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Hodgdon T, Danrad R, Patel MJ, Smith SE, Richardson ML, Ballard DH, Ali S, Trace AP, DeBenedectis CM, Zygmont ME, Lenchik L, Decker SJ. Logistics of Three-dimensional Printing: Primer for Radiologists. Acad Radiol 2018; 25:40-51. [PMID: 29030283 DOI: 10.1016/j.acra.2017.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 02/07/2023]
Abstract
The Association of University Radiologists Radiology Research Alliance Task Force on three-dimensional (3D) printing presents a review of the logistic considerations for establishing a clinical service using this new technology, specifically focused on implications for radiology. Specific topics include printer selection for 3D printing, software selection, creating a 3D model for printing, providing a 3D printing service, research directions, and opportunities for radiologists to be involved in 3D printing. A thorough understanding of the technology and its capabilities is necessary as the field of 3D printing continues to grow. Radiologists are in the unique position to guide this emerging technology and its use in the clinical arena.
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152
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Ballard DH, Trace AP, Ali S, Hodgdon T, Zygmont ME, DeBenedectis CM, Smith SE, Richardson ML, Patel MJ, Decker SJ, Lenchik L. Clinical Applications of 3D Printing: Primer for Radiologists. Acad Radiol 2018; 25:52-65. [PMID: 29030285 DOI: 10.1016/j.acra.2017.08.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 12/22/2022]
Abstract
Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.
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153
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Gaviria L, Pearson JJ, Montelongo SA, Guda T, Ong JL. Three-dimensional printing for craniomaxillofacial regeneration. J Korean Assoc Oral Maxillofac Surg 2017; 43:288-298. [PMID: 29142862 PMCID: PMC5685857 DOI: 10.5125/jkaoms.2017.43.5.288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/11/2017] [Indexed: 12/23/2022] Open
Abstract
Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.
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Affiliation(s)
- Laura Gaviria
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joseph J Pearson
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Sergio A Montelongo
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Teja Guda
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joo L Ong
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
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154
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Steinemann DC, Müller PC, Apitz M, Nickel F, Kenngott HG, Müller-Stich BP, Linke GR. An ad hoc three dimensionally printed tool facilitates intraesophageal suturing in experimental surgery. J Surg Res 2017; 223:87-93. [PMID: 29433890 DOI: 10.1016/j.jss.2017.10.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/13/2017] [Accepted: 10/12/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Three-dimensional printing (3DP) has become popular for development of anatomic models, preoperative planning, and production of tailored implants. A novel laparoscopic, transgastric procedure for distal esophageal mucosectomy was developed. During this procedure, a space holder had to be introduced into the distal esophagus for exposure during suturing. The production process and evaluation of a 3DP space holder are described herein. MATERIALS AND METHODS Computer-aided design software was used to develop models printed from polylactic acid. The prototype was adapted after testing in a cadaveric model. Subsequently, the device was evaluated in a nonsurvival porcine model. A mucosal purse-string suture was placed as orally as possible in the esophagus, in the intervention group with and in the control group without use of the tool (n = 8 each). The distance of the stitches from the Z-line was measured. The variability of stitches indicated the suture quality. RESULTS The median maximum distance from the Z-line to purse-string suture was larger in the intervention group (5.0 [3.3-6.4] versus 2.4 [2.0-4.1] cm; P = 0.013). The time taken to place the sutures was shorter in the control group (P < 0.001). Stitch variance tended to be greater in the intervention group (2.3 [0.9-2.5] versus 0.7 [0.2-0.4] cm; P = 0.051). The time required for design and production of a tailored tool was less than 24 h. CONCLUSIONS 3DP in experimental surgery enables rapid production, permits repeated adaptation until a tailored tool is obtained, and ensures independence from industrial partners. With the aid of the space holder more orally located esophageal lesions came within reach.
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Affiliation(s)
- Daniel C Steinemann
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany; Department of Surgery, St. Claraspital, Basel, Switzerland
| | - Philip C Müller
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Martin Apitz
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Hannes G Kenngott
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - Georg R Linke
- Department of General, Visceral and Transplant Surgery, University Hospital of Heidelberg, Heidelberg, Germany; Department of Surgery, Hospital STS Thun AG, Thun, Switzerland.
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155
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Garcia J, Yang Z, Mongrain R, Leask RL, Lachapelle K. 3D printing materials and their use in medical education: a review of current technology and trends for the future. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2017; 4:27-40. [PMID: 29354281 PMCID: PMC5765850 DOI: 10.1136/bmjstel-2017-000234] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/07/2017] [Accepted: 09/02/2017] [Indexed: 01/15/2023]
Abstract
3D printing is a new technology in constant evolution. It has rapidly expanded and is now being used in health education. Patient-specific models with anatomical fidelity created from imaging dataset have the potential to significantly improve the knowledge and skills of a new generation of surgeons. This review outlines five technical steps required to complete a printed model: They include (1) selecting the anatomical area of interest, (2) the creation of the 3D geometry, (3) the optimisation of the file for the printing and the appropriate selection of (4) the 3D printer and (5) materials. All of these steps require time, expertise and money. A thorough understanding of educational needs is therefore essential in order to optimise educational value. At present, most of the available printing materials are rigid and therefore not optimum for flexibility and elasticity unlike biological tissue. We believe that the manipuation and tuning of material properties through the creation of composites and/or blending materials will eventually allow for the creation of patient-specific models which have both anatomical and tissue fidelity.
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Affiliation(s)
- Justine Garcia
- Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada
| | - ZhiLin Yang
- Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada
| | - Rosaire Mongrain
- Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada
| | - Richard L Leask
- Department of Chemical Engineering, McGill University, Montreal, Quebec, Canada
| | - Kevin Lachapelle
- Department of Cardiovascular Surgery, McGill University Health Centre, Montreal, Quebec, Canada
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156
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Additive Manufacturing, Cloud-Based 3D Printing and Associated Services—Overview. JOURNAL OF MANUFACTURING AND MATERIALS PROCESSING 2017. [DOI: 10.3390/jmmp1020015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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157
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Reconstruction of Liposarcoma Resection Defect With a Made-to-Measure Polyethylene Prosthesis Using Three-Dimensional Digital Technology. J Craniofac Surg 2017; 29:e16-e17. [PMID: 29023299 DOI: 10.1097/scs.0000000000004013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Liposarcoma is considered one of the most frequently occurring tumors of the soft tissues, representing 17% to 30% of all mesenchymal cell tumors. It is less common in the head and neck representing <10% of tumors in this region. The reconstruction of defects derived from resection of these tumors presents a surgical challenge. New three-dimensional digital technologies allow more exact surgery, cause less morbidity, and achieve adequate aesthetic outcomes. OBJECTIVE The aim of this article was to describe the complex reconstruction of a defect caused by the resection of a liposarcoma in the temporal region. METHODS Three-dimensional technology allowed patient planning and a reconstruction that was as exact as possible. A made-to-measure polymethyl methacrylate prosthesis was used to correct the defect in the zygomatic arch. The temporal fossa was covered with a standard porous polyethylene prosthesis. CONCLUSIONS Satisfactory esthetic and functional results were achieved using three-dimensional digital technology for treatment planning and to fabricate a made-to-measure polyethylene prosthesis and surgical guide.
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158
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Zhao H, Yang F, Fu J, Gao Q, Liu A, Sun M, He Y. Printing@Clinic: From Medical Models to Organ Implants. ACS Biomater Sci Eng 2017; 3:3083-3097. [PMID: 33445353 DOI: 10.1021/acsbiomaterials.7b00542] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | | | | | | | - An Liu
- Department
of Vascular Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Miao Sun
- Department
of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital,
School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Yong He
- State
Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, 710054, Xi’an China
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159
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Xu L, Tian Z, Yunus A, Wang X, Chen J, Wang C, Song X. [Application of three-dimensional printing technology in bone tumor surgery]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:1069-1072. [PMID: 29851332 DOI: 10.7507/1002-1892.201703088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To discuss the effect of three-dimensional (3D) printing individualized model and guide plate in bone tumor surgery. Methods Between October 2015 and December 2016, 3D printing individualized model and guide plate for making preoperative surgical planning and intraoperative treatment were used in 5 patients of bone tumor. All the patients were male, with a median age of 32 years (range, 9-58 years). There were 1 case of cystic echinococcosis at left pelvis and pathological fracture of the proximal femur; 1 case of left iliac bone osteoblastoma associated with aneurysmal bone cyst; 1 case of fibrous dysplasia of the left femur (sheep horn deformity) with pathological fracture; 1 case of metastatic carcinoma of right calcaneus (tumor staging was T 2N 0M 0); and 1 case of Ewing sarcoma of left femur (tumor staging was T 2N 0M 0). The disease duration ranged from 1 month to 10 years (mean, 2.25 years). Results The operation was completed successfully. The operation time was 2.6-7.5 hours (mean, 4.9 hours). The intraoperative blood loss was 200-2 500 mL (mean, 1 380 mL). The intraoperative fluoroscopy times was 1-6 times (mean, 3.8 times). There was no infection after operation, and the blood supply and nerve function were good. All the patients were followed up 3-16 months (mean, 5.4 months). No loosening or breaking of the internal fixator occurred. According to Enneking scoring system, the limb function score was 15-26 (mean, 21); and the results were excellent in 2 cases, good in 2 cases, and fair in 1 case. Conclusion 3D printing technology can make the implementation of the better preoperative planning and evaluation in bone tumor surgery, and it provides a new reference for individualized treatment in patients with bone tumor.
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Affiliation(s)
- Leilei Xu
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Zheng Tian
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Akbar Yunus
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Xiaoshuai Wang
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Jiangtao Chen
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Chong Wang
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054, P.R.China
| | - Xinghua Song
- Department of Bone Tumor Surgery, Orthopedics Center, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054,
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160
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Bukhari S, Goodacre BJ, AlHelal A, Kattadiyil MT, Richardson PM. Three-dimensional printing in contemporary fixed prosthodontics: A technique article. J Prosthet Dent 2017; 119:530-534. [PMID: 28888410 DOI: 10.1016/j.prosdent.2017.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
Abstract
Digital dentistry has gained in popularity among clinicians and laboratory technicians because of its versatile applications. Three-dimensional (3D) printing has been applied in many areas of dentistry as it offers efficiency, affordability, accessibility, reproducibility, speed, and accuracy. This article describes a technique where 3D printing is used to fabricate a die-trimmed cast and to replicate gingival tissue and implant analogs. The digital workflow that replaces the conventional laboratory procedure is outlined.
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Affiliation(s)
- Sarah Bukhari
- Graduate student, Advanced Specialty Education Program in Prosthodontics, School of Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif.
| | - Brian J Goodacre
- Assistant Professor, School of Dentistry, Loma Linda University, Loma Linda, Calif
| | - Abdulaziz AlHelal
- Faculty, Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mathew T Kattadiyil
- Professor and Director, Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Paul M Richardson
- Certified Dental Technician, Loma Linda University School of Dentistry, Loma Linda, Calif
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161
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Reconstruction of Thoracic Spine Using a Personalized 3D-Printed Vertebral Body in Adolescent with T9 Primary Bone Tumor. World Neurosurg 2017; 105:1032.e13-1032.e17. [DOI: 10.1016/j.wneu.2017.05.133] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/23/2017] [Indexed: 01/09/2023]
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162
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Penno E, Gauld R. Change, Connectivity, and Challenge: Exploring the Role of Health Technology in Shaping Health Care for Aging Populations in Asia Pacific. Health Syst Reform 2017; 3:224-235. [PMID: 31514665 DOI: 10.1080/23288604.2017.1340927] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Aflthough the rapid increase in population aging observed across the globe poses significant challenges to the sustainability of health systems it has been paralleled by an exponential growth in health technologies. This article reviews the literature surrounding health technologies and explores how the future of aging and health care could be shaped by health technologies, with a particular focus on the Asia Pacific region. It shows that the field is wide in scope. The current expansion of information and communication technologies have brought a growing capacity to support health care, while future technology applications, such as robotics and 3D printing, offer a range of potential benefits to elderly populations. However, the uptake and level of development of health technologies varies widely throughout the region. Governments have begun developing frameworks to guide the implementation and monitoring of health technologies. However, a dearth of robust, evaluative studies, combined with the rapidly evolving nature of health technologies, present policy makers with a range of policy and implementation challenges, including issues surrounding infrastructure, funding, and the acceptability of technologies among older users. As health technologies play an increasingly pivotal part in health systems, there is a need to create robust mechanisms for ongoing assessment of health technology development.
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Affiliation(s)
- Erin Penno
- Dean's Office , Otago Business School, University of Otago , Dunedin , New Zealand
| | - Robin Gauld
- Dean's Office , Otago Business School, University of Otago , Dunedin , New Zealand
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163
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Facilitating surgeon understanding of complex anatomy using a three-dimensional printed model. J Surg Res 2017; 216:18-25. [DOI: 10.1016/j.jss.2017.04.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 04/03/2017] [Accepted: 04/11/2017] [Indexed: 12/18/2022]
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164
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165
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A Patient-Matched Entire First Metacarpal Prosthesis in Treatment of Giant Cell Tumor of Bone. Case Rep Orthop 2017; 2017:4101346. [PMID: 28698814 PMCID: PMC5494097 DOI: 10.1155/2017/4101346] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/09/2017] [Accepted: 05/23/2017] [Indexed: 11/25/2022] Open
Abstract
Giant cell tumor of the bones occurring in the first metacarpals frequently requires entire metacarpal resection due to the aggressive nature and high rate of recurrence. Bone reconstruction can be performed with autogenous bone grafts. Here we describe a new technique of reconstruction using a patient-matched three-dimensional printed titanium first metacarpal prosthesis. This prosthesis has a special design for ligament reconstruction in the proximal and distal portions. Good hand function and aesthetic appearance were maintained at a 24-month follow-up visit. This reconstructive technique can avoid donor-site complications and spare the autogenous bone grafts for revision options.
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166
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Jones TW, Seckeler MD. Use of 3D models of vascular rings and slings to improve resident education. CONGENIT HEART DIS 2017; 12:578-582. [PMID: 28608434 DOI: 10.1111/chd.12486] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/05/2017] [Accepted: 05/11/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Three-dimensional (3D) printing is a manufacturing method by which an object is created in an additive process, and can be used with medical imaging data to generate accurate physical reproductions of organs and tissues for a variety of applications. We hypothesized that using 3D printed models of congenital cardiovascular lesions to supplement an educational lecture would improve learners' scores on a board-style examination. DESIGN AND INTERVENTION Patients with normal and abnormal aortic arches were selected and anonymized to generate 3D printed models. A cohort of pediatric and combined pediatric/emergency medicine residents were then randomized to intervention and control groups. Each participant was given a subjective survey and an objective board-style pretest. Each group received the same 20-minutes lecture on vascular rings and slings. During the intervention group's lecture, 3D printed physical models of each lesion were distributed for inspection. After each lecture, both groups completed the same subjective survey and objective board-style test to assess their comfort with and postlecture knowledge of vascular rings. RESULTS There were no differences in the basic demographics of the two groups. After the lectures, both groups' subjective comfort levels increased. Both groups' scores on the objective test improved, but the intervention group scored higher on the posttest. CONCLUSIONS This study demonstrated a measurable gain in knowledge about vascular rings and pulmonary artery slings with the addition of 3D printed models of the defects. Future applications of this teaching modality could extend to other congenital cardiac lesions and different learners.
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Affiliation(s)
- Trahern W Jones
- Department of Pediatrics, University of Arizona College of Medicine, Arizona, USA
| | - Michael D Seckeler
- Department of Pediatrics, University of Arizona College of Medicine, Arizona, USA
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167
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Individualized 3D scanning and printing for non-melanoma skin cancer brachytherapy: a financial study for its integration into clinical workflow. J Contemp Brachytherapy 2017; 9:270-276. [PMID: 28725252 PMCID: PMC5509979 DOI: 10.5114/jcb.2017.68134] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/15/2017] [Indexed: 01/17/2023] Open
Abstract
Purpose Skin cancer is the most common tumor in the population. There are different therapeutic modalities. Brachytherapy is one of the techniques used, in which it is necessary to build customized moulds for some patients. Currently, these moulds are made by hand using rudimentary techniques. We present a new procedure based on 3D printing and the analysis of the clinical workflow. Material and methods Moulds can be made either by hand or by automated 3D printing. For making moulds by hand, a patient’s alginate negative is created and, from that, the gypsum cast and customized moulds are made by hand from the patient’s negative template. The new process is based on 3D printing. The first step is to take a 3D scan of the surface of the patient and then, 3D modelling software is used to obtain an accurate anatomical reconstruction of the treatment area. We present the clinical workflow using 3D scanning and printing technology, comparing its costs with the usual custom handmade mould protocol. Results The time spent for the new process is 6.25 hours, in contrast to the time spent for the conventional process, which is 9.5 hours. We found a 34% reduction in time required to create a mould for brachytherapy treatment. The labor cost of the conventional process is 211.5 vs. 152.5 hours, so the reduction is 59 hours. There is also a 49.5% reduction in the financial costs, mostly due to lack of need of a computed tomography (CT) scan of the gypsum and the mould. 3D scanning and printing offers financial benefits and reduces the clinical workload. Conclusions As the present project demonstrates, through the application of 3D printing technologies, the costs and time spent during the process in the clinical workload in brachytherapy treatment are reduced. Overall, 3D printing is a promising technique for brachytherapy that might be well received in the community.
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168
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Upex P, Jouffroy P, Riouallon G. Application of 3D printing for treating fractures of both columns of the acetabulum: Benefit of pre-contouring plates on the mirrored healthy pelvis. Orthop Traumatol Surg Res 2017; 103:331-334. [PMID: 28163241 DOI: 10.1016/j.otsr.2016.11.021] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 02/02/2023]
Abstract
Acetabular fractures can be challenging to treat, in part because the shape of the fixation plates needs to be adjusted during the surgical procedure. One possibility is to generate a model of the uninjured half of a fractured pelvis with 3D printing, and then pre-contour the fixation plates preoperatively on this model. The purpose of this technical note is to describe how we used 3D printing as an aid to treat acetabular fractures. The quality of the fracture reduction, fracture fixation and time savings were evaluated. Three-dimensional reconstructions of the preoperative CT scan of the pelvis were exported with OsiriX™ software, mirrored with Meshmixer™ software and then printed in polylactic acid (PLA). Two fracture fixation plates were pre-contoured on the printed hemipelvis and then sterilized. No additional intraoperative contouring was needed. Anatomical reduction was obtained with an estimated 30-minute time saving and € 6 consumables cost.
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Affiliation(s)
- P Upex
- Service d'orthopédie, groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris, France
| | - P Jouffroy
- Service d'orthopédie, groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris, France
| | - G Riouallon
- Service d'orthopédie, groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris, France.
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169
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Guibert N, Moreno B, Plat G, Didier A, Mazieres J, Hermant C. Stenting of Complex Malignant Central-Airway Obstruction Guided by a Three-Dimensional Printed Model Of The Airways. Ann Thorac Surg 2017; 103:e357-e359. [DOI: 10.1016/j.athoracsur.2016.09.082] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 09/15/2016] [Accepted: 09/22/2016] [Indexed: 12/20/2022]
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170
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Eley K. Centralised 3D printing in the NHS: a radiological review. Clin Radiol 2017; 72:269-275. [DOI: 10.1016/j.crad.2016.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 12/06/2016] [Accepted: 12/19/2016] [Indexed: 01/17/2023]
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Datta P, Ayan B, Ozbolat IT. Bioprinting for vascular and vascularized tissue biofabrication. Acta Biomater 2017; 51:1-20. [PMID: 28087487 DOI: 10.1016/j.actbio.2017.01.035] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/14/2016] [Accepted: 01/10/2017] [Indexed: 12/14/2022]
Abstract
Bioprinting is a promising technology to fabricate design-specific tissue constructs due to its ability to create complex, heterocellular structures with anatomical precision. Bioprinting enables the deposition of various biologics including growth factors, cells, genes, neo-tissues and extra-cellular matrix-like hydrogels. Benefits of bioprinting have started to make a mark in the fields of tissue engineering, regenerative medicine and pharmaceutics. Specifically, in the field of tissue engineering, the creation of vascularized tissue constructs has remained a principal challenge till date. However, given the myriad advantages over other biofabrication methods, it becomes organic to expect that bioprinting can provide a viable solution for the vascularization problem, and facilitate the clinical translation of tissue engineered constructs. This article provides a comprehensive account of bioprinting of vascular and vascularized tissue constructs. The review is structured as introducing the scope of bioprinting in tissue engineering applications, key vascular anatomical features and then a thorough coverage of 3D bioprinting using extrusion-, droplet- and laser-based bioprinting for fabrication of vascular tissue constructs. The review then provides the reader with the use of bioprinting for obtaining thick vascularized tissues using sacrificial bioink materials. Current challenges are discussed, a comparative evaluation of different bioprinting modalities is presented and future prospects are provided to the reader. STATEMENT OF SIGNIFICANCE Biofabrication of living tissues and organs at the clinically-relevant volumes vitally depends on the integration of vascular network. Despite the great progress in traditional biofabrication approaches, building perfusable hierarchical vascular network is a major challenge. Bioprinting is an emerging technology to fabricate design-specific tissue constructs due to its ability to create complex, heterocellular structures with anatomical precision, which holds a great promise in fabrication of vascular or vascularized tissues for transplantation use. Although a great progress has recently been made on building perfusable tissues and branched vascular network, a comprehensive review on the state-of-the-art in vascular and vascularized tissue bioprinting has not reported so far. This contribution is thus significant because it discusses the use of three major bioprinting modalities in vascular tissue biofabrication for the first time in the literature and compares their strengths and limitations in details. Moreover, the use of scaffold-based and scaffold-free bioprinting is expounded within the domain of vascular tissue fabrication.
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Value of 3D printing for the comprehension of surgical anatomy. Surg Endosc 2017; 31:4102-4110. [DOI: 10.1007/s00464-017-5457-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 02/03/2017] [Indexed: 12/30/2022]
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Ho D, Squelch A, Sun Z. Modelling of aortic aneurysm and aortic dissection through 3D printing. J Med Radiat Sci 2017; 64:10-17. [PMID: 28134482 PMCID: PMC5355365 DOI: 10.1002/jmrs.212] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 11/25/2016] [Accepted: 12/13/2016] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast-enhanced computed tomography (CT) scan into a three-dimensional (3D) printed model. METHODS Contrast-enhanced cardiac CT scans from two patients were post-processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast-enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast-enhanced CT of the 3D printed model. For the model with aortic dissection, measurements of the true and false lumen were taken and compared at two points on the descending aorta. RESULTS Three-dimensional printed models were generated with strong and flexible plastic material with successful replication of anatomical details of aortic structures and pathologies. The mean difference in transverse vessel diameter between the contrast-enhanced CT images before and after 3D printing was 1.0 and 1.2 mm, for the first and second models respectively (standard deviation: 1.0 mm and 0.9 mm). Additionally, for the second model, the mean luminal diameter difference between the 3D printed model and CT images was 0.5 mm. CONCLUSION Encouraging results were achieved with regards to reproducing 3D models depicting aortic aneurysm and aortic dissection. Variances in vessel diameter measurement outside a standard deviation of 1 mm tolerance indicate further work is required into the assessment and accuracy of 3D model reproduction.
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Affiliation(s)
- Daniel Ho
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
| | - Andrew Squelch
- Department of Exploration Geophysics, Western Australian School of Mines, Curtin University, Perth, Western Australia, Australia
- Pawsey Supercomputing Centre, Kensington, Western Australia, Australia
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
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Dawood A, Marti Marti B, Sauret-Jackson V, Darwood A. 3D printing in dentistry. Br Dent J 2017; 219:521-9. [PMID: 26657435 DOI: 10.1038/sj.bdj.2015.914] [Citation(s) in RCA: 427] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2015] [Indexed: 01/01/2023]
Abstract
3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.
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Affiliation(s)
- A Dawood
- Dawood and Tanner Dental Practice, 45 Wimpole St, London, W1G 8SB
| | - B Marti Marti
- Dawood and Tanner Dental Practice, 45 Wimpole St, London, W1G 8SB
| | | | - A Darwood
- University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH
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175
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Fricain JC, De Olivera H, Devillard R, Kalisky J, Remy M, Kériquel V, Le Nihounen D, Grémare A, Guduric V, Plaud A, L'Heureux N, Amédée J, Catros S. [3D bioprinting in regenerative medicine and tissue engineering]. Med Sci (Paris) 2017; 33:52-59. [PMID: 28120756 DOI: 10.1051/medsci/20173301009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Additive manufacturing covers a number of fashionable technologies that attract the interest of researchers in biomaterials and tissue engineering. Additive manufacturing applied to regenerative medicine covers two main areas: 3D printing and biofabrication. If 3D printing has penetrated the world of regenerative medicine, bioassembly and bioimprinting are still in their infancy. The objective of this paper is to make a non-exhaustive review of these different complementary aspects of additive manufacturing in restorative and regenerative medicine or for tissue engineering.
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Affiliation(s)
| | - Hugo De Olivera
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Raphaël Devillard
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Jérome Kalisky
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Murielle Remy
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Virginie Kériquel
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Damien Le Nihounen
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Agathe Grémare
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Vera Guduric
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Alexis Plaud
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Nicolas L'Heureux
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Joëlle Amédée
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
| | - Sylvain Catros
- Inserm U1026, université de Bordeaux, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France
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3D Printing Aids Acetabular Reconstruction in Complex Revision Hip Arthroplasty. Adv Orthop 2017; 2017:8925050. [PMID: 28168060 PMCID: PMC5259605 DOI: 10.1155/2017/8925050] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 11/28/2016] [Indexed: 12/26/2022] Open
Abstract
Revision hip arthroplasty requires comprehensive appreciation of abnormal bony anatomy. Advances in radiology and manufacturing technology have made three-dimensional (3D) representation of osseous anatomy obtainable, which provide visual and tactile feedback. Such life-size 3D models were manufactured from computed tomography scans of three hip joints in two patients. The first patient had undergone multiple previous hip arthroplasties for bilateral hip infections, resulting in right-sided pelvic discontinuity and a severe left-sided posterosuperior acetabular deficiency. The second patient had a first-stage revision for infection and recurrent dislocations. Specific metal reduction protocols were used to reduce artefact. The images were imported into Materialise MIMICS 14.12®. The models were manufactured using selective laser sintering. Accurate templating was performed preoperatively. Acetabular cup, augment, buttress, and cage sizes were trialled using the models, before being adjusted, and resterilised, enhancing the preoperative decision-making process. Screw trajectory simulation was carried out, reducing the risk of neurovascular injury. With 3D printing technology, complex pelvic deformities were better evaluated and treated with improved precision. Life-size models allowed accurate surgical simulation, thus improving anatomical appreciation and preoperative planning. The accuracy and cost-effectiveness of the technique should prove invaluable as a tool to aid clinical practice.
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177
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Parwani R, Curto M, Kao AP, Rowley PJ, Pani M, Tozzi G, Barber AH. Morphological and Mechanical Biomimetic Bone Structures. ACS Biomater Sci Eng 2017; 3:2761-2767. [DOI: 10.1021/acsbiomaterials.6b00652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Parwani
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - M. Curto
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - A. P. Kao
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - P. J. Rowley
- School
of Earth and Environmental Sciences, Burnaby Building, Burnaby Road, University of Portsmouth, Portsmouth PO1 3QL, United Kingdom
| | - M. Pani
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - G. Tozzi
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
| | - A. H. Barber
- School
of Engineering, Anglesea
Building, Anglesea Road, University of Portsmouth, Portsmouth PO1 3DJ, United Kingdom
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Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting. MATERIALS 2017; 10:ma10010035. [PMID: 28772395 PMCID: PMC5344552 DOI: 10.3390/ma10010035] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/16/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022]
Abstract
In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360–HV1 390, an ultimate tensile strength of 1000–1100 MPa, yield strength of 900–950 MPa, and an elongation of 8%–10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.
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179
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Matias M, Zenha H, Costa H. Three-Dimensional Printing: Custom-Made Implants for Craniomaxillofacial Reconstructive Surgery. Craniomaxillofac Trauma Reconstr 2017; 10:89-98. [PMID: 28523082 DOI: 10.1055/s-0036-1594277] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/28/2016] [Indexed: 12/31/2022] Open
Abstract
Craniomaxillofacial reconstructive surgery is a challenging field. First it aims to restore primary functions and second to preserve craniofacial anatomical features like symmetry and harmony. Three-dimensional (3D) printed biomodels have been widely adopted in medical fields by providing tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. Craniomaxillofacial reconstructive surgery was one of the first areas to implement 3D printing technology in their practice. Biomodeling has been used in craniofacial reconstruction of traumatic injuries, congenital disorders, tumor removal, iatrogenic injuries (e.g., decompressive craniectomies), orthognathic surgery, and implantology. 3D printing has proven to improve and enable an optimization of preoperative planning, develop intraoperative guidance tools, reduce operative time, and significantly improve the biofunctional and the aesthetic outcome. This technology has also shown great potential in enriching the teaching of medical students and surgical residents. The aim of this review is to present the current status of 3D printing technology and its practical and innovative applications, specifically in craniomaxillofacial reconstructive surgery, illustrated with two clinical cases where the 3D printing technology was successfully used.
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Affiliation(s)
- Mariana Matias
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Horácio Zenha
- Plastic, Reconstructive and Craniomaxillofacial Surgery Unit, Centro Hospitalar Vila Nova Gaia/Espinho, Gaia, Portugal
| | - Horácio Costa
- Plastic, Reconstructive and Craniomaxillofacial Surgery Unit, Centro Hospitalar Vila Nova Gaia/Espinho, Gaia, Portugal
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180
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Bartellas M, Ryan S, Doucet G, Murphy D, Turner J. Three-Dimensional Printing of a Hemorrhagic Cervical Cancer Model for Postgraduate Gynecological Training. Cureus 2017; 9:e950. [PMID: 28168128 PMCID: PMC5291347 DOI: 10.7759/cureus.950] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. MATERIALS AND METHODS Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials. An emergency medicine simulation case was presented to obstetrics and gynecology residents who were at varying stages of their training. The scenario included history taking and physical examination of a standardized patient. This was a hybrid simulation; a synthetic pelvic task trainer that allowed the placement of the cervical model was connected to the standardized patient. The task trainer was placed under a drape and appeared to extend from the standardized patient's body. At various points in the simulation, the standardized patient controlled the cervical bleeding through a peripheral venous line. Feedback forms were completed, and the models were discussed and evaluated with staff. RESULTS A final cervical model was created and successfully printed. Overall, the models were reported to be similar to a real cervix. The models bled well. Most models were not sutured during the scenarios, but overall, the value of the printed cervical models was reported to be high. DISCUSSION The models were well received, but it was suggested that more colors be integrated into the cervix in order to better emphasize the intended pathology. The model design requires further improvement, such as the addition of a locking mechanism, in order to ensure that the cervix stays inside the task trainer throughout the simulation. Adjustments to the simulated blood product would allow the bleeding to flow more vigorously. Additionally, a different simulation scenario might be more suitable to explore the residents' ability to suture the cervical models, as cervical suturing of a neoplasm is not a common emergency department procedure. CONCLUSION 3D-printed cervical models are an economical and anatomically accurate option for simulation training and other educational purposes.
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Affiliation(s)
| | - Stephen Ryan
- Faculty of Medicine, Memorial University of Newfoundland
| | - Gregory Doucet
- Faculty of Engineering and Applied Science, Memorial University of Newfoundland
| | - Deanna Murphy
- Faculty of Medicine, Memorial University of Newfoundland
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Kappanayil M, Koneti NR, Kannan RR, Kottayil BP, Kumar K. Three-dimensional-printed cardiac prototypes aid surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases: Early experience and proof of concept in a resource-limited environment. Ann Pediatr Cardiol 2017; 10:117-125. [PMID: 28566818 PMCID: PMC5431022 DOI: 10.4103/apc.apc_149_16] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Introduction: Three-dimensional. (3D) printing is an innovative manufacturing process that allows computer-assisted conversion of 3D imaging data into physical “printouts” Healthcare applications are currently in evolution. Objective: The objective of this study was to explore the feasibility and impact of using patient-specific 3D-printed cardiac prototypes derived from high-resolution medical imaging data (cardiac magnetic resonance imaging/computed tomography [MRI/CT]) on surgical decision-making and preoperative planning in selected cases of complex congenital heart diseases (CHDs). Materials and Methods: Five patients with complex CHD with previously unresolved management decisions were chosen. These included two patients with complex double-outlet right ventricle, two patients with criss-cross atrioventricular connections, and one patient with congenitally corrected transposition of great arteries with pulmonary atresia. Cardiac MRI was done for all patients, cardiac CT for one; specific surgical challenges were identified. Volumetric data were used to generate patient-specific 3D models. All cases were reviewed along with their 3D models, and the impact on surgical decision-making and preoperative planning was assessed. Results: Accurate life-sized 3D cardiac prototypes were successfully created for all patients. The models enabled radically improved 3D understanding of anatomy, identification of specific technical challenges, and precise surgical planning. Augmentation of existing clinical and imaging data by 3D prototypes allowed successful execution of complex surgeries for all five patients, in accordance with the preoperative planning. Conclusions: 3D-printed cardiac prototypes can radically assist decision-making, planning, and safe execution of complex congenital heart surgery by improving understanding of 3D anatomy and allowing anticipation of technical challenges.
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Affiliation(s)
- Mahesh Kappanayil
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | | | - Rajesh R Kannan
- Department of Radiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Brijesh P Kottayil
- Department of Cardiothoracic Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Krishna Kumar
- Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Mashari A, Montealegre-Gallegos M, Knio Z, Yeh L, Jeganathan J, Matyal R, Khabbaz KR, Mahmood F. Making three-dimensional echocardiography more tangible: a workflow for three-dimensional printing with echocardiographic data. Echo Res Pract 2016; 3:R57-R64. [PMID: 27974356 PMCID: PMC5302065 DOI: 10.1530/erp-16-0036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 12/14/2016] [Indexed: 11/08/2022] Open
Abstract
Three-dimensional (3D) printing is a rapidly evolving technology with several potential applications in the diagnosis and management of cardiac disease. Recently, 3D printing (i.e. rapid prototyping) derived from 3D transesophageal echocardiography (TEE) has become possible. Due to the multiple steps involved and the specific equipment required for each step, it might be difficult to start implementing echocardiography-derived 3D printing in a clinical setting. In this review, we provide an overview of this process, including its logistics and organization of tools and materials, 3D TEE image acquisition strategies, data export, format conversion, segmentation, and printing. Generation of patient-specific models of cardiac anatomy from echocardiographic data is a feasible, practical application of 3D printing technology.
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Affiliation(s)
- Azad Mashari
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.,Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Mario Montealegre-Gallegos
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Ziyad Knio
- Division of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Lu Yeh
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jelliffe Jeganathan
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Kamal R Khabbaz
- Division of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Debellemanière G, Flores M, Montard M, Delbosc B, Saleh M. Three-dimensional Printing of Optical Lenses and Ophthalmic Surgery: Challenges and Perspectives. J Refract Surg 2016; 32:201-4. [PMID: 27027628 DOI: 10.3928/1081597x-20160121-05] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 01/06/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether the historical Ridley lens could be reproduced with current three-dimensional lens printing technology. METHODS A reproduction of the Ridley lens was printed using the Printoptical Technology (LUXeXceL Group BV, Kruiningen, Netherlands). Photographs and electron microscopy images were taken. Dimensions, weight, anterior and posterior surface radius of curvature, optical transmission, back optical power, and surface analysis using interferometry were obtained. RESULTS The printed lens was 8.10 ± 0.01 mm in diameter, 2.50 ± 0.01 mm thick, and weighed 117 mg. The anterior radius of curvature was 14.63 ± 0.69 mm and the posterior radius of curvature was 10.88 ± 0.22 mm. The back focal length in air was 14.1 ± 0.4 mm. An average 75% transmission in the visible spectrum (400 to 700 nm) was achieved. Surface analysis showed significant surface roughness. CONCLUSIONS The printed reproduction of the Ridley lens was far from current clinical standards, but had the properties of a biconvex lens.
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184
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Hoang D, Perrault D, Stevanovic M, Ghiassi A. Surgical applications of three-dimensional printing: a review of the current literature & how to get started. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:456. [PMID: 28090512 DOI: 10.21037/atm.2016.12.18] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Three dimensional (3D) printing involves a number of additive manufacturing techniques that are used to build structures from the ground up. This technology has been adapted to a wide range of surgical applications at an impressive rate. It has been used to print patient-specific anatomic models, implants, prosthetics, external fixators, splints, surgical instrumentation, and surgical cutting guides. The profound utility of this technology in surgery explains the exponential growth. It is important to learn how 3D printing has been used in surgery and how to potentially apply this technology. PubMed was searched for studies that addressed the clinical application of 3D printing in all surgical fields, yielding 442 results. Data was manually extracted from the 168 included studies. We found an exponential increase in studies addressing surgical applications for 3D printing since 2011, with the largest growth in craniofacial, oromaxillofacial, and cardiothoracic specialties. The pertinent considerations for getting started with 3D printing were identified and are discussed, including, software, printing techniques, printing materials, sterilization of printing materials, and cost and time requirements. Also, the diverse and increasing applications of 3D printing were recorded and are discussed. There is large array of potential applications for 3D printing. Decreasing cost and increasing ease of use are making this technology more available. Incorporating 3D printing into a surgical practice can be a rewarding process that yields impressive results.
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Affiliation(s)
- Don Hoang
- USC Plastic and Reconstructive Surgery, Los Angeles, CA, USA
| | - David Perrault
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Milan Stevanovic
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Alidad Ghiassi
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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185
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Crafts TD, Ellsperman SE, Wannemuehler TJ, Bellicchi TD, Shipchandler TZ, Mantravadi AV. Three-Dimensional Printing and Its Applications in Otorhinolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2016; 156:999-1010. [PMID: 28421875 DOI: 10.1177/0194599816678372] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology-head and neck surgery, discusses future innovations, and explores the financial impact of these advances. Data Sources Articles were identified from PubMed and Ovid MEDLINE. Review Methods PubMed and Ovid Medline were queried for English articles published between 2011 and 2016, including a few articles prior to this time as relevant examples. Search terms included 3-dimensional printing, 3 D printing, otolaryngology, additive manufacturing, craniofacial, reconstruction, temporal bone, airway, sinus, cost, and anatomic models. Conclusions Three-dimensional printing has been used in recent years in otolaryngology for preoperative planning, education, prostheses, grafting, and reconstruction. Emerging technologies include the printing of tissue scaffolds for the auricle and nose, more realistic training models, and personalized implantable medical devices. Implications for Practice After the up-front costs of 3D printing are accounted for, its utilization in surgical models, patient-specific implants, and custom instruments can reduce operating room time and thus decrease costs. Educational and training models provide an opportunity to better visualize anomalies, practice surgical technique, predict problems that might arise, and improve quality by reducing mistakes.
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Affiliation(s)
- Trevor D Crafts
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan E Ellsperman
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Todd J Wannemuehler
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Travis D Bellicchi
- 2 Department of Prosthodontics and Facial Prosthetics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Taha Z Shipchandler
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Avinash V Mantravadi
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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186
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Tack P, Victor J, Gemmel P, Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016; 15:115. [PMID: 27769304 PMCID: PMC5073919 DOI: 10.1186/s12938-016-0236-4] [Citation(s) in RCA: 535] [Impact Index Per Article: 66.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/09/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. METHODS Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. RESULTS 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. CONCLUSION 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.
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Affiliation(s)
- Philip Tack
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Jan Victor
- Ghent University Hospital, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Paul Gemmel
- Departement of Economics & Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium
| | - Lieven Annemans
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
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187
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Patel S, Aldowaisan A, Dawood A. A novel method for soft tissue retraction during periapical surgery using 3D technology: a case report. Int Endod J 2016; 50:813-822. [DOI: 10.1111/iej.12701] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. Patel
- Endodontic Postgraduate Unit; King's College London Dental Institute London; London UK
- Private Practice; London UK
| | - A. Aldowaisan
- Endodontic Postgraduate Unit; King's College London Dental Institute London; London UK
| | - A. Dawood
- Private Practice; London UK
- Department of Maxillofacial Surgery; University College London; London UK
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188
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Mashari A, Knio Z, Jeganathan J, Montealegre-Gallegos M, Yeh L, Amador Y, Matyal R, Saraf R, Khabbaz K, Mahmood F. Hemodynamic Testing of Patient-Specific Mitral Valves Using a Pulse Duplicator: A Clinical Application of Three-Dimensional Printing. J Cardiothorac Vasc Anesth 2016; 30:1278-85. [DOI: 10.1053/j.jvca.2016.01.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Indexed: 11/11/2022]
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189
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Lin H, Shi L, Wang D. A rapid and intelligent designing technique for patient-specific and 3D-printed orthopedic cast. 3D Print Med 2016; 2:4. [PMID: 30050976 PMCID: PMC6036601 DOI: 10.1186/s41205-016-0007-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/26/2016] [Indexed: 11/30/2022] Open
Abstract
Background Two point four out of 100 people suffer from one or more fractures in the course of average lifetimes. Traditional casts are featured as cumbersome structures that result in high risk of cutaneous complications. Clinical demands for developing a hygienic cast have gotten more and more attention. 3D printing technique is rapidly growing in the fabrication of custom-made rehabilitation tools. The objective of this study is to develop a rapid and intelligent modeling technique for developing patient-specific and hygienic orthopedic casts produced by 3D printing technologies. Results A cast model is firstly created from a patient’s image to develop patient-specific features. A unique technique to creating geometric reference has been developed to perform detail modeling cast. The cast is modeled as funnel-shaped geometry to create smooth edges to prevent bruises from mild movements of injured limbs. Surface pattern includes ventilation structure and opening gap for hygienic purpose and wearing comfort. The cast can be adjusted to accommodate swelling from injured limbs during treatment. Finite element analysis (FEA) is employed to validate the mechanical performance of the cast structure and identify potential risk of the structural collapse due to concentrated stresses. The cast is fabricated by 3D printing technology using approval material. Conclusions The 3D-printed prototype is featured as super lightweight with 1/10 of weight in compared with traditional alternatives. Medical technicians with few experiences can design cast within 20 min using the proposed technique. The image-based design minimizes the distortion during healing process because of the best fit geometry. The highly ventilated structure develops hygienic benefits on reducing the risk of cutaneous complications and potentially improve treatment efficacy and increase patients’ satisfactions.
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Affiliation(s)
- Hui Lin
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT Hong Kong
| | - Lin Shi
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, NT Hong Kong.,Chow Yuk Ho Center of Innovative Technology for Medicine, The Chinese University of Hong Kong, Shatin, NT Hong Kong
| | - Defeng Wang
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, NT Hong Kong.,Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
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190
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Provaggi E, Leong JJH, Kalaskar DM. Applications of 3D printing in the management of severe spinal conditions. Proc Inst Mech Eng H 2016; 231:471-486. [PMID: 27658427 DOI: 10.1177/0954411916667761] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The latest and fastest-growing innovation in the medical field has been the advent of three-dimensional printing technologies, which have recently seen applications in the production of low-cost, patient-specific medical implants. While a wide range of three-dimensional printing systems has been explored in manufacturing anatomical models and devices for the medical setting, their applications are cutting-edge in the field of spinal surgery. This review aims to provide a comprehensive overview and classification of the current applications of three-dimensional printing technologies in spine care. Although three-dimensional printing technology has been widely used for the construction of patient-specific anatomical models of the spine and intraoperative guide templates to provide personalized surgical planning and increase pedicle screw placement accuracy, only few studies have been focused on the manufacturing of spinal implants. Therefore, three-dimensional printed custom-designed intervertebral fusion devices, artificial vertebral bodies and disc substitutes for total disc replacement, along with tissue engineering strategies focused on scaffold constructs for bone and cartilage regeneration, represent a set of promising applications towards the trend of individualized patient care.
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Affiliation(s)
- Elena Provaggi
- 1 Centre for Nanotechnology & Tissue Engineering, Division of Surgery and Interventional Science, UCL Medical School, University College London, London, UK
| | - Julian J H Leong
- 1 Centre for Nanotechnology & Tissue Engineering, Division of Surgery and Interventional Science, UCL Medical School, University College London, London, UK.,2 Royal National Orthopaedic Hospital, Stanmore, UK
| | - Deepak M Kalaskar
- 1 Centre for Nanotechnology & Tissue Engineering, Division of Surgery and Interventional Science, UCL Medical School, University College London, London, UK
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191
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The production of digital and printed resources from multiple modalities using visualization and three-dimensional printing techniques. Int J Comput Assist Radiol Surg 2016; 12:13-23. [PMID: 27480284 DOI: 10.1007/s11548-016-1461-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/19/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE Virtual digital resources and printed models have become indispensable tools for medical training and surgical planning. Nevertheless, printed models of soft tissue organs are still challenging to reproduce. This study adopts open source packages and a low-cost desktop 3D printer to convert multiple modalities of medical images to digital resources (volume rendering images and digital models) and lifelike printed models, which are useful to enhance our understanding of the geometric structure and complex spatial nature of anatomical organs. MATERIALS AND METHODS Neuroimaging technologies such as CT, CTA, MRI, and TOF-MRA collect serial medical images. The procedures for producing digital resources can be divided into volume rendering and medical image reconstruction. To verify the accuracy of reconstruction, this study presents qualitative and quantitative assessments. Subsequently, digital models are archived as stereolithography format files and imported to the bundled software of the 3D printer. The printed models are produced using polylactide filament materials. RESULTS We have successfully converted multiple modalities of medical images to digital resources and printed models for both hard organs (cranial base and tooth) and soft tissue organs (brain, blood vessels of the brain, the heart chambers and vessel lumen, and pituitary tumor). Multiple digital resources and printed models were provided to illustrate the anatomical relationship between organs and complicated surrounding structures. Three-dimensional printing (3DP) is a powerful tool to produce lifelike and tangible models. CONCLUSIONS We present an available and cost-effective method for producing both digital resources and printed models. The choice of modality in medical images and the processing approach is important when reproducing soft tissue organs models. The accuracy of the printed model is determined by the quality of organ models and 3DP. With the ongoing improvement of printing techniques and the variety of materials available, 3DP will become an indispensable tool in medical training and surgical planning.
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Clinical implementation of 3D printing in the construction of patient specific bolus for electron beam radiotherapy for non-melanoma skin cancer. Radiother Oncol 2016; 121:148-153. [PMID: 27475278 DOI: 10.1016/j.radonc.2016.07.011] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 07/08/2016] [Accepted: 07/18/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND PURPOSE Creating an individualized tissue equivalent material build-up (i.e. bolus) for electron beam radiation therapy is complex and highly labour-intensive. We implemented a new clinical workflow in which 3D printing technology is used to create the bolus. MATERIAL AND METHODS A patient-specific bolus is designed in the treatment planning system (TPS) and a shell around it is created in the TPS. The shell is printed and subsequently filled with silicone rubber to make the bolus. Before clinical implementation we performed a planning study with 11 patients to evaluate the difference in tumour coverage between the designed 3D-print bolus and the clinically delivered plan with manually created bolus. For the first 15 clinical patients a second CT scan with the 3D-print bolus was performed to verify the geometrical accuracy. RESULTS The planning study showed that the V85% of the CTV was on average 97% (3D-print) vs 88% (conventional). Geometric comparison of the 3D-print bolus to the originally contoured bolus showed a high similarity (DSC=0.89). The dose distributions on the second CT scan with the 3D print bolus in position showed only small differences in comparison to the original planning CT scan. CONCLUSIONS The implemented workflow is feasible, patient friendly, safe, and results in high quality dose distributions. This new technique increases time efficiency.
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194
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Wang L, Cao T, Li X, Huang L. Three-dimensional printing titanium ribs for complex reconstruction after extensive posterolateral chest wall resection in lung cancer. J Thorac Cardiovasc Surg 2016; 152:e5-7. [PMID: 27045041 DOI: 10.1016/j.jtcvs.2016.02.064] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/14/2016] [Accepted: 02/21/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Lei Wang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Tiesheng Cao
- Department of Diagnostic Ultrasound, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Lijun Huang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China.
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Martelli N, Serrano C, van den Brink H, Pineau J, Prognon P, Borget I, El Batti S. Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review. Surgery 2016; 159:1485-1500. [PMID: 26832986 DOI: 10.1016/j.surg.2015.12.017] [Citation(s) in RCA: 328] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/02/2015] [Accepted: 12/11/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is becoming increasingly important in medicine and especially in surgery. The aim of the present work was to identify the advantages and disadvantages of 3D printing applied in surgery. METHODS We conducted a systematic review of articles on 3D printing applications in surgery published between 2005 and 2015 and identified using a PubMed and EMBASE search. Studies dealing with bioprinting, dentistry, and limb prosthesis or those not conducted in a hospital setting were excluded. RESULTS A total of 158 studies met the inclusion criteria. Three-dimensional printing was used to produce anatomic models (n = 113, 71.5%), surgical guides and templates (n = 40, 25.3%), implants (n = 15, 9.5%) and molds (n = 10, 6.3%), and primarily in maxillofacial (n = 79, 50.0%) and orthopedic (n = 39, 24.7%) operations. The main advantages reported were the possibilities for preoperative planning (n = 77, 48.7%), the accuracy of the process used (n = 53, 33.5%), and the time saved in the operating room (n = 52, 32.9%); 34 studies (21.5%) stressed that the accuracy was not satisfactory. The time needed to prepare the object (n = 31, 19.6%) and the additional costs (n = 30, 19.0%) were also seen as important limitations for routine use of 3D printing. CONCLUSION The additional cost and the time needed to produce devices by current 3D technology still limit its widespread use in hospitals. The development of guidelines to improve the reporting of experience with 3D printing in surgery is highly desirable.
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Affiliation(s)
- Nicolas Martelli
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France; University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France.
| | - Carole Serrano
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | | | - Judith Pineau
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | - Patrice Prognon
- Pharmacy Department, Georges Pompidou European Hospital, Paris, France
| | - Isabelle Borget
- University Paris-Sud, GRADES, Faculty of Pharmacy, Châtenay-Malabry, France; Department of Health Economics, Gustave Roussy Institute, Villejuif, France
| | - Salma El Batti
- Department of Cardiac and Vascular Surgery, Georges Pompidou European Hospital, Paris, France; URDIA - Unité de Recherche en Développement, Imagerie et Anatomie - EA 4465, Université Paris Descartes, Paris, France
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de Azevedo Gonçalves Mota RC, da Silva EO, de Lima FF, de Menezes LR, Thiele ACS. 3D Printed Scaffolds as a New Perspective for Bone Tissue Regeneration: Literature Review. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/msa.2016.78039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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