A Novel 3D-Printed Bilateral Sagittal Split Osteotomy Simulation Tool for Resident Education

Background: Bilateral sagittal split osteotomy (BSSO) carries a high risk of neurosensory injury. Surgical simulation of BSSO may improve confidence, technical skills, and intuition, leading to improved intraoperative performance. We assessed the face and content validity of a novel three-dimensional (3D) printed mandible with soft tissue component for BSSO simulation. Methods: The simulation model was created using 3D printing and silicone molding. Surgical trainees were asked to perform a simulated BSSO procedure on the simulation model, both with and without the soft tissue component. This task was repeated using a commercially available model. Pre- and post-surveys assessed trainee confidence and evaluated the face and content validity of the model. Statistical analyses compared changes in confidence. Results: The simulation model cost $43 to produce ($11 for one single-use mandible component and $32 for one reusable soft tissue component). Twelve residents, including 6 junior and 6 senior residents, participated. Residents reported a significant increase in their confidence level across all domains ( P <0.01), with first-year residents reporting the greatest increase. Almost all residents agreed or strongly agreed that the simulation model (n=11, 92%), inferior alveolar nerve (n=11, 92%), and soft tissue component (n=9, 75%) were realistic. All residents preferred the simulation model over the commercially available model for BSSO. Conclusions: Our novel mandible model with soft tissue component and inferior alveolar nerve visualization is cost-effective and provides a high-fidelity, anatomically accurate platform for surgical simulation.