According to the European Union (EU) Directive 2005/36, the medical specialty of oral and maxillofacial surgery (OMFS) exists with two possible formats: dual degree OMFS called Dental, Oral and Maxillofacial Surgery (DOMFS) - basic medical and basic dental training and single medical degree Maxillofacial Surgery (MFS). Within the EU and across all of Europe, differences in the nature and quality of OMFS training coexist. By implementing the highest possible standards of training, patient care can be improved. To establish quality metrics for an ideal OMFS training programme, the European OMFS Trainee Forum of the Union Européenne des Médecins Spécialistes (UEMS) conducted a Delphi consensus protocol from November 2023 to January 2024. Facilitated by the OMFS Section of UEMS, 57 trainees from 32 countries participated. The process involved the definition of three quality levels using the red, amber, and green (RAG) rating system. Following the Delphi process, 46 domains were identified, including features within training programmes/rotations, teaching and education programmes, training placements, recording of training progression and activity, and external assessment of training programmes. The results were aligned with the UEMS OMFS European Training Requirement (ETR). With the introduction of a RAG rating, trainees and trainers can review their training programmes with the aim of improving them by moving domains from Red to Green. Raising the standard of training will benefit our patients. This initiative could mark a significant step towards the harmonisation of OMFS training, improving quality and ensuring consistent, high-level care throughout Europe.

Background and Objectives: Orbital floor fractures are challenging to treat, due to the complex orbital anatomy and limited surgical access. Emerging technologies—such as virtual surgical planning (VSP), 3D printing, patient-specific implants (PSIs), and intraoperative navigation—offer promising advancements to improve the surgical precision and clinical outcomes. This review systematically evaluates and synthesizes current technological modalities with respect to their accuracy, operative duration, cost-effectiveness, and postoperative functional outcomes. Materials and Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. The PubMed, Scopus, and PRIMO databases were searched for clinical studies published between 2019 and September 2024. Out of 229 articles identified, 9 met the inclusion criteria and were analyzed using the PICO framework. Results: VSP and 3D printing enhanced diagnostics and presurgical planning, offering improved accuracy and reduced planning time. Pre-bent PSIs shaped on 3D models showed superior accuracy, lower operative times, and better cost efficiency compared to intraoperative mesh shaping. Custom-designed PSIs offered high precision and clinical benefit but required a longer production time. Intraoperative navigation improved implant positioning and reduced the complication rates, though a detailed cost analysis remains limited. Conclusions: VSP, 3D printing, and intraoperative navigation significantly improve surgical planning and outcomes in orbital floor reconstruction. Pre-bent PSIs provide a time- and cost-effective solution with strong clinical performance. While customized PSIs offer accuracy, they are less practical in time-sensitive settings. Navigation systems are promising tools that enhance outcomes and may serve as an alternative to custom implants when time or resources are limited.

Background/Objectives: Reconstruction of orbital floor fractures remains surgically challenging due to limited intraoperative visibility and complex anatomy. Inaccurate implant placement often leads to persistent complications and the need for a revision surgery. This study evaluated the clinical accuracy and re-operation rates of a preoperative 3D-printed model-assisted technique compared to the conventional intraoperative free-hand mesh bending method. Methods: A comparative ambispective study was conducted on 74 patients with isolated orbital floor fractures. The control group (n = 34, retrospective) underwent reconstruction using intraoperatively formed titanium meshes. In the study group (n = 40, prospective), patient-specific 3D-printed models, created by mirroring the healthy contralateral orbit, were used for preoperative mesh adaptation. Primary outcomes included the rate of revision surgery due to implant malposition, changes in orbital volume, and postoperative diplopia. Results: The 3D model group demonstrated a significantly lower rate of revision surgery compared to the control group. In the retrospective group, 5 patients (15%) required reoperation due to implant malposition, whereas no patients (0%) in the prospective 3D group required secondary intervention (p = 0.017). While both techniques effectively restored orbital volume, the 3D group showed greater volumetric precision with less variance. The mean volume difference in the affected orbit was 3078 ± 2204 mm³ in the control group, compared to 2390 ± 1893 mm³ in the study 3D group. At the 6-month follow-up, persistent diplopia was observed in 12% of the control group compared to only 3% in the study group. Conclusions: The use of in-house 3D-printed models for preoperative mesh forming significantly enhances surgical precision and eliminates the need for revision surgery due to implant malposition. This workflow offers a cost-effective, predictable, and accessible alternative to expensive patient-specific implants (PSIs) or intraoperative navigation systems, improving patient safety and long-term clinical outcomes.