It’s official: we’re one step closer to cyborg awesomeness. After four years of research by the Netherlands Cancer Institute and the Dutch Mobius 3D Technology (M3DT), a titanium lower jaw has been successfully implanted into a head and neck cancer patient.
The jawbone was reconstructed from the patient’s 3D MRI and CT scans, making it a perfect fit in its new boney home.
This is a major step in the treatment of head and neck cancer, a disease which affects as many as 600,000 people every year. For most people, especially those whose cancer is caught early, the treatment is fairly minimal surgery, sometimes using lasers, or radiation therapy.
For some, though, more aggressive action is needed, and part of the lower jaw must be removed. As you might expect, this can have a massive impact on the patient’s life, since it renders them unable to speak, chew, and other essential actions – not to mention being quite noticeable from an aesthetic viewpoint.
To account for this, surgeons will reconstruct the jaw with bone from elsewhere in the body – usually from the fibula, in the lower leg. But this isn’t always possible: about three in 10 patients are deemed ineligible for the procedure due to existing vascular issues.
Even when it is an option, the procedure can have significant drawbacks. It’s a long and complex surgery, lasting up to 12 hours on average and requiring highly technical procedures to connect up the native and implanted blood vessels. The bone will also need to be shaped to fit your jaw and stitched into place.
For those who can’t have the donor bone operation, the solution is a titanium implant. Unfortunately, until now, it’s not been a particularly fancy one: the patients receive just a titanium plate, and a local or regional tissue transfer to bridge the defect.
These, too, cause problems: in 40 percent of cases, they end up breaking through mucosa or skin in the mouth, and the screws attaching the plate can come loose.
That’s why this new 3D-printed jaw is so important. Not only is it the perfect shape and weight to fit the patient’s anatomy – without requiring the loss of a shin bone to create it – but it’s also much stronger than the titanium plates currently used. That’s partly because of an improved fastening technique, but it’s also due to a new mesh structure placed on the inside of the implant which adds strength while keeping the weight of the structure down to about that of bone.
“Because the implant is custom-made, the jaw retains its fit and pressure on the overlying mucosa or skin is distributed more evenly,” the Netherlands Cancer Institute said in a statement. “We hope this will diminish complications and improve functional and aesthetic outcomes.”
“Even the tools the surgeon uses in the operation are patient-specific,” they added. “The operation is also simpler and shorter.”
This is only the first success, but the surgeons and engineers behind the titanium jaw expect it to be widely available within the next two years. Meanwhile, research is being undertaken to expand this new technique, to provide implants for elsewhere in the face and skull.