The need for 3D facial reconstruction surgery
In the UK alone, approximately 60,000 craniofacial reconstruction surgeries – operations to repair the skull and jaw bones – are carried out each year. These operations are needed as a result of trauma, such as road traffic accidents, surgery to remove tumours or to correct congenital anomalies in babies and children born with conditions such as cleft lip and palate.
Current treatment options
Traditionally, metal implants, bone grafts and artificial prosthetics are used in facial reconstruction. However, none of these options is ideal.
- Bone grafts are at risk of considerable complications including:
- Insufficient supply of donor bone or poor quality bone
- Pain and non-healing at the site from which the bone graft has been taken
- Rejection of the bone graft
- Infection in the transplanted bone
- Difficulty creating the exact shape required
- Metal implants can be manufactured to fit the patient’s skull or jaw; however, complications include:
- Rejection of the implant
- Metal toxicity
- Deterioration of the surrounding bone allowing the implant to become loose
- Multiple operations for children and teenagers whose metal implants need to be replaced with larger sizes as they grow.
All of these factors can lead to the need for repeat surgeries and can result in psychological issues, especially amongst patients who experience ongoing disfigurement.
3D facial reconstruction surgery has the potential to be one of the most exciting medical advancements of our age. While 3D printing offers huge promise, the technique is currently hampered by the materials that can be used. For example, while 3D printing is already being used to create metal implants tailored to the exact size and shape needed, patients can still experience complications if the implant becomes loose or is rejected.
A material to match
At RAFT, we are undertaking research to develop a new type of material that will transform 3D facial reconstruction surgery.
This material will be developed specifically for 3D printing and used to create a custom-fit facial implant. Digital models will be created from X-rays and CT scans, which will be used to develop bespoke 3D biological implants strong enough for use in facial reconstruction procedures.
Once fitted, the implant will create a scaffold which will encourage the patient’s own bone to grow to the required shape and size within the body. The scaffold itself will be biodegradable, meaning that, as the bone grows, the scaffold will gradually be absorbed into the patient’s body leaving the new healthy bone behind.
Facing the future with 3D facial reconstruction surgery
The most exciting aspect of RAFT’s 3D facial reconstruction research is that the material we are using will help the body to grow new bone, providing significant benefits to patients including:
- A natural look
- Reduction in the number of operations
- Integration with the rest of the skull and jaw – it won’t come loose
- Reduced risk of rejection
- New bone will grow in line with the rest of the body
£190,000 over three years starting 2016 to fund:
- The customisation of a 3D printer and the development of specialist software
- A PhD student to work on the 3D facial reconstruction surgery research
- Project consumables such as laboratory equipment and all the elements needed to develop the material for the 3D printed scaffold.
Our 3D facial reconstruction surgery research is scheduled for completion in summer 2019, by which point we will be in a position to conduct pre-clinical trials in order to bring the new treatment to patients within 3 years.
RAFT 3D Facial Reconstruction Surgery Research Scientists:
- Dr Lilian Hook
- Dr Elena Garcia
- Nazanin Owji, PhD Student
RAFT 3D facial reconstruction surgery Research Partner:
RAFT is working in collaboration with the UCL Eastman Dental Institute. The 3D facial reconstruction surgery research project will be undertaken by Nazanin Owji under the supervision of Professor Jonathan Knowles (Professor of Biomaterials Science and Head of the Biomaterials and Regenerative Medicine group at the Eastman Dental Institute, UCL), Professor Anne Young (Professor of Biomaterials at the Eastman Dental Institute, UCL), and RAFT’s scientists Dr Lilian Hook and Dr Elena Garcia.