Advanced Manufacturing of PLA Surgical Templates for Orbital Floor Geometry: Optimizing Fidelity and Surface Morphology via Variable Layer Height MEX 3D Printing.

Abstract

Precise orbital floor reconstruction requires personalised surgical templates that combine high geometric fidelity with manufacturing efficiency. This study presents and validates the TARMM procedure, developed to optimise the production of polylactide (PLA) templates. A key innovation is the integration of advanced machine learning algorithms (Random Forest) and Mitchell-Netravali interpolation to reduce medical reconstruction artefacts, as well as the implementation of Material Extrusion (MEX) technology with Variable Layer Height (VLH). This strategy minimises the stair-step effect on complex anatomical curvatures while maintaining high process throughput. The results demonstrate that the TARMM procedure ensures a geometric error within ±0.1 mm. A strong linear correlation (r = 0.99) was found between layer height and surface roughness (Sa), indicating that a 0.07 mm layer in critical areas significantly improves template morphology and facilitates the contouring of titanium meshes. The clinical validation across 21 cases confirmed a 30 min reduction in surgical preparation time. The developed method serves as a low-cost, high-precision alternative to photopolymerization technologies, contributing to modern 3D printing applications in maxillofacial surgery.