Byline: Vincenzo Abbate, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Giorgio Iaconetta, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Luigi Califano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Antonio Pansini, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Paola Bonavolonta, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Antonio Romano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Giovanni Salzano, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Teresa Somma, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples; Luca D'Andrea, Neurosurgery Department Salerno, University of Salerno, Fisciano, Italy.; Giovanni Dell'Aversana Orabona, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples 'Federico II,' Naples Abstract BACKGROUND:: Restoring the orbital cavity integrity in orbital floor defects is a challenging issue due to the anatomical complexity of the floor's surface. This is a showcase for technical description of a novel 'in house' rapid prototyping protocol aimed to customize implant for orbital floor reconstruction. METHODS:: The authors present 4 cases to show our Computer-aided-design and Computer-aided-manufacturing digital workflow. The system was based on a 3D-printed press that; through a virtually designed mold, was used to conform a patient specific titanium mesh for orbital floor reconstruction. RESULTS:: The merging procedure analysis by iPlan Cranial 3.0 (Brainlab, Munich, Germany) highlighted a 0.71 [+ or -] 0.23 mm (P <0.05) discrepancy in a point-to-point superimposition between the digital planned reconstruction and the real in vivo result. CONCLUSIONS:: The authors expect that this technique will reduce operative time and cost however further study and larger series may better define the applicability in everyday surgical practice.