Logo: to the web site of Uppsala University

PURPOSE: Additive manufacturing (AM) is an innovative printing technology that can manufacture 3-dimensional solid objects by adding layers of material from model data. AM in oral and maxillofacial surgery (OMFS) provides several clinical applications such as surgical guides and implants. However, the adoption of AM in OMFS is not well covered. The purpose was to study the adoption of AM in OMFS in university and non-university hospitals in Sweden. Three research questions were addressed: What is the degree of using AM solutions in university and non-university hospitals?; What are AM solutions used?; How are the AM solutions accessed (production mode) in university hospitals and non-university hospitals?

METHODS: A survey was distributed to OMF surgeons in Sweden. The questionnaire consisted of 16 questions. Data were analyzed through descriptive and content analysis.

RESULTS: A total of 14 university and non-university hospitals were captured. All 14 hospitals have adopted AM technology and 11 of the hospitals adopted AM in OMFS. Orthognathic and trauma surgery are two major types of surgery that involve AM technology where material extrusion and vat polymerization are the two most used AM technologies in OMFS. The primary application of AM was in medical models and guides.

CONCLUSION: Majority of Swedish university hospitals and non-university hospitals have adopted AM in OMFS. The type of hospital (university or non-university hospital) has no impact on AM adoption. AM in OMFS in Sweden can be perceived to be a mature clinical application.

OBJECTIVES: Hospitals in many European countries have implemented Additive Manufacturing (AM) technology for multiple Oral and Maxillofacial Surgery (OMFS) applications. Although the technology is widely implemented, surgeons also play a crucial role in whether a hospital will adopt the technology for surgical procedures. The study has two objectives: (1) to investigate how hospital type (university or non-university hospital) influences surgeons' views on AM, and (2) to explore how previous experience with AM (AM experience or not) influences surgeons' views on AM.

MATERIALS AND METHODS: An online questionnaire to capture surgeons' views was designed, consisting of 11 Likert scale questions formulated according to the Consolidated Framework for Implementation Research (CFIR). The questionnaire was sent to OMF surgeons through the channel provided by the Association of Oral and Maxillofacial Surgery in Sweden. Data were analyzed using the Mann-Whitney U test to identify significant differences among OMF surgeons in terms of organizational form (i.e., university hospital or non-university hospital) and experience of AM (i.e., AM experience or no-experience).

RESULTS: In total, 31 OMF surgeons responded to the survey. Views of surgeons from universities and non-universities, as well as between surgeons with experience and no-experience, did not show significant differences in the 11 questions captured across five CFIR domains. However, the "individual characteristics" domain in CFIR, consisting of three questions, did show significant differences between surgeons' experience with AM and no-experience (P-values: P = 0.01, P = 0.01, and P = 0.04).

CONCLUSIONS: Surgeons, whether affiliated with university hospitals or non-university hospitals and regardless of their prior experience with AM, generally exhibit a favorable attitude towards AM. However, there were significant differences in terms of individual characteristics between those who had prior experience with AM and those who did not.

CLINICAL RELEVANCE: This investigation facilitates the implementation of AM in OMFS by reporting on the views of OMF surgeons on AM.