Pioneers used 3D technology in groundbreaking jawbone operation

3D printers are now so advanced that they can produce customised medical devices and implants. Here, speaks to one patient who has benefited from this groundbreaking technology

When Debbie Hawkins went to the dentist after feeling a lump near her wisdom tooth, she claims it was dismissed as nothing more than a cyst.

But it turned out to be a benign tumour, which had grown to the point where it was close to breaking her jaw.

“I’d had the lump for a few years and it would flare up now and again,” said Debbie, from Swansea.

“It would go red and would sometimes ache and hurt, but I kept on being told that there was nothing to worry about.

“My dentist took X-rays and said it was a cyst. I didn’t question it for the simple fact that I’m not medically trained.”

Mum Debbie was eventually referred by the dentist to Morriston Hospital in Swansea, where further X-rays and a biopsy was carried out.

“When the doctor told me it was a tumour and not a cyst I couldn’t believe it,” she said.

Because the condition was rare, she said the biopsy results were sent from Morriston Hospital to Singleton, to the University Hospital of Wales and then to Queen Elizabeth Hospital in Birmingham.

Staff at Morriston, part of Abertawe Bro Morgannwg University (ABMU) Health Board, then decided that Debbie would be the first in Wales to undergo a pioneering procedure.

It involved removing and rebuilding a section of her lower jawbone with the helping of 3D printing technology.

Previously, surgeons used a length of bone from the leg (fibula) to replace sections of jaw which had to be removed because of cancers or other tumours.

But to retain the aesthetic shape of the jaw it had to be set too low to allow for dental implants.

Alternatively, it could be set high enough to allow implants but the shape of the jawline was then lost.

It is common practice for the piece of fibula bone in the jaw to be trimmed during the operation to fit and held in place with a metal plate that the surgeon had to bend by eye.

This is both time-consuming and requires a great deal of skill.

Now Morriston is using the 3D technology to design the entire procedure from start to finish in advance.

Using the patient’s CT images, the team designs an anatomically-accurate titanium implant, which both fixes the fibula bone in place and maintains the aesthetic shape of the jawline.

The team also creates millimetreperfect cutting guides, so the length taken from the fibula exactly match- es the excised section of jaw.

Debbie’s procedure was carried out by the team of oral and maxillofacial surgeons at Morriston Hospital – Madhav Kittur, Ketan Shah and Simon Hodder.

They worked with maxillofacial laboratory services manager Peter Llewelyn