SA first as 3D-printed jaw implants help two men to smile again

2014-07-24 00:00

KIMBERLEY — Two disfigured men can smile again after receiving South Africa’s first 3D-printed jaw bone implantations.

It is only the second time in the world that such an operation has taken place.

Conducting the operations in the Kimberley hospital were prosthodontist professor Cules van den Heever; maxilo-facial (jaw, face and mouth) surgeons doctors Waleed Ikram and Kobus Hoek; and two dentists, doctors Philip Johnson and ­Riaan Liebenberg.

Half of the lower jaw of a 31-year-old man from Springbok was replaced with a 3D “bone” printed in titanium powder. His jaw was destroyed by a tumour.

The second patient, aged 20, from Kuruman had a broken steel lower jaw that was replaced. Van den Heever said the men will now have facial structure, although teeth cannot yet be implanted in titanium jaws.

The Central University of Technology (CUT) in Bloemfontein printed the jawbones. Director of the Centre for Rapid Prototyping and Manufacturing at CUT, Gerrie Booysen, said the 3D printer extruded molten titanium powder in precise layers to make an exact replica of a patient’s jawbone.

Before the advent of 3D printers, medical parts would be made using computer numerical control (CNC) milling, which wasted up to 80% of the titanium block. In contrast, 3D printing melts every grain of the titanium powder.

Van den Heever said they were very proud to be part of the pioneering operation in South Africa. He said the Northen Cape had about 500 patients with cancers that affected their heads and necks. These cancers cause lifelong disfigurement. Three dimensional printing is simpler, cheaper and quicker than previous procedures, which entailed removing parts of a patient’s fibula, skin, muscle and arteries to replant in the jaw.

“It is a long, painful and complex procedure that does not always succeed.”

Another technique is to implant steel plates, but these can break and erode, which does not happen easily with titanium plates.

Ikram said the cost of the jaw bone implantation had come down from R100 000 to R20 000.

“We rely a lot on donors to help patients in the Northern Cape. The Northern Cape’s Department of Health fully supports us.”

• The first successful 3D-printed jawbone implantation was done by a team of researchers and engineers from Belgium and the Netherlands from the University of Hasselt’s Biomed research institute. They replaced the full jaw of a 83-year old female with a serious jaw infection. She reportedly had unrestricted mandibular movement within a day of surgery. The university reported the jaw was 3D-printed within a few hours using additive laser melting technology to melt titanium powder. The final jaw was coated with plasma-sprayed artificial bone and included sites to fix prosthetics teeth into the design.

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