The following steps were followed by the CRPM’s research team:

Segmentation of CT data: The above images show the software that was used to segment the bony features from the soft tissue in order to prepare a 3D computer model from the patient’s CT data.

Generation of 3D computer model: The 3D model of the patient’s skull and upper jaw clearly shows the affected area. This 3D model was loaded onto a 3D printing machine to be manufactured from plastic powder and laser sintering process.

Innovation at Central University of Technology, Free State (CUT) enabled a medical first in South Africa, when Ennica Mahkge, a young woman from Gauteng who was born without a nose and nasal passages received extensive jaw and facial surgery and a new nasal prosthesis at Mediclinic Kloof in Pretoria on Saturday, 22 June 2013.

To allow Mahkge (19) to breathe, an opening in her windpipe was created at birth, which unfortunately increased her tendency to develop upper respiratory tract infections, and ultimately caused a chronic infection. This resulted in the need to do a nose replacement operation, where nasal passages were created by moving Mahkge’s jaw forward and down, in order to create space for the new nasal passages.

Central University of Technology, Free State (CUT), together with a team of specialists from the University of Pretoria and Mediclinic Kloof has been working tirelessly for months to make this life changing surgery possible.

The Centre for Rapid Prototyping and Manufacturing (CRPM) at CUT played a vital role in the reconstructive surgery by using Additive Manufacturing technology, better known as three dimensional printing to construct two models of Mahkge’s skull so that the team of doctors could carry out pre-operative planning and simulate the operation.

“These models were essential for the success of the operation, as the patient was born without a nasal passage. Without these models the operations would have been impossible”, said Dr van den Heever from the Department of Prosthodontics of the University of Pretoria (UP).

“With only about 50 documented cases in the world and the first in South Africa, there is no absolute protocol in place for the surgeons to draw from,” says Gerrie Booysen, the Director of the Centre for Rapid Prototyping and Manufacturing (CRPM) at CUT. “That is why the pre-operative models played such a vital role in empowering the doctors to plan and simulate the operation in the finest detail.”

The pre-operative model assisted the surgeons to determine where the upper jaw needs to be cut in order to place it in the correct position and to prepare the titanium plates that was used to reconstruct the upper jaw. This shortened the operating time considerably, which reduces the chances of complications due to a prolonged operation such as infections or excessive blood loss.

For more information about the CRPM and CUT please visit

More about CUT

CUT is a leader in many technology fields ranging from learning programmes in Science, Technology, Engineering and Mathematics (STEM) a broad field in which CUT has about 45% of its enrolments, much higher than many other South African universities. Further, CUT’s research and innovation leadership in many areas, more especially in rapid prototyping and manufacturing is world class. The latter has been honoured by both the Medical Research Council (MRC) as part of its National Medical Device Platform and the National Research Foundation (NRF), with the latter having granted CUT a Chair in this area. Through its social and technological innovations CUT aims to contribute towards the social-economic development in the region as well as in the rest of South Africa and internationally.