Evaluation of 3D visualization, planning and printing techniques in alveolar cleft repair, and their effect on patients' burden

The aim of this study was to describe our auxiliary surgical techniques in alveolar cleft reconstruction and evaluate the patients burden after 3 years of surgical experience. At the Cleft center, Semmelweis University Budapest, 28 patients underwent alveolar bone grafting between September 2017 and September 2020. We have used CBCT scans and computer software to perform 3D simulation of the alveolar defect and planning of patient- and defect specific grafts. An individual graft mold was designed for each alveolar defect and 3D printed for intra-operative use. During the surgical intervention, the mold was used to harvest the most appropriate amount and precise shape of graft material. We used cancellous iliac crest graft. After performing a descriptive statistical analysis of our patient group, we used a quality-of-life questionnaire to measure the patient's self-perception. In all cases the treatment sequence could be applied, planning and surgery was successful and uneventful. Patients did not experience more pain, bleeding or any feeding impairment. No inflammatory or wound healing reactions were observed. There were no major adverse effects causing permanent problems. Our follow-up and patient satisfaction questionnaire showed that our treatment sequence with auxiliary techniques brought no further burden to the patients care and hospitalization, even though it is more complex. Efficacy of this treatment method and improvement in graft integration has yet to be determined.