Academic literature on the topic 'Maxillofacial Additive Manufactured Surgical Guides'
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Journal articles on the topic "Maxillofacial Additive Manufactured Surgical Guides"
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Dérand, Per, Lars-Erik Rännar, and Jan-M. Hirsch. "Imaging, Virtual Planning, Design, and Production of Patient-Specific Implants and Clinical Validation in Craniomaxillofacial Surgery." Craniomaxillofacial Trauma & Reconstruction 5, no. 3 (September 2012): 137–43. http://dx.doi.org/10.1055/s-0032-1313357.
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The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes®, Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and mesh to replace resected bone that can function as a carrier for bone or bone substitutes were designed and tested during reconstructive maxillofacial surgery. A clinically fit, well within the requirements for what is needed and obtained using traditional free hand bending of commercially available devices, or even higher precision, was demonstrated in ablative surgery in four patients.
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Chakravarthy, Chitra, Daisy Aranha, Santosh Kumar Malyala, and Ravi S. Patil. "Cast Metal Surgical Guides: An Affordable Adjunct to Oral and Maxillofacial Surgery." Craniomaxillofacial Trauma & Reconstruction Open 5 (January 1, 2020): 247275122096026. http://dx.doi.org/10.1177/2472751220960268.
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Additive manufacturing or 3-dimensional (3D) printing technology has an incredulous ability to create complex constructs with high exactitude. Surgical guides printed using this technology allows the transfer of the virtual surgical plan to the operating table, optimizing aesthetic outcomes, and functional rehabilitation. A vast variety of materials are currently being used in medical 3D printing, including metals, ceramics, polymers, and composites. The guides fabricated with titanium have high strength, excellent biocompatibility, and are sterilizable but take time to print and are expensive. We have thus followed a hybrid approach to fabricate an inexpensive surgical guide using metal where the advantage of 3D printing technology has been combined with the routinely followed investment casting procedure to fabricate guides using nickel–chromium, which has all the advantages of a metal and is cost-effective.
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Tereshchuk, Sergey, Sergey Ivanov, Daniil Korabelnikov, and Vladimir Sukharev. "The use of additive technologies in reconstructive maxillofacial surgery." Russian Medical and Social Journal 1, no. 2 (September 30, 2019): 29–39. http://dx.doi.org/10.35571/rmsj.2019.2.003.
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Introduction. Modern technologies make it possible not only to plan reconstructive surgery virtually, but also to manufacture templates for resection and osteotomy, customized titanium plates based on the results of planning.
Objective. To analyze the results of application of additive technologies for planning and performing reconstructive operations in the Maxillofacial Surgery and Stomatology Center at Burdenko Main Military Clinical Hospital
Patients and Methods. 144 operations to eliminate different locations bone defects were performed in the Maxillofacial Surgery and Stomatology Center in 2007 - 2017. 136 patients (93%) had de-fects of the bones of the facial skeleton and the skull calvarium. In other cases, there were defects of the clavicle (2 patients), defects of the femur (2 patients), defects of the humerus (2 patients), a defect of the radius (1 patient), a defect of the navicular bone (1 patient).
Results. Flaps were used to close the defects in 87% of cases (125 patients), and alloplastic implants were utilized in 13% of cases (19 patients). Additive technologies were used in 85% (n = 123) cases for planning the operation to eliminate defects, as well as for manufacturing surgical models and templates. Clinical cases are considered as examples of the use of the additive technologies for planning and performing reconstructive operations to close bone defects of different locations.
The incidence of postoperative complications in the group of patients with facial skeleton and crani-al vault bones defects who underwent surgical interventions using templates was 26%, including minor complications - 17.5%, large - 8.5%. Among minor complications, hematomas (5%) and sup-puration (5%) of the recipient wound prevailed, less often similar complications were hematomas (4%) and suppuration (3%) of the donor wound. Large complications were represented by cases of complete (4%) or partial (5%) transplant necrosis.
During surgical interventions without a template, it took significantly longer than the average time of grafting and graft formation (212 ± 18.7 min) than during operations with a template, including with a guide for drilling (136 ± 12.6 min, p <0.001) and without a guide for drilling (160 ± 16.3 min, p <0.001).
Conclusion. The use of surgical models and templates during reconstructive operations shortens the time of the operation and reduces the number of postoperative complications.
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Zhang, Rong Feng, Peng Yun Wang, Ming Yang, Xuebo Dong, Xue Liu, Yiguang Sang, and An Tong. "Application of 3D Printing Technology in Orthopedic Medical Implant -Spinal surgery as an example." International Journal of Bioprinting 5, no. 2 (June 4, 2019): 3. http://dx.doi.org/10.18063/ijb.v5i2.168.
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Additive manufacturing has been used in complex spinal surgical planning since the 1990s and is now increasingly utilized to produce surgical guides, templates, and more recently customized implants. Surgeons report beneficial impacts using additively manufactured biomodels as pre-operative planning aids as it generally provides a better representation of the patient’s anatomy than on-screen viewing of computed tomography (CT) or magnetic resonance imaging (MRI). Furthermore, it has proven to be very beneficial in surgical training and in explaining complex deformity and surgical plans to patients/ parents. This paper reviews the historical perspective, current use, and future directions in using additive manufacturing in complex spinal surgery cases. This review reflects the authors’ opinion of where the field is moving in light of the current literature. Despite the reported benefits of additive manufacturing for surgical planning in recent years, it remains a high niche market. This review raises the question as to why the use of this technology has not progressed more rapidly despite the reported advantages – decreased operating time, decreased radiation exposure to patients intraoperatively, improved overall surgical outcomes, pre-operative implant selection, as well as being an excellent communication aid for all medical and surgical team members. Increasingly, the greatest benefits of additive manufacturing technology in spinal surgery are customdesigned drill guides, templates for pedicle screw placement, and customized patient-specific implants. In view of these applications, additive manufacturing technology could potentially revolutionize health care in the near future.
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Pieralli, Stefano, Benedikt Christopher Spies, Valentin Hromadnik, Robert Nicic, Florian Beuer, and Christian Wesemann. "How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?" Journal of Clinical Medicine 9, no. 8 (July 22, 2020): 2322. http://dx.doi.org/10.3390/jcm9082322.
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3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.
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Carfagni, Monica, Flavio Facchini, Rocco Furferi, Marco Ghionzoli, Lapo Governi, Antonio Messineo, Francesca Uccheddu, and Yary Volpe. "Towards a CAD-based automatic procedure for patient specific cutting guides to assist sternal osteotomies in pectus arcuatum surgical correction." Journal of Computational Design and Engineering 6, no. 1 (January 3, 2018): 118–27. http://dx.doi.org/10.1016/j.jcde.2018.01.001.
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Abstract Pectus Arcuatum, a rare congenital chest wall deformity, is characterized by the protrusion and early ossification of sternal angle thus configuring as a mixed form of excavatum and carinatum features. Surgical correction of pectus arcuatum always includes one or more horizontal sternal osteotomies, consisting in performing a V-shaped horizontal cutting of the sternum (resection prism) by means of an oscillating power saw. The angle between the saw and the sternal body in the V-shaped cut is determined according to the peculiarity of the specific sternal arch. The choice of the right angle, decided by the surgeon on the basis of her/his experience, is crucial for a successful intervention. The availability of a patient-specific surgical guide conveying the correct cutting angles can considerably improve the chances of success and, at the same time, reduce the intervention time. The present paper aims to propose a new CAD-based approach to design and produce custom-made surgical guides, manufactured by using additive manufacturing techniques, to assist the sternal osteotomy. Starting from CT images, the procedure allows to determine correct resection prism and to shape the surgical guide accordingly taking into account additive manufacturing capabilities. Virtually tested against three case studies the procedure demonstrated its effectiveness. Highlights Patient-specific surgical guide improves the chances of success in sternal osteotomy. A CAD-based approach to design and produce custom-made surgical guides is proposed. The proposed framework entails both a series of automatic and user-guided tasks.
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A, Manmadhachary, Santosh Kumar Malyala, Ravi Kumar Y., Haranadha Reddy M., and Adityamohan Alwala. "Design & Manufacturing of Implant for reconstructive surgery: A Case Study." KnE Engineering 2, no. 2 (February 9, 2017): 143. http://dx.doi.org/10.18502/keg.v2i2.608.
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<p>Additive Manufacturing (AM), also known as 3D printing is an emerging technology in oral & maxillofacial surgery with respect to reconstructive bone surgery. Such treatment protocols often require customized implants to fulfill the functional and aesthetic requirements. Currently, such customized implants are being manufactured using AM technology. This paper describes a mandible defect of oral & maxillofacial surgery. The fracture and defect of the mandible inferior border is one of the serious complications during alignment and fixing of the implant. Reconstruction of such defects is daunting tasks. The case report describes a method based on Computer Aided Design (CAD) and AM for individual design, fabrication and implantation of a mandible inferior border. A 40-year old male meet an accident with rash drive. The patient specific customized implant is designed with patient Computed Tomography (CT) data. The CT images in Digital Imaging and Communication in Medicine (DICOM) file format is used to develop a 3D CAD model of customized implant. The implant is designed to maintain the symmetry of mandible from right to left. The designed implant model is manufactured by Fused Deposition Modelling (FDM) techniques with a biocompatible material. The patient mandible prototype model was manufactured by AM process, which is helpful for pre-planning of surgical procedures. For these pre-planning surgical procedures, a perfect fit obtained during surgery. The patient ultimately regained reasonable mandible contour and appearance of the face. </p>
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Frizziero, Leonardo, Gian Maria Santi, Christian Leon-Cardenas, Giampiero Donnici, Alfredo Liverani, Francesca Napolitano, Paola Papaleo, et al. "An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children." Applied Sciences 11, no. 9 (April 29, 2021): 4057. http://dx.doi.org/10.3390/app11094057.
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The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.
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Kittur, M. A., N. Scott, P. L. Evans, and S. C. Hodder. "Setting up an ‘in house’ service to provide 3D computer planning and additive manufactured surgical guides for fibula free flaps." International Journal of Oral and Maxillofacial Surgery 44 (October 2015): e92. http://dx.doi.org/10.1016/j.ijom.2015.08.639.
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Grover, Chetna, Pankaj Dhawan, and Shivam Singh Tomar. "REDEFINING PROSTHODONTICS WITH 3D PRINTING." International Journal of Advanced Research 9, no. 07 (July 31, 2021): 1093–100. http://dx.doi.org/10.21474/ijar01/13193.
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Dentistry is amidst a digital revolution and patients are the definitive recipients of these innovative technological advancements. Three-dimensional (3D) printing is no more considered the future, but isthe reality for daily clinical practice. The term 3D printing, additionally referred as rapid prototyping, is commonly used to depict an additive manufacturing method which adds numerous layers under computerized control in order to create a three-dimensional object. Using this procedure, 3-Dimensional printed restorations, crowns, bridges, surgical guides and implants can be manufactured rapidly with extreme accuracy and precision. The benefits of this innovative technique exceed its drawbacks. 3D printing has prompted a change in digital dentistry with its broad learning, penetrating opportunities and a wide scope of applications. This article will facilitate an understanding of the digital workflow, methods and current uses of 3D printing in prosthetic dentistry.
Book chapters on the topic "Maxillofacial Additive Manufactured Surgical Guides"
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Spake, Carole S. L., and Albert S. Woo. "Additive Manufacturing in Medicine and Craniofacial Applications of 3D Printing." In Additive Manufacturing in Biomedical Applications, 454–65. ASM International, 2022. http://dx.doi.org/10.31399/asm.hb.v23a.a0006852.
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Abstract This article provides highlights of the general process and workflow of creating a 3D-printed model from a medical image and discusses the applications of additively manufactured materials. It provides a brief background on Food and Drug Administration (FDA) classification and regulation of medical devices, with an emphasis on 3D-printed devices. Then, the article discusses two broad applications of 3D printing in craniofacial surgery: surgery and education. Next, it discusses, with respect to surgical applications, preoperative planning, use in the operating room, surgical guides, and implants. The article includes sections on education that focus on the use of 3D-printed surgical simulators and other tools to teach medical students and residents. It briefly touches on the FDA regulations associated with the respective application of 3D printing in medicine. Lastly, the article briefly discusses the state of medical billing and reimbursement for this service.