## 3 Results
### NASSS Framework
#### 3.2.6. Wider System  
Political/Policy Context  
The Ministry of Health and Medical Education (MOHME) is responsible for setting policies and regulations related to healthcare services in Iran. Therefore, it is essential to ensure that the use of 3D printing in maxillofacial surgery aligns with the country's healthcare policies and regulations. The shortage of dental professionals, particularly in rural areas, is a major issue in Iran's healthcare system. The Supreme Council of the Cultural Revolution's plan to increase admission capacity in dental fields and distribute specialist doctors to disadvantaged areas is a step in the right direction. Additionally, allowing oral and maxillofacial surgeons to have offices in cities with shortages of such specialists can help alleviate the issue. Improving the quality of education and providing facilities to young medical and dental students can also address the shortage of medical professionals in the country. By addressing these issues, Iran can improve the access to necessary medical services for its population [46]. Improving the speed and accuracy of dental care through 3D printing technology could help further alleviate shortages.  
Regulatory/Legal Issues  
The use of 3D printing in healthcare presents regulatory and legal challenges, such as product liability, compliance with regulations, intellectual property, and privacy and environmental concerns. The absence of specific 3D printing laws makes it difficult for hospitals and manufacturers to protect themselves from liability and ensure compliance with guidelines. There is a need for quality control procedures to ensure compliance with CAD files, printers, software, and material guidelines [23]. Iran's Food and Drug Administration (FDA) regulates medical devices, including those produced using 3D printing technology. Obtaining appropriate approvals from the FDA and addressing legal issues related to liability and intellectual property rights are crucial when using 3D printing in maxillofacial surgery [43]. In addition, all 12 surgeons who participated in our survey agreed on the necessity of implementing rules to address regulatory and legal considerations for patient safety and compliance when integrating 3D printing technology into their treatments.  
Sociocultural Context  
The adoption of 3D printing technology in maxillofacial surgery could revolutionize the way in which surgeries are performed but concerns over safety and efficacy in Iran may impact its implementation. Patients and community members may prefer traditional surgical methods and may require education on the benefits of using 3D printing in maxillofacial surgery. Providing replicas of the target area can increase patients' confidence and understanding of the procedure. Collaboration between hospitals, research institutions, and medical device manufacturers can help to promote the use of this technology, overcoming funding and resource-related barriers. Addressing sociocultural factors through education and collaboration can ensure that patients in Iran benefit from 3D printing in maxillofacial surgery [15]. Of the 12 surgeons who participated in our survey, 33% agreed that patients were not aware of the effectiveness of 3D printers in maxillofacial surgery, while 58% believed patients preferred traditional methods, and 33% had safety concerns. These attitudes and preferences significantly affect the adoption of 3D printers in maxillofacial surgery. All respondents believed that comprehensive educational programs, financial incentives, and a supportive organizational culture could encourage or facilitate the adoption of 3D printer technology among patients.