Feasibility study of low-dose CT technology for maxillofacial bone 3D printing in skeletal class III malocclusion

Background: Skeletal class III malocclusion is one of the most common dental and maxillofacial malformations. Three-dimensional (3D) printing technology has become widely applied in orthopaedics. The CT radiation dose experienced during the acquisition of data sources for 3D printing is a growing concern. This study explored the feasibility of low-dose CT technology in maxillofacial bone 3D printing and the clinical value of maxillofacial bone 3D printing in class III malocclusion. Methods Ninety patients with class III malocclusion who planned to undergo maxillofacial bone 3D printing and 3D-CT were prospectively enrolled and randomly divided into conventional CT dose 3D printing group (Group A, n = 28), low CT dose 3D printing group (Group B, n = 32) and 3D-CT control group (Group C, n = 30). A 4-point scale was adopted to evaluate the quality of maxillofacial bone 3D printing, and a Likert-scale questionnaire was used to assess its clinical value. Results No significant differences were observed in general demographic characteristics between Groups A, B and C. The radiation dose in Group B (0.3 mSv) was reduced by approximately 63% compared with that in Group A (0.8 mSv), and there were no significant differences between Groups A and B in 3D printing quality indexes (includes to clarity, integrity, accuracy or artefacts) (all P  > 0.05). There were significantly higher subjective scores for the clinical value of maxillofacial bone 3D printing than for 3D-CT in diagnosing and classifying, formulating the surgical plan, simulating the surgical process and predicting postoperative recovery (all P  < 0.05). Conclusions Low-dose CT technology can be effectively applied for maxillofacial bone 3D printing, reducing the radiation dose without affecting the 3D printing quality. Maxillofacial bone 3D printing technology is superior to 3D-CT in class III malformations.