{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:12:00Z","timestamp":1774613520700,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Digital surgery integrates advanced imaging, computational modeling, additive manufacturing, and intraoperative navigation technologies. Although widely explored, most platforms remain fragmented and lack regulatory cohesion. The B-onic Platform was conceived as a unified workflow that enables surgical planning, device personalization, and intraoperative navigation within a regulatory-compliant framework. Objective: This study aimed to present a comprehensive single-center clinical evaluation of the implementation of the B-onic Platform in a large single-center cohort, focusing on efficiency, patient safety, and surgeon-reported outcomes. Methods: A retrospective review of 308 consecutive surgical plans was performed at La Paz University Hospital (Madrid, Spain) between 2020 and 2024 and compared with institutional historical controls from 2018 to 2019. Procedures included maxillofacial surgery, traumatology, reconstructive surgery, and other specialties. The platform incorporated imaging-based CAD modeling, 3D-printed biomodels and guides, and immersive validation through the NavigatorPro XR module. Outcomes analyzed were preoperative planning time, operative duration, 30-day complication and rehospitalization rates, intraoperative blood loss, and surgeon-reported perception of anatomical understanding and intraoperative confidence. Results: Mean preoperative planning time was reduced by 34% (\u221242 h; 95% CI: \u221248 to \u221236 h; p &lt; 0.01) compared with historical controls. Mean operative duration decreased from 226 \u00b1 74 min to 181 \u00b1 61 min (\u221245 min; 95% CI: \u221252 to \u221238 min; p &lt; 0.001). The 30-day postoperative complication rate decreased from 12.9% to 10.7% (absolute reduction 2.2%; 95% CI: 0.2\u20134.1%; p = 0.037), while rehospitalization rates declined from 9.1% to 4.3% (p = 0.012). Mean length of hospital stay decreased from 6.8 \u00b1 3.1 to 5.2 \u00b1 2.3 days (p = 0.022), and intraoperative blood loss was reduced by 12\u201330% across specialties (p = 0.008). NavigatorPro XR halved validation time for guides and implants (71.8 \u00b1 22.4 h vs. 35.6 \u00b1 18.9 h; p &lt; 0.001). Ninety-two percent of surveyed surgeons reported improved 3D anatomical understanding and enhanced intraoperative safety. Conclusions: The B-onic Platform has transitioned from a prototype to a consolidated system, integrated into routine practice with significant gains in efficiency, safety, and training value. These findings support the potential of the platform as a precision surgery model; however, further multicenter prospective studies are required to confirm scalability.<\/jats:p>","DOI":"10.3390\/jcm15072548","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:12:25Z","timestamp":1774609945000},"page":"2548","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["B-onic Platform: A Single-Center Clinical Evaluation of an Integrated FabLab Workflow for Patient-Specific Surgical Planning and XR-Based Validation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-9800","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Cebri\u00e1n-Carretero","sequence":"first","affiliation":[{"name":"Maxillofacial Surgery Department, La Paz University Hospital, Instituto de Investigaci\u00f3n La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Tadeo","family":"Borjas G\u00f3mez","sequence":"additional","affiliation":[{"name":"FabLab Department, La Paz University Hospital, 3D FabLab, Instituto de Investigaci\u00f3n La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5619-7721","authenticated-orcid":false,"given":"Celia","family":"del Peso Ley","sequence":"additional","affiliation":[{"name":"FabLab Department, La Paz University Hospital, 3D FabLab, Instituto de Investigaci\u00f3n La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2068-8758","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Rubio Bolivar","sequence":"additional","affiliation":[{"name":"FabLab Department, La Paz University Hospital, 3D FabLab, Instituto de Investigaci\u00f3n La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9607-9178","authenticated-orcid":false,"given":"Celia","family":"Mart\u00edn Cubillo","sequence":"additional","affiliation":[{"name":"FabLab Department, La Paz University Hospital, 3D FabLab, Instituto de Investigaci\u00f3n La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8703-7134","authenticated-orcid":false,"given":"N\u00e9stor","family":"Montesdeoca Garc\u00eda","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgeon, Private Practice, 28003 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9869-9240","authenticated-orcid":false,"given":"Carlos","family":"Navarro-Cu\u00e9llar","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery Department, Gregorio Mara\u00f1\u00f3n General Hospital, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2660-370X","authenticated-orcid":false,"given":"Jorge","family":"Maga\u00f1a","sequence":"additional","affiliation":[{"name":"Rayo Seco Systems, ISP-XR Systems, C\/Jos\u00e9 de Echegaray, 28232 Las Rozas de Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/j.surg.2015.12.017","article-title":"Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review","volume":"159","author":"Martelli","year":"2016","journal-title":"Surgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s12938-016-0236-4","article-title":"3D-printing techniques in a medical setting: A systematic literature review","volume":"15","author":"Tack","year":"2016","journal-title":"Bio-med. 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