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Splintless orthognathic surgery in edentulous patients-a pilot study. Int J Oral Maxillofac Surg 2019; 49:587-594. [PMID: 31587823 DOI: 10.1016/j.ijom.2019.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/19/2019] [Accepted: 08/29/2019] [Indexed: 11/21/2022]
Abstract
The aim of this pilot study was to evaluate the accuracy and predictability of a splintless treatment protocol for edentulous patients undergoing orthognathic surgery in four consecutive cases. All operations were virtually planned, followed by computer-aided design of individual osteotomy guides and patient-specific fixation implants, which were three-dimensionally printed in titanium. In order to evaluate the discrepancy between the planned and the achieved postoperative result, the postoperative outcome was compared to the virtual treatment plan. Rotational and translational movement and discrepancies with the planned movements were quantified for the maxilla; the advancement was quantified for the mandible. For the maxilla, there was a mean translation discrepancy of 0.6mm. With regard to rotation, there was a mean discrepancy of 1.9°, 0.1°, and 0.4° for pitch, yaw, and roll, respectively. The mean discrepancy in translation of the mandible was 0.4mm. The results of this pilot study indicate that the splintless treatment protocol for orthognathic surgery in edentulous patients presented here is accurate and predictable.
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52
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Abstract
This article summarizes the current use of patient-specific implants in oral and maxillofacial surgery.
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53
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Stokbro K, Borg SW, Andersen MØ, Thygesen T. Patient-specific 3D printed plates improve stability of Le Fort 1 osteotomies in vitro. J Craniomaxillofac Surg 2019; 47:394-399. [DOI: 10.1016/j.jcms.2018.12.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/04/2018] [Accepted: 12/21/2018] [Indexed: 11/25/2022] Open
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54
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Shaheen E, Shujaat S, Saeed T, Jacobs R, Politis C. Three-dimensional planning accuracy and follow-up protocol in orthognathic surgery: a validation study. Int J Oral Maxillofac Surg 2019; 48:71-76. [DOI: 10.1016/j.ijom.2018.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/24/2018] [Accepted: 07/19/2018] [Indexed: 11/30/2022]
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Oberoi G, Nitsch S, Edelmayer M, Janjić K, Müller AS, Agis H. 3D Printing-Encompassing the Facets of Dentistry. Front Bioeng Biotechnol 2018; 6:172. [PMID: 30525032 PMCID: PMC6262086 DOI: 10.3389/fbioe.2018.00172] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/29/2018] [Indexed: 12/14/2022] Open
Abstract
This narrative review presents an overview on the currently available 3D printing technologies and their utilization in experimental, clinical and educational facets, from the perspective of different specialties of dentistry, including oral and maxillofacial surgery, orthodontics, endodontics, prosthodontics, and periodontics. It covers research and innovation, treatment modalities, education and training, employing the rapidly developing 3D printing process. Research-oriented advancement in 3D printing in dentistry is witnessed by the rising number of publications on this topic. Visualization of treatment outcomes makes it a promising clinical tool. Educational programs utilizing 3D-printed models stimulate training of dental skills in students and trainees. 3D printing has enormous potential to ameliorate oral health care in research, clinical treatment, and education in dentistry.
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Affiliation(s)
- Gunpreet Oberoi
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
| | - Sophie Nitsch
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Health Sciences, FH Wien, University of Applied Sciences, Vienna, Austria
| | - Michael Edelmayer
- Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Department of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Klara Janjić
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Anna Sonja Müller
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Hermann Agis
- Department of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
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56
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Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
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Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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57
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Van den Bempt M, Liebregts J, Maal T, Bergé S, Xi T. Toward a higher accuracy in orthognathic surgery by using intraoperative computer navigation, 3D surgical guides, and/or customized osteosynthesis plates: A systematic review. J Craniomaxillofac Surg 2018; 46:2108-2119. [PMID: 30420150 DOI: 10.1016/j.jcms.2018.10.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/04/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022] Open
Abstract
The aim of this study was to systematically review the accuracy of intraoperative computer navigation, three-dimensional surgical guides and customized osteosynthesis plates for the transfer of the virtual surgical plan to the patient in orthognathic surgery. A systematic review of the currently available publications was performed in databases MEDLINE, Embase, and Cochrane Library, using a PICOS search strategy, and reported according to PRISMA. The initial search yielded 3050 articles. In total, 16 studies were included for final quantitative analyses. The results of individual studies demonstrated a comparable accuracy in the transfer of planned surgical displacement of the jaws. A large variability was found with regard to the method of accuracy assessment and reported outcomes. The findings of this review show that these modern techniques have the potential to replace interocclusal splints in routine clinical practice in the future. We recommend that authors presenting new data on the accuracy of a technique should choose the method of accuracy assessment meticulously, acquiring postoperative imaging as soon as possible after surgery. They should report as much as possible, summarizing values or, ideally, even the raw data of the accuracy assessment in order to allow comparison with other techniques in a meta-analysis.
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Affiliation(s)
- Maxim Van den Bempt
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Jeroen Liebregts
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Thomas Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
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58
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Stokbro K, Bell RB, Thygesen T. Patient-Specific Printed Plates Improve Surgical Accuracy In Vitro. J Oral Maxillofac Surg 2018; 76:2647.e1-2647.e9. [PMID: 30196082 DOI: 10.1016/j.joms.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE It remains unclear to what extent patient-specific printed plates can improve surgical outcomes in orthognathic procedures. This study aimed to quantify the surgical accuracy of patient-specific printed plates in vitro and to compare the results with patients' actual surgical outcomes. PATIENTS AND METHODS This in vitro study enrolled 20 postoperative orthognathic surgical patients, all treated with inferior maxillary repositioning. The preoperative midfaces were re-created in a 3-dimensionally printed model. The osteotomy and screw holes were placed at prespecified positions using a 3-dimensional guide. The dental segment was repositioned by means of the patient-specific plates. The primary outcome was the mean reposition at 3 dental reference points. The primary predictor variable was the obtained surgical reposition in vitro compared with the virtual surgical plan. Confounding variables were gender, age, occlusion, and bimaxillary surgery. The secondary outcome was surgical accuracy, and the secondary predictor was the in vitro outcomes versus the patients' surgical outcomes. Surgical accuracy was defined as the difference between the obtained reposition and the virtual surgical plan on a continuous scale. The differences were recorded in 3 dimensions according to the positive value of the 3 axes: right, anterior, and posterior. The results were analyzed using mixed-model regression and 1-sample t tests. RESULTS In the 20 patients (age, 18 to 64 years; 40% of patients were women), the mean planned reposition was 2.9 mm anterior and 1.8 mm inferior. In all models, the osteotomy edge was rounded off to position the plate in the predetermined position. Overall, the maxilla was positioned 0.5 mm anterior and 0.3 mm inferior to the planned position using patient-specific plates. CONCLUSIONS The patient-specific plates positioned the maxilla in close approximation to the planned position without surgically relevant differences. The osteotomy edge must be carefully inspected for interference with the patient-specific plates to avoid displacement of the planned maxillary repositioning.
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Affiliation(s)
- Kasper Stokbro
- PhD Fellow and Oral and Maxillofacial Surgical Resident, Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
| | - R Bryan Bell
- Medical Director, Providence Oral, Head and Neck Cancer Program and Clinic, Providence Cancer Center, Portland, OR
| | - Torben Thygesen
- Head of Department, Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark
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Yang WF, Choi WS, Leung YY, Curtin JP, Du R, Zhang CY, Chen XS, Su YX. Three-dimensional printing of patient-specific surgical plates in head and neck reconstruction: A prospective pilot study. Oral Oncol 2018; 78:31-36. [DOI: 10.1016/j.oraloncology.2018.01.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 12/14/2017] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
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