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Sampat SC, Kadam IV, Kadam A, Sahwal KS, Ingle S. Fabrication of a 3D-Printed Interim Bite Splint for a Hemimandibulectomy Patient: A Case Report. Cureus 2024; 16:e64120. [PMID: 39119417 PMCID: PMC11309738 DOI: 10.7759/cureus.64120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Mandibular continuity defects can result in varying degrees of cosmetic disfigurement. Restoration of form and function may require surgical reconstruction of the affected area. While surgical reconstruction may improve the overall prognostic outcomes for the patient, the definitive prosthetic phase can commence only after a substantial time lag for adequate hard/soft tissue healing. This interim phase often challenges the patient's masticatory ability. The traditional reconstruction of hemimandibulectomy defects has its own limitations. This case report describes the fabrication of a 3D-printed bite splint for a patient with limited mouth opening and significant malocclusion due to surgical over-correction. The prosthesis given served as an appliance to improve the masticatory ability of the patient.
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Affiliation(s)
- Saumil C Sampat
- Department of Prosthodontics, Dr. G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, IND
| | - Ishan V Kadam
- Department of Prosthodontics, Dr. G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, IND
| | - Ankita Kadam
- Department of Prosthodontics, Dr. G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, IND
| | - Kanchan S Sahwal
- Department of Prosthodontics, Dr. G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, IND
| | - Sangharsh Ingle
- Department of Prosthodontics, Dr. G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, IND
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Louro RS, Moraschini V, Melhem-Elias F, Sturzinger GPS, Amad RA, Shibli JA. Digital Implant-Supported Restoration Planning Placed in Autologous Graft Using Titanium Implants Produced by Additive Manufacturing. Dent J (Basel) 2024; 12:192. [PMID: 39056980 PMCID: PMC11276212 DOI: 10.3390/dj12070192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 06/05/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
This clinical report presents a technique to reconstruct extensively resected mandibles using a combination of autologous bone grafts and additive manufacturing techniques. Mandibular defects, often arising from trauma, tumors, or congenital anomalies, can severely impact both function and aesthetics. Conventional reconstruction methods have their limitations, often resulting in suboptimal outcomes. In these reports, we detail clinical cases where patients with different mandibular defects underwent reconstructive surgery. In each instance, autologous grafts were harvested to ensure the restoration of native bone tissue, while advanced virtual planning techniques were employed for precise graft design and dental implant placement. The patients experienced substantial improvements in masticatory function, speech, and facial aesthetics. Utilizing autologous grafts minimized the risk of rejection and complications associated with foreign materials. The integration of virtual planning precision allowed customized solutions, reducing surgical duration and optimizing implant positioning. These 2 cases underscores the potential of combining autologous grafts with virtual planning precision and dental implants produced by additive manufacturing for mandible reconstruction.
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Affiliation(s)
- Rafael Seabra Louro
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil; (R.S.L.); (V.M.); (G.P.S.S.)
| | - Vittorio Moraschini
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil; (R.S.L.); (V.M.); (G.P.S.S.)
| | - Fernando Melhem-Elias
- Department of Oral and Maxillofacial Surgery, School of Dentistry of the University of São Paulo, São Paulo 05508-000, Brazil;
| | - George Patrick Sotero Sturzinger
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Niterói 24020-140, Brazil; (R.S.L.); (V.M.); (G.P.S.S.)
| | - Renata Augusto Amad
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, Brazil;
| | - Jamil A. Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-040, Brazil;
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Shilo D, Capucha T, Krasovsky A, Blanc O, Emodi O, Haze A, Rachmiel A. Real-time Reconstruction of Comminuted Mandibular Fractures Using 3D Printing. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5645. [PMID: 38510331 PMCID: PMC10954053 DOI: 10.1097/gox.0000000000005645] [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: 10/21/2023] [Accepted: 01/16/2024] [Indexed: 03/22/2024]
Abstract
Background Comminuted fractures of the jaws are complex injuries requiring special attention. In the past, treatment included closed reduction using maxillomandibular fixation. With advancements in technology and fixation systems, open reduction became a prevalent option. These fractures are difficult to reconstruct during the primary treatment phase, thus resulting in higher complication rates. The introduction of three-dimensional (3D) planning and printing brought about superior outcomes, yet these focus on secondary reconstruction due to the need for outsourcing planning and titanium printing. Methods In this report, we describe real-time in-house 3D planning and printing using computer-assisted design software and a 3D-fused deposition printer for virtual reduction of the comminuted fractures and printing of the reconstructed mandible. Results Following virtual 3D reduction, the newly created mandibles were 3D printed. The model was then used to preband a reconstruction plate, which in turn was used as a template during surgery for reducing the segments. The process of virtual reduction and printing should take a couple of hours at most. The results of five cases showed good alignment and proper function. Conclusion Three-dimensional technology can be applied in the everyday primary care treatment protocol of comminuted fractures as an in-house tool which greatly improves both functional and aesthetic outcomes.
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Affiliation(s)
- Dekel Shilo
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Tal Capucha
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Andrei Krasovsky
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Ori Blanc
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Omri Emodi
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amir Haze
- Department of Orthopedics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Adi Rachmiel
- From the Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Bevini M, Vitali F, Ceccariglia F, Badiali G, Tarsitano A. Accuracy Evaluation of an Alternative Approach for a CAD-AM Mandibular Reconstruction with a Fibular Free Flap via a Novel Hybrid Roto-Translational and Surface Comparison Analysis. J Clin Med 2023; 12:jcm12051938. [PMID: 36902725 PMCID: PMC10003983 DOI: 10.3390/jcm12051938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Although the fibula free flap represents the gold standard for mandibular reconstructions, when implanted as a single barrel, this flap does not have the cross-sectional requisites to restore the native mandibular height, which is in turn required for the implant-supported dental rehabilitation of the patient. Our team has developed a design workflow that already considers the predicted dental rehabilitation, positioning the fibular free flap in the correct craniocaudal position to restore the native alveolar crest. The remaining height gap along the inferior mandibular margin is then filled by a patient-specific implant. The aim of this study is to evaluate the accuracy in transferring the planned mandibular anatomy resulting from said workflow on 10 patients by means of a new rigid body analysis method, derived from the evaluation of orthognathic surgery procedures. The analysis method has proved to be reliable and reproducible, and the results obtained show that the procedure already has satisfactory accuracy (4.6° mean total angular discrepancy, 2.7 mm total translational discrepancy, 1.04 mm mean neo-alveolar crest surface deviation), while also pointing out possible improvements to the virtual planning workflow.
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Affiliation(s)
- Mirko Bevini
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Oral and Maxillofacial Surgery Unit, Via Albertoni 15, 40138 Bologna, Italy
| | - Francesco Vitali
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Oral and Maxillofacial Surgery Unit, Via Albertoni 15, 40138 Bologna, Italy
- Correspondence:
| | - Francesco Ceccariglia
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Oral and Maxillofacial Surgery Unit, Via Albertoni 15, 40138 Bologna, Italy
| | - Giovanni Badiali
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Oral and Maxillofacial Surgery Unit, Via Albertoni 15, 40138 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
| | - Achille Tarsitano
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Oral and Maxillofacial Surgery Unit, Via Albertoni 15, 40138 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy
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Kuehle R, Kuebler M, Fuchs J, Weichel F, Moratin J, Freier K, Engel M, Hoffmann J, Ristow O, Freudlsperger C. The value of prebent reconstruction plates and in-house 3D printing. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101381. [PMID: 36642249 DOI: 10.1016/j.jormas.2023.101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Reconstruction plates, prebent on 3D printed models, are a cheap, quick, and safe solution to improve mandibular reconstruction procedures. The European Medical Device Regulation has changed recently and severely affects 3D printing in hospitals. Therefore, its legitimation must be discussed. This retrospective observational Case-Control Study aimed to evaluate the impact of prebent reconstruction plates on the condylar position in the temporomandibular joint after continuity resection of the mandible in oncological cases. MATERIALS AND METHODS We included patients who underwent segmental mandibular resection without exarticulation of the condyle or history of prior surgery. The patients were divided into groups with prebent plates on a stereolithographic model and intraoperatively bent reconstruction plates. The segmental defects were categorized using the Jewer Classification. Computed Tomography (CT) scans before and after surgery were analyzed using a standardized method to measure the metric movement of the condyles, as well as their angulation to reference planes to quantify positional changes (primary outcome measures). The influence of the defect location, according to the Jewer classification, was evaluated as a secondary outcome measure. RESULTS 73 patients, including 33 with preformed reconstruction plates, were included. We could show significantly fewer rotational deviations in cases of prefabricated osteosynthesis in the coronal plane (p<0,001) and in the sagittal plane (p<0,027). DISCUSSION Using preformed reconstruction plates on 3D printed models improves the correct anatomical position of the condyle after mandibular resection. Especially Jewer-class-L defects seem to benefit from individualized reconstruction plates.
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Affiliation(s)
- Reinald Kuehle
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
| | - Medea Kuebler
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Jennifer Fuchs
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Frederic Weichel
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Julius Moratin
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Kolja Freier
- University of Heidelberg Saarland, Department of Oral and Maxillofacial Surgery, Kirrberger Straße 100, D-66421 Homburg/Saar, Germany
| | - Michael Engel
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Jürgen Hoffmann
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Oliver Ristow
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
| | - Christian Freudlsperger
- University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany
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The Precision of Different Types of Plates Fabricated With a Computer-Aided Design and Manufacturing System in Mandibular Reconstruction With Fibular-Free Flaps. J Craniofac Surg 2023; 34:187-197. [PMID: 36168132 DOI: 10.1097/scs.0000000000009037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/27/2022] [Indexed: 01/11/2023] Open
Abstract
Computer-assisted surgery (CAS) has been introduced to mandible reconstruction with fibular-free flap in cutting guide placement. When CAS cooperates with different plate fixations, the results show various degrees of errors by which this study aimed to evaluate. Mock surgeries were conducted in 3D-printed mandibles with 2 types of defects, limited or extensive, reconstructed from 2 ameloblastoma patients. Three types of fixations, miniplate, manually bending reconstruction plate, and patient-specific plate, are tested, each of which was performed 3 times in each type of defect, adding up to 18 surgeries. One with the least errors was selected and applied to patients whose 3D-printed mandibles were derived. Finally, in vivo errors were compared with the mock. In limited defect, average errors show no statistical significance among all types. In extensive defect, patient-specific plate had a significantly lower average condylar error than manually bending reconstruction plate and miniplate (8.09±2.52 mm vs. 25.49±2.72 and 23.13±13.54 mm, respectively). When patient-specific plate was applied in vivo , the errors were not significantly different from the mock. Patient-specific plates that cooperated with CAS showed the least errors. Nevertheless, manually bent reconstruction plates and miniplates could be applied in limited defects with caution.
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7
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Annino DJ, Hansen EE, Sethi RK, Horne S, Rettig EM, Uppaluri R, Goguen LA. Accuracy and outcomes of virtual surgical planning and 3D-printed guides for osseous free flap reconstruction of mandibular osteoradionecrosis. Oral Oncol 2022; 135:106239. [DOI: 10.1016/j.oraloncology.2022.106239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/24/2022] [Accepted: 10/28/2022] [Indexed: 11/14/2022]
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8
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Annino DJ, Sethi RK, Hansen EE, Horne S, Dey T, Rettig EM, Uppaluri R, Kass JI, Goguen LA. Virtual planning and 3D-printed guides for mandibular reconstruction: Factors impacting accuracy. Laryngoscope Investig Otolaryngol 2022; 7:1798-1807. [PMID: 36544971 PMCID: PMC9764818 DOI: 10.1002/lio2.830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/11/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Examine accuracy and factors impacting accuracy for mandibular reconstruction with virtual surgical planning, 3D printed osteotomy guides and preoperatively bent mandibular reconstruction plate (VSP/3Dprinted-guide/plate). Method Retrospective review of osseous-free-flap mandibular reconstructions with VSP/3Dprinted-guide/plate between January 2015 and July 2020 at a single academic medical center.Patient demographics, disease, and treatment variables were extracted. Accuracy was assessed by 3D-model-overlay with cephalometric and donor-bone segment length measurements. Multivariate analyses were performed to determine factors impacting cephalometric accuracy. Results 60 cases met criteria: 41 (68%) cancer, 14 (23%) osteoradionecrosis (ORN), 5 (8%) secondary mandibular reconstruction. Thirteen cases (22%) were Brown class III or IV. Thirty-nine cases (65%) had ≥2 flap bone segments. Average donor-bone length was 82 mm (SD: 28). 3D-model-overlay accuracy demonstrated minimal deviation between planned and actual reconstruction: intercondylar distance = 2.10 mm (SD: 2.2); intergonial distance = 2.23 mm (SD: 1.9); anterior-posterior distance (APD) = 1.76 mm (SD: 1.5); gonial angle (GA) = 3.11 degrees (SD: 2.4). Mean change in donor-bone segment length inferiorly was 2.67 mm (SD: 2.6) and superiorly 3.27 mm (SD: 3.2). Higher number of donor-bone segments was associated with decreased accuracy in GA (p = .023) and longer donor-bone length was associated with decreased accuracy in APD (p = .031). Conclusion To our knowledge this is the largest series assessing surgical accuracy of VSP/3Dprinted-guide/plate for osseous-free-flap mandibular reconstruction. We demonstrate highly accurate results, with increased number of donor-bone segments and donor-bone length associated with decreased accuracy. Our findings further support VSP/3Dprinted-guide/plate as a reliable and accurate tool for mandibular reconstruction. Level of Evidence Level 4.
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Affiliation(s)
- Donald J. Annino
- Division of OtolaryngologyBrigham and Women's Hospital, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Rosh K. Sethi
- Division of OtolaryngologyBrigham and Women's Hospital, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
- Center for Surgery and Public HealthBrigham and Women's HospitalBostonMassachusettsUSA
| | | | | | - Tanujit Dey
- Center for Surgery and Public HealthBrigham and Women's HospitalBostonMassachusettsUSA
| | - Eleni M. Rettig
- Division of OtolaryngologyBrigham and Women's Hospital, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
- Center for Surgery and Public HealthBrigham and Women's HospitalBostonMassachusettsUSA
| | - Ravindra Uppaluri
- Division of OtolaryngologyBrigham and Women's Hospital, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Laura A. Goguen
- Division of OtolaryngologyBrigham and Women's Hospital, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
- Department of OtolaryngologyHarvard Medical SchoolBostonMassachusettsUSA
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Ostaș D, Almășan O, Ileșan RR, Andrei V, Thieringer FM, Hedeșiu M, Rotar H. Point-of-Care Virtual Surgical Planning and 3D Printing in Oral and Cranio-Maxillofacial Surgery: A Narrative Review. J Clin Med 2022; 11:jcm11226625. [PMID: 36431101 PMCID: PMC9692897 DOI: 10.3390/jcm11226625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
This paper provides an overview on the use of virtual surgical planning (VSP) and point-of-care 3D printing (POC 3DP) in oral and cranio-maxillofacial (CMF) surgery based on a literature review. The authors searched PubMed, Web of Science, and Embase to find papers published between January 2015 and February 2022 in English, which describe human applications of POC 3DP in CMF surgery, resulting in 63 articles being included. The main review findings were as follows: most used clinical applications were anatomical models and cutting guides; production took place in-house or as "in-house-outsourced" workflows; the surgeon alone was involved in POC 3DP in 36 papers; the use of free versus paid planning software was balanced (50.72% vs. 49.27%); average planning time was 4.44 h; overall operating time decreased and outcomes were favorable, though evidence-based studies were limited; and finally, the heterogenous cost reports made a comprehensive financial analysis difficult. Overall, the development of in-house 3D printed devices supports CMF surgery, and encouraging results indicate that the technology has matured considerably.
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Affiliation(s)
- Daniel Ostaș
- Department of Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Robert R. Ileșan
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 21 Spitalstrasse, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 16 Gewerbestrasse, 4123 Allschwil, Switzerland
- Correspondence:
| | - Vlad Andrei
- Department of Oral Rehabilitation, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 15 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 21 Spitalstrasse, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 16 Gewerbestrasse, 4123 Allschwil, Switzerland
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Implantology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu, 400029 Cluj-Napoca, Romania
| | - Horațiu Rotar
- Department of Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
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Zoabi A, Oren D, Tejman-Yarden S, Redenski I, Kablan F, Srouji S. “ Initial experience with augmented reality for treatment of an orbital floor fracture – A Technical Note ”. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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11
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Cebrián Carretero JL, Navarro Cuéllar C. New Technologies for Personalized Medicine in Head and Neck Oncologic and Reconstructive Surgery. J Clin Med 2022; 11:jcm11154261. [PMID: 35893352 PMCID: PMC9329913 DOI: 10.3390/jcm11154261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
The search for standardized protocols has been a constant concern in Head and Neck Reconstructive Surgery [...]
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Affiliation(s)
- José Luis Cebrián Carretero
- Department of Oral and Maxilofacial Surgery, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IDIPAZ, 28046 Madrid, Spain
- Correspondence:
| | - Carlos Navarro Cuéllar
- División of Oral and Maxillofacial Surgery, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, 28007 Madrid, Spain;
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12
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Zoabi A, Redenski I, Oren D, Kasem A, Zigron A, Daoud S, Moskovich L, Kablan F, Srouji S. 3D Printing and Virtual Surgical Planning in Oral and Maxillofacial Surgery. J Clin Med 2022; 11:jcm11092385. [PMID: 35566511 PMCID: PMC9104292 DOI: 10.3390/jcm11092385] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
Compared to traditional manufacturing methods, additive manufacturing and 3D printing stand out in their ability to rapidly fabricate complex structures and precise geometries. The growing need for products with different designs, purposes and materials led to the development of 3D printing, serving as a driving force for the 4th industrial revolution and digitization of manufacturing. 3D printing has had a global impact on healthcare, with patient-customized implants now replacing generic implantable medical devices. This revolution has had a particularly significant impact on oral and maxillofacial surgery, where surgeons rely on precision medicine in everyday practice. Trauma, orthognathic surgery and total joint replacement therapy represent several examples of treatments improved by 3D technologies. The widespread and rapid implementation of 3D technologies in clinical settings has led to the development of point-of-care treatment facilities with in-house infrastructure, enabling surgical teams to participate in the 3D design and manufacturing of devices. 3D technologies have had a tremendous impact on clinical outcomes and on the way clinicians approach treatment planning. The current review offers our perspective on the implementation of 3D-based technologies in the field of oral and maxillofacial surgery, while indicating major clinical applications. Moreover, the current report outlines the 3D printing point-of-care concept in the field of oral and maxillofacial surgery.
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Affiliation(s)
- Adeeb Zoabi
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Idan Redenski
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Daniel Oren
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Adi Kasem
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Asaf Zigron
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Shadi Daoud
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Liad Moskovich
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Fares Kablan
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Samer Srouji
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
- Correspondence:
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Truscott A, Zamani R, Akrami M. Comparing the use of conventional and three-dimensional printing (3DP) in mandibular reconstruction. Biomed Eng Online 2022; 21:18. [PMID: 35305669 PMCID: PMC8934485 DOI: 10.1186/s12938-022-00989-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background There are a number of clinical disorders that require mandibular reconstruction (MR). Novel three-dimensional (3D) printing technology enables reconstructions to be more accurate and beneficial to the patient. However, there is currently no evidence identifying which techniques are better suited for MR, based on the type of clinical disorder the patient has. In this study, we aim to compare 3D techniques with conventional techniques to identify how best to reconstruct the mandible based on the clinical cause that necessitates the reconstructive procedure: cancerous or benign tumours, clinical disorders, infection or disease and trauma or injury. Methods PubMed, Scopus, Embase and Medline were searched to identify relevant papers that outline the clinical differences between 3D and conventional techniques in MR. Data were evaluated to provide a clear outline of suitable techniques for surgery. Results 20 of 2749 papers met inclusion criteria. These papers were grouped based on the clinical causes that required MR into four categories: malignant or benign tumour resection; mandibular trauma/injury and other clinical disorders. Conclusions The majority of researchers favoured 3D techniques in MR. However, due to a lack of standardised reporting in these studies it was not possible to determine which specific techniques were better for which clinical presentations.
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Möllmann HL, Apeltrath L, Karnatz N, Wilkat M, Riedel E, Singh DD, Rana M. Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction. Front Oncol 2021; 11:719028. [PMID: 34900674 PMCID: PMC8660676 DOI: 10.3389/fonc.2021.719028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives This retrospective study compared two mandibular reconstruction procedures-conventional reconstruction plates (CR) and patient-specific implants (PSI)-and evaluated their accuracy of reconstruction and clinical outcome. Methods Overall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences. Results In the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI. Conclusion For reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.
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Affiliation(s)
- Henriette L Möllmann
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Laura Apeltrath
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Nadia Karnatz
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Max Wilkat
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Erik Riedel
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Daman Deep Singh
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Majeed Rana
- Department of Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
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Lai Y, Wang C, Mao C, Lu M, Ouyang Q, Fang Y, Cai Z, Chen W. Mandible reconstruction with free fibula flaps: Accuracy of a cost-effective modified semicomputer-assisted surgery compared with computer-assisted surgery - A retrospective study. J Craniomaxillofac Surg 2021; 50:274-280. [PMID: 34930668 DOI: 10.1016/j.jcms.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/29/2021] [Accepted: 12/04/2021] [Indexed: 11/30/2022] Open
Abstract
A new individualized, cost-effective, modified semi-computer-assisted surgery (MSCAS) concept for free fibular flap mandibular reconstruction is reported and compared with the computer-assisted surgery (CAS) concept. Patients were divided into two groups and retrospectively reviewed. In the MSCAS and CAS groups, intraoperative guides were created using computer-aided design with manual fabrication and computer-aided design and manufacturing, respectively. Differences in specific linear and angular parameters on pre- and postoperative computed tomography scans were calculated for morphometric comparison, and clinical parameters and efficiency were analysed. RESULTS: Eighteen patients (CAS, 7; MSCAS, 11), were included. The morphometric comparison showed no significant differences between the groups. The mean deviation of the mandibular ramus length, body length, width 1 and width 2 was 0.82 ± 0.29 mm, 1.84 ± 0.43 mm, 1.89 ± 0.61 mm and 1.45 ± 0.61 mm in the CAS group versus 1.56 ± 0.54 mm, 1.72 ± 0.33 mm, 2.24 ± 0.55 mm and 2.36 ± 0.50 mm in the MSCAS group (p = 0.7804, p = 0.9997, p = 0.9814 and p = 0.6334). The mean deviation of the sagittal, axial and coronal mandibular angles was 1.56 ± 0.48°, 1.93 ± 0.50° and 2.15 ± 0.72° in the CAS group versus 2.19 ± 0.35°, 1.86 ± 0.35° and 1.94 ± 0.55° in the MSCAS group (p = 0.7594, p = 0.9996 and p = 0.9871). There were no significant differences in clinical parameters, efficiency or postoperative complications between the groups. CONCLUSION: The accuracy and operative efficiency of the MSCAS concept are comparable to those of the more expensive CAS concept. Therefore, in times of increasing clinical costs, this concept might be an adequate and inexpensive alternative to preoperative CAS.
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Affiliation(s)
- Yongzhen Lai
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Chengyong Wang
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Chuanqing Mao
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Meng Lu
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Qiming Ouyang
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Yihong Fang
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Zhiyu Cai
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China
| | - Weihui Chen
- Department of Oral and Cranio-maxillofacial Science, Fujian Medical University Union Hospital, No. 28, Xinquan Road, Fuzhou City, 350001, Fujian Province, China.
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Antúnez-Conde R, Salmerón JI, Díez-Montiel A, Agea M, Gascón D, Sada Á, Navarro Cuéllar I, Tousidonis M, Ochandiano S, Arenas G, Navarro Cuéllar C. Mandibular Reconstruction With Fibula Flap and Dental Implants Through Virtual Surgical Planning and Three Different Techniques: Double-Barrel Flap, Implant Dynamic Navigation and CAD/CAM Mesh With Iliac Crest Graft. Front Oncol 2021; 11:719712. [PMID: 34676161 PMCID: PMC8525397 DOI: 10.3389/fonc.2021.719712] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Vertical discrepancy between the fibula flap and the native mandible results in difficult prosthetic rehabilitation. The aim of this study was to evaluate the outcomes of 3D reconstruction of the mandible in oncologic patients using three different techniques through virtual surgical planning (VSP), cutting guides, customized titanium mesh and plates with CAD/CAM technology, STL models and intraoperative dynamic navigation for implant placement. Material and methods Material and Methods Three different techniques for mandibular reconstruction and implant rehabilitation were performed in 14 oncologic patients. Five patients (36%) underwent VSP, cutting guides, STL models and a customized double-barrel titanium plate with a double-barrel flap and immediate implants. In six patients (43%), VSP, STL models and a custom-made titanium mesh (CAD/CAM) for 3D reconstruction with iliac crest graft over a fibula flap with deferred dental implants were performed. Three patients (21%) underwent VSP with cutting guides and customized titanium plates for mandibular reconstruction and implant rehabilitation using intraoperative dynamic navigation was accomplished. Vertical bone reconstruction, peri-implant bone resorption, implant success rate, effects of radiotherapy in vertical reconstruction, bone resorption and implant failure, mastication, aesthetic result and dysphagia were evaluated. Results Significant differences in bone growth between the double-barrel technique and iliac crest graft with titanium mesh technique were found (p<0.002). Regarding bone resorption, there were no significant differences between the techniques (p=0.11). 60 implants were placed with an osseointegration rate of 91.49%. Five implants were lost during the osseointegration period (8%). Peri-implant bone resorption was measured with a mean of 1.27 mm. There was no significant difference between the vertical gain technique used and implant survival (p>0.385). Implant survival rates were higher in non-irradiated patients (p<0.017). All patients were rehabilitated with a fixed implant-supported prosthesis reporting a regular diet (80%), normal swallowing (85.7%) and excellent aesthetic results. Conclusions Multi-stage implementation of VSP, STL models and cutting guides, CAD/CAM technology, customized plates and in-house dynamic implant navigation for mandibular defects increases bone-to-bone contact, resolves vertical discrepancy and improves operative efficiency with reduced complication rates and minimal bone resorption. It provides accurate reconstruction that optimizes implant placement, thereby improving facial symmetry, aesthetics and function.
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Affiliation(s)
- Raúl Antúnez-Conde
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Ignacio Salmerón
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Alberto Díez-Montiel
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marc Agea
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dafne Gascón
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ángela Sada
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ignacio Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Tousidonis
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Santiago Ochandiano
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Gema Arenas
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Carlos Navarro Cuéllar
- Maxillofacial Surgery Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Shaikh MQ, Nath SD, Akilan AA, Khanjar S, Balla VK, Grant GT, Atre SV. Investigation of Patient-Specific Maxillofacial Implant Prototype Development by Metal Fused Filament Fabrication (MF 3) of Ti-6Al-4V. Dent J (Basel) 2021; 9:dj9100109. [PMID: 34677171 PMCID: PMC8534331 DOI: 10.3390/dj9100109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
Additive manufacturing (AM) and related digital technologies have enabled several advanced solutions in medicine and dentistry, in particular, the design and fabrication of patient-specific implants. In this study, the feasibility of metal fused filament fabrication (MF3) to manufacture patient-specific maxillofacial implants is investigated. Here, the design and fabrication of a maxillofacial implant prototype in Ti-6Al-4V using MF3 is reported for the first time. The cone-beam computed tomography (CBCT) image data of the patient’s oral anatomy was digitally processed to design a 3D CAD model of the hard tissue and fabricate a physical model by stereolithography (SLA). Using the digital and physical models, bone loss condition was analyzed, and a maxillofacial implant initial design was identified. Three-dimensional (3D) CAD models of the implant prototypes were designed that match the patient’s anatomy and dental implant requirement. In this preliminary stage, the CAD models of the prototypes were designed in a simplified form. MF3 printing of the prototypes was simulated to investigate potential deformation and residual stresses. The patient-specific implant prototypes were fabricated by MF3 printing followed by debinding and sintering using a support structure for the first time. MF3 printed green part dimensions fairly matched with simulation prediction. Sintered parts were characterized for surface integrity after cutting the support structures off. An overall 18 ± 2% shrinkage was observed in the sintered parts relative to the green parts. A relative density of 81 ± 4% indicated 19% total porosity including 11% open interconnected porosity in the sintered parts, which would favor bone healing and high osteointegration in the metallic implants. The surface roughness of Ra: 18 ± 5 µm and a Rockwell hardness of 6.5 ± 0.8 HRC were observed. The outcome of the work can be leveraged to further investigate the potential of MF3 to manufacture patient-specific custom implants out of Ti-6Al-4V.
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Affiliation(s)
- Mohammad Qasim Shaikh
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Subrata Deb Nath
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Arulselvan Arumugam Akilan
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Saleh Khanjar
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
| | - Vamsi Krishna Balla
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, 196 Raja S.C. Mullick Road, Kolkata 700 032, India
| | | | - Sundar Vedanarayanan Atre
- Materials Innovation Guild, University of Louisville, Louisville, KY 40208, USA; (M.Q.S.); (S.D.N.); (A.A.A.); (S.K.); (V.K.B.)
- Correspondence:
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Candido I, da Silva CV, Santos Garcia E, da Silva AF, Fernandes Poleti TF, Gialain I, Borba A. The usefulness of a facial digital biobank for ameloblastoma resection and fracture fixation - A case report. Ann Maxillofac Surg 2021; 11:325-328. [PMID: 35265508 PMCID: PMC8848715 DOI: 10.4103/ams.ams_73_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 11/04/2022] Open
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Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study. Clin Oral Investig 2020; 25:2905-2914. [PMID: 33025147 PMCID: PMC8060197 DOI: 10.1007/s00784-020-03607-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
Objectives The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. Materials and methods Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. Results One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. Conclusions Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. Clinical relevance A treatment algorithm for mandibular reconstructions on the basis of our results is presented. Electronic supplementary material The online version of this article (10.1007/s00784-020-03607-8) contains supplementary material, which is available to authorized users.
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Lu T, Shao Z, Liu B, Wu T. Recent advance in patient-specific 3D printing templates in mandibular reconstruction. J Mech Behav Biomed Mater 2020; 106:103725. [PMID: 32250956 DOI: 10.1016/j.jmbbm.2020.103725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/22/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
Abstract
Patient-specific 3D printing template is used in mandibular defect reconstruction with multiple deficiencies. During the operation, the template can accurately transfer the preoperative design, assisting surgeons to complete the surgery with high efficiency and accuracy. The template design has been continuously improved to obtain good application for miscellaneous classification and description. This review attempted to preliminarily analyse and summarise recent advancements in personalized 3D printing templates in mandibular reconstruction from the aspects of functional classification, existing problems, improved strategies and post-surgery evaluation by reviewing studies and through our combined clinical work and experience on hundreds of reconstruction surgeries.
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Affiliation(s)
- Tingwei Lu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Wuhan University, Hubei Province, China; Department of Oral and Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Zhe Shao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Wuhan University, Hubei Province, China
| | - Bing Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Wuhan University, Hubei Province, China.
| | - Tianfu Wu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, Wuhan University, Hubei Province, China.
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Jehn P, Spalthoff S, Korn P, Zeller AN, Dittmann J, Zimmerer R, Tavassol F, Gellrich NC. Patient-specific implant modification for alloplastic bridging of mandibular segmental defects in head and neck surgery. J Craniomaxillofac Surg 2020; 48:315-322. [DOI: 10.1016/j.jcms.2020.01.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/17/2020] [Accepted: 01/28/2020] [Indexed: 11/16/2022] Open
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Goormans F, Sun Y, Bila M, Schoenaers J, Geusens J, Lübbers HT, Coucke W, Politis C. Accuracy of computer-assisted mandibular reconstructions with free fibula flap: Results of a single-center series. Oral Oncol 2019; 97:69-75. [DOI: 10.1016/j.oraloncology.2019.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/30/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
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