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Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2023; 81:E95-E119. [PMID: 37833031 DOI: 10.1016/j.joms.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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2
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Reconstructive Surgery. J Oral Maxillofac Surg 2023; 81:E263-E299. [PMID: 37833026 DOI: 10.1016/j.joms.2023.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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3
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Zhang Z, Zhao Z, Han W, Kim BS, Yan Y, Chen X, Lin L, Shen W, Chai G. Accuracy and safety of robotic navigation-assisted distraction osteogenesis for hemifacial microsomia. Front Pediatr 2023; 11:1158078. [PMID: 37228439 PMCID: PMC10203510 DOI: 10.3389/fped.2023.1158078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/19/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction This study aimed to verify the accuracy and safety of distraction osteogenesis for hemifacial microsomia assisted by a robotic navigation system based on artificial intelligence. Methods The small sample early-phase single-arm clinical study, available at http://www.chictr.org.cn/index.aspx, included children aged three years and older diagnosed with unilateral hemifacial microsomia (Pruzansky-Kaban type II). A preoperative design was performed, and an intelligent robotic navigation system assisted in the intraoperative osteotomy. The primary outcome was the accuracy of distraction osteogenesis, including the positional and angular errors of the osteotomy plane and the distractor, by comparing the preoperative design plan with the actual images one week postoperatively. Perioperative indicators, pain scales, satisfaction scales, and complications at one week were also analyzed. Results Four cases (mean 6.5 years, 3 type IIa and 1 type IIb deformity) were included. According to the craniofacial images one week after surgery, the osteotomy plane positional error was 1.77 ± 0.12 mm, and the angular error was 8.94 ± 4.13°. The positional error of the distractor was 3.67 ± 0.23 mm, and the angular error was 8.13 ± 2.73°. Postoperative patient satisfaction was high, and no adverse events occurred. Discussion The robotic navigation-assisted distraction osteogenesis in hemifacial microsomia is safe, and the operational precision meets clinical requirements. Its clinical application potential is to be further explored and validated.
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Affiliation(s)
- Ziwei Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhijie Zhao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wenqing Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Byeong Seop Kim
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingjie Yan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaojun Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Li Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Weimin Shen
- Department of Burn and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Gang Chai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Patient-specific Composite Anatomic Models: Improving the Foundation for Craniosynostosis Repair. J Craniofac Surg 2023; 34:1078-1081. [PMID: 36727996 DOI: 10.1097/scs.0000000000009182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023] Open
Abstract
Preoperative surgical planning incorporating computer-aided design and manufacturing is increasingly being utilized today within the fields of craniomaxillofacial, orthopedic, and neurosurgery. Application of these techniques for craniosynostosis reconstruction can include patient-specific anatomic reference models, "normal" reference models or patient-specific cutting/marking guides based on the presurgical plan. The major challenge remains the lack of tangible means to transfer the preoperative plan to the operating table. We propose a simple solution to utilize a digitally designed, 3D-printed "composite model" as a structural template for cranial vault reconstruction. The composite model is generated by merging the abnormal patient cranial anatomy with the "dural surface topography" of an age-matched, sex-matched, and ethnicity-matched normative skull model. We illustrate the applicability of this approach in 2 divergent cases: 22-month-old African American male with sagittal synostosis and 5-month-old White male with metopic synostosis. The aim of this technical report is to describe our application of this computer-aided design and modeling workflow for the creation of practical 3D-printed skulls that can serve as intraoperative frameworks for the correction of craniosynostosis. With success in our first 2 cases, we believe this approach of a composite model is another step in reducing our reliance on subjective guesswork, and the fundamental aspect of the workflow has a wider application within the field of craniofacial surgery for both clinical patient care and education.
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Advances and Innovations in Ablative Head and Neck Oncologic Surgery Using Mixed Reality Technologies in Personalized Medicine. J Clin Med 2022; 11:jcm11164767. [PMID: 36013006 PMCID: PMC9410374 DOI: 10.3390/jcm11164767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
The benefit of computer-assisted planning in head and neck ablative and reconstructive surgery has been extensively documented over the last decade. This approach has been proven to offer a more secure surgical procedure. In the treatment of cancer of the head and neck, computer-assisted surgery can be used to visualize and estimate the location and extent of the tumor mass. Nowadays, some software tools even allow the visualization of the structures of interest in a mixed reality environment. However, the precise integration of mixed reality systems into a daily clinical routine is still a challenge. To date, this technology is not yet fully integrated into clinical settings such as the tumor board, surgical planning for head and neck tumors, or medical and surgical education. As a consequence, the handling of these systems is still of an experimental nature, and decision-making based on the presented data is not yet widely used. The aim of this paper is to present a novel, user-friendly 3D planning and mixed reality software and its potential application for ablative and reconstructive head and neck surgery.
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6
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Application of trans-sutural distraction osteogenesis based on an optical surgical navigation system to correct midfacial dysplasia. Sci Rep 2022; 12:13181. [PMID: 35915079 PMCID: PMC9343408 DOI: 10.1038/s41598-022-16013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/04/2022] [Indexed: 11/08/2022] Open
Abstract
Midfacial hypoplasia is a common maxillofacial deformity in patients with cleft lip and palate, which requires surgical treatment. However, trans-sutural distraction osteogenesis (TSDO) remains some disadvantages, including difficulty in accurate location of surgical path, prolonged operation time, and excess surgical bleeding. This study aimed to evaluate the application of an optical surgical navigation system (OSNS) developed for TSDO. Six consecutive patients with midfacial hypoplasia who required TSDO were included in the study. Preoperatively, a head computed tomography was performed, and the data were imported into Mimics software (version: 20.0.0.691, Materialise Inc, Belgium) to design a three-dimensional simulation of the surgical approach. TSDO was performed with the use of OSNS. The accuracy and results of the procedure were initially evaluated by comparing the preoperative and postoperative periods. The patients included five boys and one girl, with an average age of 10 years; five with postoperative cleft lip and palate, and one without combined cleft lip and palate. The surgical procedure was successful, with a postoperative follow-up of 4–5 months. All patients demonstrated good treatment results without complications. In conclusioin, OSNS-assisted TSDO can noninvasively correct midfacial dysplasia, improve surgical precision, reduce bleeding and obtain better clinical results. OSNS can guide the TSDO safely and effectively.
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Computer Aided Orthognathic Surgery: A General Method for Designing and Manufacturing Personalized Cutting/Repositioning Templates. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Orthognathic surgery allows broad-spectrum deformity correction involving both aesthetic and functional aspects on the TMJ (temporo-mandibular joint) and on the facial skull district. The combination of Reverse Engineering (RE), Virtual Surgery Planning (VSP), Computer Aided Design (CAD), Additive Manufacturing (AM), and 3D visualization allows surgeons to plan, virtually, manipulations and the translation of the human parts in the operating room. This work’s aim was to define a methodology, in the form of a workflow, for surgery planning and for designing and manufacturing templates for orthognathic surgery. Along the workflow, the error chain was checked and the maximum error in virtual planning was evaluated. The three-dimensional reconstruction of the mandibular shape and bone fragment movements after segmentation allow complete planning of the surgery and, following the proposed method, the introduction of both the innovative evaluation of the transversal intercondylar distance variation after mandibular arch advancement/set and the possibility of use of standard plates to plan and realize a customized surgery. The procedure was adopted in one clinical case on a patient affected by a class III malocclusion with an associated open bite and right deviation of the mandible with expected good results. Compared with the methods from most recent literature, the presented method introduces two elements of novelty and improves surgery results by optimizing costs and operating time. A new era of collaboration among surgeons and engineer has begun and is now bringing several benefits in personalized surgery.
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8
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Zhang WB, Soh HY, Yu Y, Guo CB, Yu GY, Peng X. Improved procedure for Brown's Class III maxillary reconstruction with composite deep circumflex iliac artery flap using computer-assisted technique. Comput Assist Surg (Abingdon) 2021; 26:9-14. [PMID: 33503386 DOI: 10.1080/24699322.2021.1876168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Reconstruction of Brown's Class III maxillary defect can be challenging due to the complex geometry of maxilla. We aimed to introduce an improved method for maxillary reconstruction with a composite deep circumflex iliac artery (DCIA) flap aided by virtual surgical planning and intraoperative navigation. A 27-year-old woman diagnosed with left maxillary fibromyxoma was admitted to our institution in December 2018. Pre-operative facial and iliac computed tomography data were obtained for virtual surgical planning. Personalized cutting template, tooth-supported surgical guide, and rapid prototype model with reconstructed orbital floor were printed for pre-operative preparation. Surgery was completely guided by the intraoperative navigation system. The root mean square estimate of the reconstructed area was 3.68 mm. The average errors measured on the lateral and medial DCIA segments were 0.61 and 0.85 mm, respectively. Application of virtual surgical planning and intraoperative navigation could potentially enhance the reconstruction outcomes.
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Affiliation(s)
- Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hui Yuh Soh
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Yao Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Chuan-Bin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
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9
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Virtual Surgical Planning and the “In-House” Rapid Prototyping Technique in Maxillofacial Surgery: The Current Situation and Future Perspectives. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11031009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The first applications of computer-aided design/computer-aided manufacturing (CAD/CAM) in maxillofacial surgery date back to the 1980s. Since then, virtual surgical planning (VSP) has undergone significant development and is now routinely used in daily practice. Indeed, in an extraordinary period, such as that of the current COVID-19 pandemic, it offers a valuable tool in relation to the protection of healthcare workers. In this paper we provide a comprehensive summary of the clinical applications reported in the literature and review our experience using an in-house rapid prototyping technique in the field of maxillofacial surgery. methods: Our research was focused on reconstructive surgery, traumatology (especially in relation to orbital floor and zygomatic arch fractures), and COVID-19 masks. The first step was a radiographic study. Next, computed tomography (CT) scans were segmented in order to obtain a three-dimensional (3D) model. Finally, in the editing phase, through the use of specific software, a customized device for each patient was designed and printed. results: Four reconstructive procedures were performed with a perfect fitting of the surgical device produced by means of VSP. In nine orbital floor fracture cases a good overlapping of the mesh on the orbital floor was obtained. In sixteen zygomatic arch cases the post-operative CT scan showed an excellent fitting of the device and a correct fracture reduction. Regarding the COVID-19 period, six masks and shields produced proved to provide effective protection. conclusions: The timescale and costs required for the production of our “home-made” virtual design are low, which makes this method applicable to a large number of cases, for both ordinary and extraordinary activities.
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10
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Zeiderman MR, Pu LLQ. Contemporary reconstruction after complex facial trauma. BURNS & TRAUMA 2020; 8:tkaa003. [PMID: 32341916 PMCID: PMC7175762 DOI: 10.1093/burnst/tkaa003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/07/2020] [Indexed: 11/12/2022]
Abstract
Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.
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Affiliation(s)
- Matthew R Zeiderman
- Division of Plastic Surgery, Department of Surgery, University of California, Davis, 2335 Stockton Boulevard, Room 6008 Sacramento, CA 95817, USA
| | - Lee L Q Pu
- Division of Plastic Surgery, Department of Surgery, University of California, Davis, 2335 Stockton Boulevard, Room 6008 Sacramento, CA 95817, USA
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11
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Yu N, Nguyen T, Cho YD, Kavanagh NM, Ghassib I, Giannobile WV. Personalized scaffolding technologies for alveolar bone regenerative medicine. Orthod Craniofac Res 2019; 22 Suppl 1:69-75. [PMID: 31074155 DOI: 10.1111/ocr.12275] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2018] [Indexed: 01/09/2023]
Abstract
The reconstruction of alveolar bone defects associated with teeth and dental implants remains a clinical challenge in the treatment of patients affected by disease or injury of the alveolus. The aim of this review was to provide an overview on advances made in the use of personalized scaffolding technologies coupled with biologics, cells and gene therapies that offer future clinical applications for the treatment of patients requiring periodontal and alveolar bone regeneration. Over the past decade, advancements in three-dimensional (3D) imaging acquisition technologies such as cone-beam computed tomography (CBCT) and precise scaffold fabrication methods such as 3D bioprinting have resulted in personalized scaffolding constructs based on individual patient-specific anatomical data. Furthermore, 'fiber-guiding' scaffold designs utilize topographical cues to guide ligamentous fibers to form in orientation towards the root surface to improve tooth support. Therefore, a topic-focused literature search was conducted looking into fiber-guiding and image-based scaffolds and their associated clinical applications.
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Affiliation(s)
- Ning Yu
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Trang Nguyen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Young D Cho
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan.,Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Nolan M Kavanagh
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - Iya Ghassib
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan
| | - William V Giannobile
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, College of Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan.,Biointerfaces Institute, University of Michigan North Campus Research Complex, Ann Arbor, Michigan
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12
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Olsson AB, Dillon J, Kolokythas A, Schlott BJ. Reconstructive Surgery. J Oral Maxillofac Surg 2019; 75:e264-e301. [PMID: 28728733 DOI: 10.1016/j.joms.2017.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Abstract
Mandible reconstruction has evolved over the years with advances in surgical options and three-dimensional technology. Although nonvascularized bone grafting is still used, vascularized flaps show advantages with immediate reconstruction, the possibility of immediate dental implants, and the ability to reconstruct composite defects of both soft tissue and bone. This article discusses current vascularized techniques for mandible reconstruction. While each reconstructive method has advantages and disadvantages, a defect-based reconstruction focused on full rehabilitation allows surgeons to plan and counsel the patient for the best available reconstruction.
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Affiliation(s)
- Roderick Y Kim
- Division of Maxillofacial Oncologic and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, Fort Worth, Texas
| | - Mofiyinfolu Sokoya
- Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Yadranko Ducic
- Department of Facial Plastic and Reconstructive Surgery, Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Fayette Williams
- Division of Maxillofacial Oncologic and Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, John Peter Smith Health Network, Fort Worth, Texas
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Chen G, Han Q, Liu H, Zhang H, Jiang Z, Feng N, Chang F. Accurate Osteotomy for the Treatment of a Rare Case of Postaxial Polydactyly of the Foot That Originated From a Deformed Calcaneus Using a 3D-Printed Guiding Plate. J Foot Ankle Surg 2019; 58:171-175. [PMID: 30448182 DOI: 10.1053/j.jfas.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Indexed: 02/03/2023]
Abstract
Polydactyly is a common congenital deformity of the foot that can be categorized as preaxial, central, or postaxial. Current treatments involve resecting the supernumerary toe(s) and repairing the normal toe(s) and soft tissue. Here, we present the first published report describing a very rare case of polydactyly of the foot, in which the supernumerary toe originated from a deformed calcaneus, which formed an abnormal bony bump. Preoperatively, 3-dimensional (3D) computed tomography reconstruction images revealed the morphology of the deformed toe and calcaneus, and gait analysis showed an abnormal weightbearing zone in the left foot. The 3D printing technology and a specially designed 3D-printed guiding plate were used for osteotomy. Postoperatively, x-ray showed that the calcaneus had a normal shape and surface, whereas gait analysis showed that the left foot was uniformly loaded and the area of pain was eliminated. Our findings should raise awareness among clinicians that a 3D-printed guiding plate is useful in the treatment of such an unusual deformity.
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Affiliation(s)
- Gaoyang Chen
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Qing Han
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - He Liu
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Hanyang Zhang
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Zhende Jiang
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Naibo Feng
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Fei Chang
- Chief, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China.
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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: 140] [Impact Index Per Article: 23.3] [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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16
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Lin HH, Lonic D, Lo LJ. 3D printing in orthognathic surgery − A literature review. J Formos Med Assoc 2018; 117:547-558. [DOI: 10.1016/j.jfma.2018.01.008] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/24/2017] [Accepted: 01/03/2018] [Indexed: 12/15/2022] Open
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17
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Tran NH, Tantidhnazet S, Raocharernporn S, Kiattavornchareon S, Pairuchvej V, Wongsirichat N. Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome. J Clin Med Res 2018; 10:429-436. [PMID: 29581806 PMCID: PMC5862091 DOI: 10.14740/jocmr3372w] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 02/20/2018] [Indexed: 11/11/2022] Open
Abstract
Background The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS. Methods Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method. Results The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria. Conclusion In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS.
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Affiliation(s)
- Ngoc Hieu Tran
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand
| | - Syrina Tantidhnazet
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand; Natthamet Wongsirichat, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand.
| | - Somchart Raocharernporn
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand
| | - Sirichai Kiattavornchareon
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand
| | - Verasak Pairuchvej
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand
| | - Natthamet Wongsirichat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand
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Virtual Surgical Planning: The Pearls and Pitfalls. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1443. [PMID: 29464146 PMCID: PMC5811276 DOI: 10.1097/gox.0000000000001443] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/20/2017] [Indexed: 11/26/2022]
Abstract
Objective Over the past few years, virtual surgical planning (VSP) has evolved into a useful tool for the craniofacial surgeon. Virtual planning and computer-aided design and manufacturing (CAD/CAM) may assist in orthognathic, cranio-orbital, traumatic, and microsurgery of the craniofacial skeleton. Despite its increasing popularity, little emphasis has been placed on the learning curve. Methods A retrospective analysis of consecutive virtual surgeries was done from July 2012 to October 2016 at the University of Montreal Teaching Hospitals. Orthognathic surgeries and free vascularized bone flap surgeries were included in the analysis. Results Fifty-four virtual surgeries were done in the time period analyzed. Forty-six orthognathic surgeries and 8 free bone transfers were done. An analysis of errors was done. Eighty-five percentage of the orthognathic virtual plans were adhered to completely, 4% of the plans were abandoned, and 11% were partially adhered to. Seventy-five percentage of the virtual surgeries for free tissue transfers were adhered to, whereas 25% were partially adhered to. The reasons for abandoning the plans were (1) poor communication between surgeon and engineer, (2) poor appreciation for condyle placement on preoperative scans, (3) soft-tissue impedance to bony movement, (4) rapid tumor progression, (5) poor preoperative assessment of anatomy. Conclusion Virtual surgical planning is a useful tool for craniofacial surgery but has inherent issues that the surgeon must be aware of. With time and experience, these surgical plans can be used as powerful adjuvants to good clinical judgement.
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Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy. Case Rep Dent 2018; 2017:8013874. [PMID: 29318057 PMCID: PMC5727690 DOI: 10.1155/2017/8013874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 11/05/2017] [Indexed: 02/08/2023] Open
Abstract
In maxillofacial surgery, every patient presents special problems requiring careful evaluation. Conventional methods to study the deformities are still reliable, but the advent of tridimensional (3D) imaging, especially computed tomography (CT) scan and laser scanning of casts, created the opportunity to better understanding the skeletal support and the soft tissue structures. Nowadays, virtual technologies are increasingly employed in maxillofacial surgery and demonstrated precision and reliability. However, in complex surgical procedures, these new technologies are still controversial. Especially in the less frequent cases of three-part maxillary surgery, the experience is limited, and scientific literature cannot give a clear support. This paper presents the case of a young patient affected by a complex long face dentofacial deformity treated by a bimaxillary surgery with three-part segmentation of the maxilla. The operator performed the surgical study completely with a virtual workflow. Pre- and postoperative CT scan and optical scanning of plaster models were collected and compared. Every postoperatory maxillary piece was superimposed with the presurgical one, and the differences were examined in a color-coded map. Only mild differences were found near the osteotomy lines, when the bony surface and the teeth demonstrated an excellent coincidence.
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Development and refinement of computer-assisted planning and execution system for use in face-jaw-teeth transplantation to improve skeletal and dento-occlusal outcomes. Curr Opin Organ Transplant 2017; 21:523-9. [PMID: 27517508 DOI: 10.1097/mot.0000000000000350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To describe the development and refinement of the computer-assisted planning and execution (CAPE) system for use in face-jaw-teeth transplants (FJTTs). RECENT FINDINGS Although successful, some maxillofacial transplants result in suboptimal hybrid occlusion and may require subsequent surgical orthognathic revisions. Unfortunately, the use of traditional dental casts and splints pose several compromising shortcomings in the context of FJTT and hybrid occlusion. Computer-assisted surgery may overcome these challenges. Therefore, the use of computer-assisted orthognathic techniques and functional planning may prevent the need for such revisions and improve facial-skeletal outcomes. SUMMARY A comprehensive CAPE system for use in FJTT was developed through a multicenter collaboration and refined using plastic models, live miniature swine surgery, and human cadaver models. The system marries preoperative surgical planning and intraoperative execution by allowing on-table navigation of the donor fragment relative to recipient cranium, and real-time reporting of patient's cephalometric measurements relative to a desired dental-skeletal outcome. FJTTs using live-animal and cadaveric models demonstrate the CAPE system to be accurate in navigation and beneficial in improving hybrid occlusion and other craniofacial outcomes. Future refinement of the CAPE system includes integration of more commonly performed orthognathic/maxillofacial procedures.
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Cottrell DA, Farrell B, Ferrer-Nuin L, Ratner S. Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2017; 75:e94-e125. [DOI: 10.1016/j.joms.2017.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Fu K, Liu Y, Gao N, Cai J, He W, Qiu W. Reconstruction of Maxillary and Orbital Floor Defect With Free Fibula Flap and Whole Individualized Titanium Mesh Assisted by Computer Techniques. J Oral Maxillofac Surg 2017; 75:1791.e1-1791.e9. [PMID: 28463685 DOI: 10.1016/j.joms.2017.03.054] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE We sought to investigate the clinical application of free fibula flap and individualized titanium mesh through the use of a virtual planning and guiding template to assist the reconstruction of maxilla and orbital floor defects. PATIENTS AND METHODS Between 2015 and 2016, a total of 6 adult patients with maxillary and orbital floor defects were enrolled in this study. Preoperative virtual planning, including virtual maxillary resection and fibular reconstruction, was performed in all cases according to 3-dimensional radiographic and clinical findings. A 3-dimensionally printed resin model and prebent templates were used to guide the harvesting and positioning of the fibula flap during surgery. Then, an individualized titanium mesh was used to support the orbital floor and restore the maxillary contour. The results were confirmed by postoperative computed tomography scans and clinical follow-up. RESULTS Preoperative virtual planning and prebent templates can be used to guide the harvesting and positioning of the fibula flap, as well as the forming and positioning of the individualized titanium mesh, with satisfactory results. All flaps survived, and symmetrical facial contours were achieved with normal lower jaw movement and proper vertical distance for dental implants in all patients. CONCLUSIONS Computer-aided techniques such as virtual planning, 3-dimensionally printed models, and prebent guide templates can be used to harvest and position a free fibula flap, form personalized titanium mesh, and ultimately improve the clinical efficacy of maxillary and orbital floor reconstruction.
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Affiliation(s)
- Kun Fu
- Attending, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiming Liu
- Attending, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ning Gao
- Attending, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinghua Cai
- Resident, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei He
- Professor and Department Head, Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weiliu Qiu
- Professor and Academician Expert, Department of Stomatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; and Academician Expert Workstation of Head and Neck Tumor of Henan Province, Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, and School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Three-Dimensional Printing of Reduction Template in the Contouring of Craniofacial Fibrous Dysplasia. J Craniofac Surg 2016; 27:1792-1794. [DOI: 10.1097/scs.0000000000002960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Resorbable Mesh as a Containment System in Mandibular Reconstruction. J Craniofac Surg 2016; 27:1795-1798. [PMID: 27548828 DOI: 10.1097/scs.0000000000002961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The recent advances seen in computer technologies and biomaterials have changed the approach to craniomaxillofacial surgery. In this report, the authors describe the technique of using a resorbable containment system for bone graft in a large mandibular reconstruction patient. The authors provide a patient report with a 1-year follow-up.
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Lorenz KJ, Böckers A, Fassnacht U, Wilde F, Wegener M. Implementation of a miniaturised navigation system in head and neck surgery for the detection and removal of foreign bodies. Eur Arch Otorhinolaryngol 2016; 274:553-559. [PMID: 27430225 DOI: 10.1007/s00405-016-4212-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
The removal of embedded blast-generated fragments from soft tissue is very difficult, especially in the head and neck regions. First, because many retained foreign materials are non-metallic and can, therefore, not be detected by fluoroscopy, and second, because a broad exploration of the soft tissue is not possible in the facial area for functional and cosmetic reasons. Intraoperative navigation computer-assisted surgery (CAS) may facilitate the retrieval of foreign bodies and reduce exploration trauma. In a blind trial, five test specimens of different materials (glass, metal, wood, plastic, and stone) were inserted on the left and right sides of the head and neck of ten body donors through an intraoral incision. A second physician then detected and removed the foreign bodies from one side of the body without and from the other side of the body with navigation. We measured the duration of surgery, the extent of tissue trauma caused during surgery, the time it took to remove the foreign bodies, and the subjective evaluation of the usefulness of navigation. With the aid of the navigation system, the various foreign bodies were detected after an average of 26.7 (±35.1) s (p < 0.0001) and removed after an average of 79.1 (±66.2) s (p = 0.0239), with an average incision length of 10.0 (±3.5) mm. Without the navigation system, the foreign bodies were located after an average of 86.5 (±77.7) s and removed after an average of 74.1 (±45.9) s, with an average incision length of 13.0 mm (±3.6) mm (=0.0007). Intraoperative navigation systems are a valuable tool for removing foreign bodies from the soft tissue of the face and neck. Both the duration of surgery and the incision length can be reduced using navigation systems. Depending on the material of the foreign bodies and the signal intensity in the CT/MRI scanner, however, the detection reliability varies. All in all, navigation is considered to be a useful tool.
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Affiliation(s)
- K J Lorenz
- Department of Otorhinolaryngology, German Armed Forces Hospital, Ulm, Germany.
| | - A Böckers
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - U Fassnacht
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - F Wilde
- Department of Maxillo-facial Surgery, German Armed Forces Hospital, Ulm, Germany
| | - M Wegener
- Department of Maxillo-facial Surgery, German Armed Forces Hospital, Ulm, Germany
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Garib DG, Calil LR, Leal CR, Janson G. Is there a consensus for CBCT use in Orthodontics? Dental Press J Orthod 2016; 19:136-49. [PMID: 25715727 PMCID: PMC4296664 DOI: 10.1590/2176-9451.19.5.136-149.sar] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 08/28/2014] [Indexed: 11/21/2022] Open
Abstract
This article aims to discuss current evidence and recommendations for cone-beam
computed tomography (CBCT) in Orthodontics. In comparison to conventional radiograph,
CBCT has higher radiation doses and, for this reason, is not a standard method of
diagnosis in Orthodontics. Routine use of CBCT in substitution to conventional
radiograph is considered an unaccepted practice. CBCT should be indicated with
criteria only after clinical examination has been performed and when the benefits for
diagnosis and treatment planning exceed the risks of a greater radiation dose. It
should be requested only when there is a potential to provide new information not
demonstrated by conventional scans, when it modifies treatment plan or favors
treatment execution. The most frequent indication of CBCT in Orthodontics, with some
evidence on its clinical efficacy, includes retained/impacted permanent teeth; severe
craniofacial anomalies; severe facial discrepancies with indication of
orthodontic-surgical treatment; and bone irregularities or malformation of TMJ
accompanied by signs and symptoms. In exceptional cases of adult patients when
critical tooth movement are planned in regions with deficient buccolingual thickness
of the alveolar ridge, CBCT can be indicated provided that there is a perspective of
changes in orthodontic treatment planning.
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Affiliation(s)
| | | | | | - Guilherme Janson
- Department of Orthodontics, School of Dentistry, University of São Paulo, Bauru
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Liu TJ, Ko AT, Tang YB, Lai HS, Chien HF, Hsieh TMH. Clinical Application of Different Surgical Navigation Systems in Complex Craniomaxillofacial Surgery. Ann Plast Surg 2016; 76:411-9. [DOI: 10.1097/sap.0000000000000429] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The effect of the angle of acuteness of additive manufactured models and the direction of printing on the dimensional fidelity: clinical implications. Odontology 2016; 105:108-115. [DOI: 10.1007/s10266-016-0239-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
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Abstract
The aim of the current study was to evaluate the accuracy of computer-guided mandibular fracture reduction. A total of 24 patients with fractured mandible were included in the current study. A preoperative cone beam computed tomography (CBCT) scan was performed on all of the patients. Based on CBCT, three-dimensional reconstruction and virtual reduction of the mandibular fracture segments were done and a virtual bone borne surgical guide was designed and exported as Standard Tessellation Language file. A physical guide was then fabricated using a three-dimensional printing machine. Open reduction and internal fixation was done for all of the patients and the fracture segments were anatomically reduced with the aid of the custom-fabricated surgical guide. Postoperative CBCT was performed after 7 days and results of which were compared with the virtually reduced preoperative mandibular models. Comparison of values of lingula-sagittal plane, inferior border-sagittal plane, and anteroposterior measurements revealed no statistically significant differences between the virtual and the clinically reduced CBCT models. Based on the results of the current study, computer-based surgical guide aid in obtaining accurate anatomical reduction of the displaced mandibular fractured segments. Moreover, the computer-based surgical guides were found to be beneficial in reducing fractures of completely and partially edentulous mandibles.
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Stokbro K, Aagaard E, Torkov P, Bell R, Thygesen T. Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation. Int J Oral Maxillofac Surg 2016; 45:8-18. [DOI: 10.1016/j.ijom.2015.07.010] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/31/2015] [Accepted: 07/16/2015] [Indexed: 11/29/2022]
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ZHI LIQIANG, LI MENG, LIU KAI, MA XING. ADVANCED 3D RAPID PROTOTYPING BIOMODELING TECHNIQUE FOR KNEE SURGERY. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415400503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Advanced three-dimensional (3D) models have played more and more essential roles in orthopedics surgical interventions. In order to improve the clinical outcomes of knee surgery (KS) including minimally invasive knee surgery (MIKS), the melted extrusion modeling (MEM), a rapid prototyping (RP) technique, was used efficiently to fabricate real life-size 3D physical models of interesting knees. The applications and advantages of the tangible RP-constructed 3D models in KS were elucidated in this study. As a result, better preparation including optimal preoperative planning was made so that KS could be performed in an accurate, safe and fast manner for each case. Besides, the surgical skills of MIKS were substantially improved. Therefore, the results suggest that KS can benefit much from the advanced 3D modeling technique.
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Affiliation(s)
- LI-QIANG ZHI
- Department of Orthopedics The First Affiliated Hospital of Xi’an Jiaotong University Xi’an 710061, China
| | - MENG LI
- Department of Orthopedics The First Affiliated Hospital of Xi’an Jiaotong University Xi’an 710061, China
| | - KAI LIU
- Department of Orthopedics The First Affiliated Hospital of Xi’an Jiaotong University Xi’an 710061, China
| | - XING MA
- Department of Orthopedics The First Affiliated Hospital of Xi’an Jiaotong University Xi’an 710061, China
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Lin X, Chen T, Liu J, Jiang T, Yu D, Shen SGF. Point-based superimposition of a digital dental model on to a three-dimensional computed tomographic skull: an accuracy study in vitro. Br J Oral Maxillofac Surg 2014; 53:28-33. [PMID: 25300890 DOI: 10.1016/j.bjoms.2014.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/10/2014] [Indexed: 11/18/2022]
Abstract
We investigated the accuracy of point-based superimposition of a digital dental model on to a 3-dimensional computed tomographic (CT) skull with intact dentition. The physical model was scanned by CT to give a virtual skull model, and a plaster dental model was taken and laser-scanned to give a digital dental model. Three different background investigators were recruited and calibrated to make the point-based superimposition, and afterwards were asked to repeat 5 superimpositions each. Five bone-to-tooth measurements for the maxilla and 6 for the mandible were selected to indicate the relation of teeth to skull. Repeated measures were made on the physical model to act as a control group, and on the virtual model to act as the test group. The absolute agreement intra-class correlation coefficient (ICC) was used to assess the intra/inter-investigator reliability; Bland-Altman analysis was used to calculate the general differences, limits of agreement, and precision ranges of the estimated limits. Inter/intra-investigator reliability was excellent with ICC varying from 0.986 to 1; Bland-Altman analysis indicated that general difference was 0.01 (0.25)mm, the upper limit of agreement was 0.50mm and the lower limit -0.47 mm, and the precision range for the upper limit was 0.43 mm to 0.57 mm and for the lower limit -0.54 mm to -0.40 mm. Clinically acceptable accuracy can be achieved using a direct point-based method to superimpose a digital dental model on to a 3-dimensional CT skull.
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Affiliation(s)
- X Lin
- Department of Stomatology, The Chinese PLA General Hospital Hainan Branch, Sanya, Hainan, China; Department of Oral & Maxillofacial Surgery, The Chinese PLA General Hospital Institution of Stomatology, Beijing, China; Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - T Chen
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - J Liu
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - T Jiang
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - D Yu
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - S G F Shen
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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Stokbro K, Aagaard E, Torkov P, Bell R, Thygesen T. Virtual planning in orthognathic surgery. Int J Oral Maxillofac Surg 2014; 43:957-65. [DOI: 10.1016/j.ijom.2014.03.011] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 03/14/2014] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
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Shen P, Zhang S, Yang C, Huang D. The mandibular symmetry evaluation of total temporomandibular joint replacement on developing sheep. J Craniomaxillofac Surg 2014; 42:201-5. [DOI: 10.1016/j.jcms.2013.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 04/17/2013] [Accepted: 04/17/2013] [Indexed: 11/16/2022] Open
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Reinbacher KE, Pau M, Wallner J, Zemann W, Klein A, Gstettner C, Aigner RM, Feichtinger M. Minimal invasive biopsy of intraconal expansion by PET/CT/MRI image-guided navigation: a new method. J Craniomaxillofac Surg 2014; 42:1184-9. [PMID: 24726395 DOI: 10.1016/j.jcms.2014.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/09/2013] [Accepted: 02/10/2014] [Indexed: 11/29/2022] Open
Abstract
UNLABELLED Intraorbital tumours are often undetected for a long period and may lead to compression of the optic nerve and loss of vision. Although CT, MRI's and ultrasound can help in determining the probable diagnosis, most orbital tumours are only diagnosed by surgical biopsy. In intraconal lesions this may prove especially difficult as the expansions are situated next to sensitive anatomical structures (eye bulb, optic nerve). In search of a minimally invasive access to the intraconal region, we describe a method of a three-dimensional, image-guided biopsy of orbital tumours using a combined technique of hardware fusion between (18)F-FDG Positron Emission Tomography ((18)F-FDG PET), magnetic resonance imaging (MRI) and Computed Tomography (CT). METHOD AND MATERIAL We present 6 patients with a total of 7 intraorbital lesions, all of them suffering from diplopia and/or exophthalmos. There were 3 female and 3 male patients. The patients age ranged from 20 to 75 years. One of the patients showed beginning loss of vision. Another of the patients had lesions in both orbits. The decision to obtain image-guided needle biopsies for treatment planning was discussed and decided at an interdisciplinary board comprising other sub-specialities (ophthalmology, neurosurgery, maxillofacial surgery, ENT, plastic surgery). All patients underwent 3D imaging preoperatively ((18)F-FDG PET/CT or (18)F-FDG PET/CT plus MRI). Data was transferred to 3D navigation system. Access to the lesions was planned preoperatively on a workstation monitor. Biopsy-needles were then calibrated intraoperatively and all patients underwent three-dimensional image-guided needle biopsies under general anaesthesia. RESULTS 7 biopsies were performed. The histologic subtype was idiopathic orbital inflammation in 2 lesions, lymphoma in 2, Merkel cell carcinoma in 1, hamartoma in 1 and 1 malignant melanoma. The different pathologies were subsequently treated in consideration of the actual state of the art. In cases where surgical removal of the lesion was performed the histological diagnosis was confirmed in all cases. CONCLUSION There is a wide range of possible treatment modalities for orbital tumours depending on the nature of the lesion. Histological diagnosis is mandatory to select the proper management and operation. The presented method allows minimal-invasive biopsy even in deep intraconal lesions, enabling the surgeon to spare critical anatomical structures. Vascular lesions such as cavernous haemangioma, tumour of the lacrimal gland or dermoid cysts present a contraindication and have to be excluded.
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Affiliation(s)
- Knut E Reinbacher
- Department of Oromaxillofacial Surgery (Head: Univ. Prof. Dr. Kärcher Hans), Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
| | - Mauro Pau
- Department of Oromaxillofacial Surgery (Head: Univ. Prof. Dr. Kärcher Hans), Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Jürgen Wallner
- Department of Oromaxillofacial Surgery (Head: Univ. Prof. Dr. Kärcher Hans), Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Wolfgang Zemann
- Department of Oromaxillofacial Surgery (Head: Univ. Prof. Dr. Kärcher Hans), Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Angelika Klein
- Clinic for Ophthalmology, Medical University Graz, Austria
| | - Christian Gstettner
- Clinic for Radiology (Head: Reingard M. Aigner, PHD, MD), Medical University Graz, Austria
| | - Reingard M Aigner
- Clinic for Radiology (Head: Reingard M. Aigner, PHD, MD), Medical University Graz, Austria
| | - Matthias Feichtinger
- Department of Oromaxillofacial Surgery (Head: Univ. Prof. Dr. Kärcher Hans), Medical University Graz, Auenbruggerplatz 5, 8036 Graz, Austria
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de Farias TP, Dias FL, Galvão MS, Boasquevisque E, Pastl AC, Albuquerque Sousa B. Use of prototyping in preoperative planning for patients with head and neck tumors. Head Neck 2014; 36:1773-82. [PMID: 24478238 DOI: 10.1002/hed.23540] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2013] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Prototyping technologies for reconstructions consist of obtaining a 3-dimensional model of the object of interest. Solid models are constructed by the deposition of materials in successive layers. The purpose of this study was to perform a double-blind, randomized, prospective study to evaluate the efficacy of prototype use in head and neck surgeries. METHODS Thirty-seven cases were randomized into prototype and nonprototype groups. The following factors were recorded: the time of plate and locking screw apposition, flap size, time for reconstruction, and an aesthetic evaluation. RESULTS The prototype group exhibited a reduced surgical time (43.7 minutes vs 127.7 minutes, respectively; p = .001), a tendency to reduce the size of the bone flap taken for reconstruction, and better aesthetic results than the group that was not prototyped. CONCLUSION The use of prototyping demonstrated a trend toward a reduced surgical time, smaller bone flaps, and better aesthetic results.
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Affiliation(s)
- Terence Pires de Farias
- Department of Head and Neck Surgery, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
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Fasel JHD, Beinemann J, Schaller K, Gailloud P. A critical inventory of preoperative skull replicas. Ann R Coll Surg Engl 2013; 95:401-4. [PMID: 24025287 DOI: 10.1308/003588413x13629960046994] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Physical replicas of organs are used increasingly for preoperative planning. The quality of these models is generally accepted by surgeons. In view of the strong trend towards minimally invasive and personalised surgery, however, the aim of this investigation was to assess qualitatively the accuracy of such replicas, using skull models as an example. METHODS Skull imaging was acquired for three cadavers by computed tomography using clinical routine parameters. After digital three-dimensional (3D) reconstruction, physical replicas were produced by 3D printing. The facsimilia were analysed systematically and compared with the best gold standard possible: the macerated skull itself. RESULTS The skull models were far from anatomically accurate. Non-conforming rendering was observed in particular for foramina, sutures, notches, fissures, grooves, channels, tuberosities, thin-walled structures, sharp peaks and crests, and teeth. CONCLUSIONS Surgeons should be aware that preoperative models may not yet render the exact anatomy of the patient under consideration and are advised to continue relying, in specific conditions, on their own analysis of the native computed tomography or magnetic resonance imaging.
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Affiliation(s)
- J H D Fasel
- University of Geneva, Switzerland; Clinical Anatomy Research Group, Department of Cellular Physiology and Metabolism, University Medical Center, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland.
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Huotilainen E, Jaanimets R, Valášek J, Marcián P, Salmi M, Tuomi J, Mäkitie A, Wolff J. Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process. J Craniomaxillofac Surg 2013; 42:e259-65. [PMID: 24268714 DOI: 10.1016/j.jcms.2013.10.001] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/08/2013] [Accepted: 10/08/2013] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The process of fabricating physical medical skull models requires many steps, each of which is a potential source of geometric error. The aim of this study was to demonstrate inaccuracies and differences caused by DICOM to STL conversion in additively manufactured medical skull models. MATERIAL AND METHODS Three different institutes were requested to perform an automatic reconstruction from an identical DICOM data set of a patients undergoing tumour surgery into an STL file format using their software of preference. The acquired digitized STL data sets were assessed and compared and subsequently used to fabricate physical medical skull models. The three fabricated skull models were then scanned, and differences in the model geometries were assessed using established CAD inspection software methods. RESULTS A large variation was noted in size and anatomical geometries of the three physical skull models fabricated from an identical (or "a single") DICOM data set. CONCLUSIONS A medical skull model of the same individual can vary markedly depending on the DICOM to STL conversion software and the technical parameters used. Clinicians should be aware of this inaccuracy in certain applications.
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Affiliation(s)
- Eero Huotilainen
- BIT Research Centre, Department of Industrial Engineering and Management, School of Science and Technology, Aalto University, P.O. Box 15500, FI-00076 Helsinki, Finland
| | - Risto Jaanimets
- Oral and Maxillofacial Unit, Department of Otorhinolaryngology, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland; Medical Imaging Center, Department of Radiology, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland.
| | - Jiří Valášek
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Technická 2896/2, 616 69 Brno, Czech Republic
| | - Petr Marcián
- Institute of Solid Mechanics, Mechatronics and Biomechanics, Faculty of Mechanical Engineering, Brno University of Technology, Technická 2896/2, 616 69 Brno, Czech Republic
| | - Mika Salmi
- BIT Research Centre, Department of Industrial Engineering and Management, School of Science and Technology, Aalto University, P.O. Box 15500, FI-00076 Helsinki, Finland
| | - Jukka Tuomi
- BIT Research Centre, Department of Industrial Engineering and Management, School of Science and Technology, Aalto University, P.O. Box 15500, FI-00076 Helsinki, Finland
| | - Antti Mäkitie
- BIT Research Centre, Department of Industrial Engineering and Management, School of Science and Technology, Aalto University, P.O. Box 15500, FI-00076 Helsinki, Finland; Dept. of Otolaryngology - Head & Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 220, FI-00029 Helsinki, Finland
| | - Jan Wolff
- Oral and Maxillofacial Unit, Department of Otorhinolaryngology, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland; Medical Imaging Center, Department of Radiology, Tampere University Hospital, P.O. Box 2000, FI-33521 Tampere, Finland
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Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:238-57. [DOI: 10.1016/j.oooo.2013.06.002] [Citation(s) in RCA: 221] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 06/03/2013] [Indexed: 12/13/2022]
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Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits. INTERNATIONAL ORTHOPAEDICS 2013; 37:1597-603. [PMID: 23793460 DOI: 10.1007/s00264-013-1908-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to compare bone healing of experimental osteotomies applying either piezosurgery or two different oscillating saw blades in a rabbit model. METHODS The 16 rabbits were randomly assigned into four groups to comply with observation periods of one, two, three and five weeks. In all animals, four osteotomy lines were performed on the left and right nasal bone using a conventional saw blade, a novel saw blade and piezosurgery. RESULTS All three osteotomy techniques revealed an advanced gap healing starting after one week. The most pronounced new bone formation took place between two and three weeks, whereby piezoelectric surgery revealed a tendency to faster bone formation and remodelling. Yet, there were no significant differences between the three modalities. CONCLUSIONS The use of a novel as well as the piezoelectric bone-cutting instrument revealed advanced bone healing with a favourable surgical performance compared to a traditional saw.
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Cottrell DA, Edwards SP, Gotcher JE. Surgical correction of maxillofacial skeletal deformities. J Oral Maxillofac Surg 2013; 70:e107-36. [PMID: 23127998 DOI: 10.1016/j.joms.2012.07.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kang SH, Kim MK, Kim JH, Park HK, Lee SH, Park W. The Validity of Marker Registration for an Optimal Integration Method in Mandibular Navigation Surgery. J Oral Maxillofac Surg 2013; 71:366-75. [DOI: 10.1016/j.joms.2012.03.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 03/30/2012] [Accepted: 03/31/2012] [Indexed: 11/17/2022]
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Current Applications of 3-D Intraoperative Navigation in Craniomaxillofacial Surgery. Ann Plast Surg 2012; 69:271-8. [DOI: 10.1097/sap.0b013e31822a3ec3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Magraw C, Lam D, Park A, Perrino M, Eisig S. Poster 04: Computer-Simulated Neonatal Mandibular Distraction Osteogenesis. J Oral Maxillofac Surg 2012. [DOI: 10.1016/j.joms.2012.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bui TG, Bell RB, Dierks EJ. Technological advances in the treatment of facial trauma. Atlas Oral Maxillofac Surg Clin North Am 2012; 20:81-94. [PMID: 22365431 DOI: 10.1016/j.cxom.2011.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Tuan G Bui
- Head and Neck Surgical Associates, Portland, OR, USA.
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Bai S, Bi Y, Dong Y, Feng Z, Zhao Y. Computer-aided design/computer-aided manufacturing implant guide used in flapless surgery for auricular prosthesis. J Oral Maxillofac Surg 2012; 70:1338-41. [PMID: 22494513 DOI: 10.1016/j.joms.2012.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 02/03/2012] [Accepted: 02/03/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Shizhu Bai
- Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Olszewski R. Surgical Engineering in Cranio-Maxillofacial Surgery: A Literature Review. JOURNAL OF HEALTHCARE ENGINEERING 2012. [DOI: 10.1260/2040-2295.3.1.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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McCormick SU, Drew SJ. Virtual Model Surgery for Efficient Planning and Surgical Performance. J Oral Maxillofac Surg 2011; 69:638-44. [DOI: 10.1016/j.joms.2010.10.047] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 10/14/2010] [Indexed: 10/18/2022]
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