.

Keywords: Three-dimensional printing (3D printing); class III malocclusion; computed tomography (CT); low-dose; maxillofacial bone.