3D printing of anatomical models for surgeons: an investigation on repeatability

  • Jean H. D. Fasel
  • Didier D. Malis
  • Carina Wiederer
  • Niels Hagenbuch
Original Paper


As part of the trend towards personalised medicine, surgeons are increasingly using 3D printed replicas for preoperative planning. This raises the question of how reliable these models are. This paper examines the repeatability of manufacturing human mandibles. Five polyamide replicas were produced using selective laser sintering and digitised using structured light scanning. Quantitative comparisons were made using Mimics Software. The differences were analysed graphically, using histograms and kernel density estimates. The mean differences ranged between + 0.0274 (SD 0.0671) mm and − 0.0284 (SD 0.0629) mm. The median of absolute differences was 0.0308 mm, i.e. 50% of absolute differences were smaller than 31 \(\upmu \hbox {m}\). For the 22,811,168 differences measured, all were between + 1.9836 and − 2.0526 mm. The proportion of absolute differences below 0.10 mm was between 82.09 and 98.84%, and between 94.43 and 99.90% when using a threshold of 0.20 mm. 99.95% of the absolute differences were below 1.00 mm. In conclusion: 3D printed models may not be identical, even when based on the same imaging study and patient; on the other hand, identical replicas can be obtained with a constant production chain; we recommend that four distinguishing criteria should be used in future investigations: qualitative and quantitative accuracy, repeatability and reproducibility.


Additive manufacturing 3D printing Anatomical models Repeatability Preoperative planning 



  1. 1.
    Hoang, D., Perrault, D., Stevanovic, M., et al.: Surgical applications of three-dimensional printing: a review of the current literature and how to get started. Ann. Transl. Med. 4, 456:1–19 (2016)Google Scholar
  2. 2.
    Huotilainen, E., Jaanimets, R., Valasek, J., et al.: Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process. J. Craniomaxillofac. Surg. 42, e259–e265 (2014)CrossRefGoogle Scholar
  3. 3.
    Fasel, J.H.D., Beinemann, J., Schaller, K., et al.: A critical inventory of preoperative skull replicas. Ann. R. Coll. Surg. Engl. 95, 401–404 (2013)CrossRefGoogle Scholar
  4. 4.
    Martelli, N., Serrano, C., van den Brink, H., et al.: Advantages and disadvantages of 3-dimensional printing in surgery: a systematic review. Surgery 159, 1485–1500 (2016)CrossRefGoogle Scholar
  5. 5.
    FCAT (Federative Committee on Anatomical Terminology): Terminologia Anatomica. Stuttgart/New York, Thieme, pp. 15–16 (1998)Google Scholar
  6. 6.
    R Core Team: R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing (2017)Google Scholar
  7. 7.
    Sarkar, D.: Lattice: Multivariate Data Visualization with R. Springer, New York (2008)CrossRefzbMATHGoogle Scholar
  8. 8.
    Liang, X., Jacobs, R., Lambrichts, I., et al.: Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clin. Anat. 20, 246–251 (2007)CrossRefGoogle Scholar
  9. 9.
    Bartlett, J.W., Frost, C.: Reliability, repeatability and reproducibility: analysis of measurement errors in continuous variables. Ultrasound Obstet. Gynecol. 31, 466–475 (2008)CrossRefGoogle Scholar
  10. 10.
    Ender, A., Mehl, A.: Accuracy in dental medicine, a new way to measure trueness and precision. J. Vis. Exp. 86, e51374:1–13 (2014)Google Scholar
  11. 11.
    Liu, S., Mi, Z., Langenburg, G.M., et al.: Accuracy and reliability of feature selection by Chinese fingerprint examiners. Forensic Sci. Res. 2, 203–209 (2017)CrossRefGoogle Scholar
  12. 12.
    George, E., Liacouras, P., Rybicki, F.J., et al.: Measuring and establishing the accuracy and reproducibility of 3D printed medical models. RadioGraphics 37, 1424–1450 (2017)CrossRefGoogle Scholar
  13. 13.
    Fasel, J.H.D., Knoepfli, A.S., San Millan, D., et al.: Quantitative evaluation of 3D printed anatomical objects: a comparison of optical surface scanning and micro-computed tomography. SM J. Biomed. Eng. 3, 1021:1–4 (2017)Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Jean H. D. Fasel
    • 1
  • Didier D. Malis
    • 2
  • Carina Wiederer
    • 3
  • Niels Hagenbuch
    • 4
  1. 1.Clinical Anatomy Research Group, Anatomy Sector, Departments of Cell Physiology and Metabolism, and Surgery, University Medical Centre and HospitalsUniversity of GenevaGenevaSwitzerland
  2. 2.Department of Oral and Maxillofacial SurgeryClinique des GrangettesChêne-BougeriesSwitzerland
  3. 3.Materialise GmbHGilchingGermany
  4. 4.ConstatSpiezSwitzerland

Personalised recommendations