Managing Orbital Floor Fractures With Three-Dimensional (3D)-Printed Surgical Guides: A Narrative Review

Orbital floor fractures are a common consequence of maxillofacial trauma and can result in significant functional and esthetic morbidity, including diplopia, enophthalmos, and impaired ocular motility if not accurately reconstructed. Conventional freehand orbital floor reconstruction relies heavily on intraoperative judgment and visual estimation, which may compromise precision, particularly in complex defects involving posterior orbital anatomy. The objective of this review is to evaluate the clinical effectiveness, accuracy, and feasibility of three-dimensional (3D)-printed patient-specific surgical guides in the management of orbital floor fractures. A comprehensive literature review was conducted using major electronic databases to identify prospective and comparative clinical studies assessing guide-assisted orbital reconstruction, with an emphasis on surgical accuracy, functional outcomes, complication rates, and workflow efficiency. The reviewed evidence demonstrates that 3D-printed surgical guides enable more precise implant positioning and improved restoration of orbital volume by translating virtual preoperative planning into reproducible intraoperative execution. Radiological assessments consistently show reduced discrepancies between reconstructed and contralateral orbits, while clinical outcomes indicate lower rates of postoperative diplopia, enophthalmos, and need for revision surgery compared with conventional techniques. 3D-printed surgical guides represent a promising adjunct in orbital floor fracture management, offering enhanced precision, predictability, and improved functional and esthetic outcomes, although further standardized and cost-effectiveness studies are warranted.