Dr Cules van den Heever and teamIn a South African hospital, two patients had surgery to replace their mandibles with titanium implants created with 3D printing technology after they lost portions of their faces due to cancer and ancillary diseases.

Oral and maxillofacial surgery is used to treat diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the mouth. 3D printing is fast becoming the preferred process to produce the structures necessary for successful recreation of the facial elements underlying the human visage.

An operation headed by Dr Cules van den Heever from the University of Pretoria and the Central University of Technology Centre of Rapid Prototyping and Manufacturing, assisted by Dr Walleed Ikram, Head of the Kimberley Hospital Dental Unit, Dr Kobus Hoek, a maxillofacial surgeon and doctors Philip Johnsson and Riaan Liebenberg implanted the titanium mandible prostheses which were prototyped with an Objet Connex 350 3D printer. Materialise's Mimics, 3-matic and Magics software was used in the process.

The team then used one of the ten additive manufacturing devices on site at the university, an EOS Direct Metal Laser Sintering (DMLS) printer, to print the prosthesis directly in titanium for use in the patients.

"Cancer is a terrible disease affecting many people. More than 500 new cases of head and neck cancer are diagnosed every year in the Northern Cape alone," said van den Heever. "These cancers cause serious disfiguration and negatively affect patients' living quality. The idea with these implants is to fix the facial contour and restore normal function and appearance."

Last year, a team of Belgian surgeons performed a similar operation to improve the life of an eighty-year-old woman who had lost her jaw to a bone infection.

The team in Belgium created a customized, 3D printed titanium jaw implant from 3D scanning data aimed at restoring her ability to eat, drink and speak.

The implants were built via a process which includes MRI scans taken to provide surgeons exact topographical information which ultimately helped them develop a plan for the customized implants to be permanently attached to the patients' remaining maxillofacial structure.

The jaws were created by fusing titanium powder in the correct shape and took just two days to manufacture.