Personalized Surgery: application to pediatric maxillofacial surgery

Personalized surgery, or should we say surgery using customized medical devices, has been widely developed in maxillofacial surgery, and has brought a major progress. These new techniques mainly use the planning and 3D printing processes of cutting guides, osteosynthesis plates or perfectly adapted implants. The use of these procedures in pediatrics must consider the residual maxillofacial growth. This "personalized" surgery is perfectly applicable to pediatric maxillofacial oncology, allowing resection planning based on radiological data. It also allows optimal bone reconstruction by micro-anastomosed, pre-shaped flaps with reduced surgical time. In orthognathic, interceptive, or end-of-growth surgery, it increases the precision of bone movements and reduces surgical time. In reconstructive surgery, it allows the realization of implants prepared from mirroring data, with an increase of the facial symmetry effect. The use of planning and printing of 3D models has been democratized, thanks to the implementation of fab-lab within our institutions. Nevertheless, the printing of medical devices remains subject to strict European regulations, requiring industrial partnerships and involving a cost and manufacturing time.