Susie Robinson before the accident

Susie Robinson was 20 years old when the car she was driving went off the road and crashed into a tree one evening in 1989. The policeman who arrived on the scene didn’t expect to find any survivors. Incredibly, everyone in the car lived – but most of them would be left with life-altering scars from the accident. For Robinson, that scar was a shattered jawbone that required 30 pins and a good deal of wire to hold it in place, and left her missing four of her top teeth. Over the next three decades, she would spend more than $80,000 and undergo around 15 surgeries to try to repair the damage, but nothing ever quite fixed it completely.

After the accident

For the last decade and a half, Robinson’s false teeth have been held in place by a set of dental implants that recently cracked, requiring replacement. Robinson was looking at several more surgeries – first doctors would have to operate on her hip, taking bone from there and using it to build up her missing jaw. Six months later, they would operate again, screwing the implants into the new bone. Even then, she wouldn’t have teeth for a few months, and the outcome wasn’t a sure thing, as so much scar tissue had built up over the years.

It took Robinson almost a year to recover from the original implant surgery, and she was reluctant to go through it all again. But in September of last year, she met Dr. George Dimitroulis, who in 2015 implanted the first 3D printed titanium jaw in Australia into a patient. Dr. Dimitroulis’ implant, called the Osseoframe, is a new twist on an old idea; metal frames called subperiosteal frames were used decades ago to replace missing jawbones and hold teeth in place until the 1990s, when they fell out of favor because they were expensive, required multiple surgeries, and were a “one size fits all” deal, unable to be adjusted to fit individual patients.

Recently, Robinson’s old implants cracked and needed to be removed. [Image: Eddie Jim]

3D printing changed all of that. The Osseoframe is customized to perfectly match every individual patient’s jaw, 3D printed from patient scans. Microscrews hold the titanium implant in place until the bone can grow around it, and false teeth can be screwed directly onto the prongs of the frame. It requires only one surgery, taking about an hour.

Since Dr. Dimitroulis implanted the first Osseoframe, there have been a few challenges – the biggest being patients’ gums peeling away from the frame. He’s addressed that problem by creating larger holes in the frame, allowing for better blood flow. He will be presenting the device to dentists and surgeons for the first time this weekend at the International Conference on Oral and Maxillofacial Surgery in Hong Kong.

“The dental and medical professions are quite conservative and when you bring in a new technology that threatens existing practices they put up a wall,” he said. “My biggest challenge is convincing surgeons and dentists that this is not a one-off 3D-printed gimmick for some rare disorder but in fact it’s something that may well be a game-changer as far as dental implants are concerned.”

A scan of Robinson’s jaw with the 3D printed implant [Image: Dr. George Dimitroulis/ABC]

Robinson didn’t need to be convinced.

“When he said to me, ‘We are going to 3D print you a new maxilla and then add some implants,’ I’m not actually sure what I thought,” she said. “I probably just walked out in a daze.”

The procedure involved making an incision in Robinson’s gum, fitting in the 3D printed implant, and then sewing her gum back closed over it, leaving two prongs exposed, onto which the false teeth were screwed. It was fast and simple – the surgery took only a little over an hour, and Robinson was smiling and talking an hour after that. Less than a week later, her mouth feels completely normal, for perhaps the first time in nearly 30 years – as if she’s forgotten to put her dentures in, she said.

Robinson examines her new teeth. [Image: ABC]

“It’s amazing,” she said. “You sort of hear about 3D printing but it feels like it’s a school project in a way, you don’t actually think that it is going to have that level of implication. I’m just an everyday person, I’m not particularly special, so for that technology to be available for people like me, well, that’s fantastic for everyday people. I think it’s extraordinary really.”

Discuss in the 3D Printed Jaw forum at 3DPB.com.

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