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Block OM, Khromov T, Hoene G, Schliephake H, Brockmeyer P. In-house virtual surgical planning and guided mandibular reconstruction is less precise, but more economical and time-efficient than commercial procedures. Head Neck 2024; 46:871-883. [PMID: 38205891 DOI: 10.1002/hed.27642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND To compare an in-house and a commercially available surgical planning solution for mandibular reconstruction in terms of postoperative reconstruction accuracy and economic benefit. METHODS Twenty-nine consecutive patients with advanced oral squamous cell carcinoma (OSCC) requiring segmental mandibular reconstruction were enrolled. Fifteen patients underwent in-house surgical planning and 14 patients underwent a commercially available planning solution. A morphometric comparison of preoperative and postoperative computed tomography (CT) data sets and a cost-benefit comparison were performed. RESULTS Volumes of planned and reconstructed bone segments differed significantly for both in-house planning (p = 0.0431) and commercial planning (p < 0.0001). Significant differences in osteotomy angles were demonstrated for in-house planning (p = 0.0391). Commercial planning was superior to in-house planning for total mandibular deviation (p = 0.0217), intersegmental space volumes (p = 0.0035), and lengths (p = 0.0007). No significant difference was found between the two planning solutions in terms of intersegmental ossification and the incidence of wound healing disorders. In-house planning took less time than commercial planning (p < 0.0001). Component manufacturing costs (p < 0.0001) and total cumulative costs (p < 0.0001) were significantly lower for in-house planning. CONCLUSIONS In-house surgical planning is less accurate but has a cost advantage and could be performed in less time.
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Affiliation(s)
- Ole Moritz Block
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Tatjana Khromov
- Department of Clinical Chemistry, University Medical Center Goettingen, Goettingen, Germany
| | - Georg Hoene
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, Goettingen, Germany
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2
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Zheng X, Wang R, Brantnell A, Thor A. Adoption of additive manufacturing in oral and maxillofacial surgery among university and non-university hospitals in Sweden: findings from a nationwide survey. Oral Maxillofac Surg 2024; 28:337-343. [PMID: 36920654 PMCID: PMC10914879 DOI: 10.1007/s10006-023-01147-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/05/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Additive manufacturing (AM) is an innovative printing technology that can manufacture 3-dimensional solid objects by adding layers of material from model data. AM in oral and maxillofacial surgery (OMFS) provides several clinical applications such as surgical guides and implants. However, the adoption of AM in OMFS is not well covered. The purpose was to study the adoption of AM in OMFS in university and non-university hospitals in Sweden. Three research questions were addressed: What is the degree of using AM solutions in university and non-university hospitals?; What are AM solutions used?; How are the AM solutions accessed (production mode) in university hospitals and non-university hospitals? METHODS A survey was distributed to OMF surgeons in Sweden. The questionnaire consisted of 16 questions. Data were analyzed through descriptive and content analysis. RESULTS A total of 14 university and non-university hospitals were captured. All 14 hospitals have adopted AM technology and 11 of the hospitals adopted AM in OMFS. Orthognathic and trauma surgery are two major types of surgery that involve AM technology where material extrusion and vat polymerization are the two most used AM technologies in OMFS. The primary application of AM was in medical models and guides. CONCLUSION Majority of Swedish university hospitals and non-university hospitals have adopted AM in OMFS. The type of hospital (university or non-university hospital) has no impact on AM adoption. AM in OMFS in Sweden can be perceived to be a mature clinical application.
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Affiliation(s)
- Xuewei Zheng
- Department of Civil and Industrial Engineering, Industrial Engineering and Management, Ångströmlaboratoriet, Uppsala University, Lägerhyddsvägen 1, 752 37, Uppsala, Sweden
| | - Ruilin Wang
- Department of Civil and Industrial Engineering, Industrial Engineering and Management, Ångströmlaboratoriet, Uppsala University, Lägerhyddsvägen 1, 752 37, Uppsala, Sweden
| | - Anders Brantnell
- Department of Civil and Industrial Engineering, Industrial Engineering and Management, Ångströmlaboratoriet, Uppsala University, Lägerhyddsvägen 1, 752 37, Uppsala, Sweden.
- Department of Women's and Children's Health, Healthcare Sciences and E-Health, Uppsala University, MTC-Huset, Dag Hammarskjölds Väg 14B, 1 Tr, 752 37, Uppsala, Sweden.
| | - Andreas Thor
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Akademiska Sjukhuset, Ingång 79, 751 85, Uppsala, SV, Sweden
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3
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Godinho MR, Mestrinho LA. In-house three-dimensional printing for surgical planning: learning curve from a case series of temporomandibular joint and related disorders. Front Vet Sci 2024; 11:1347107. [PMID: 38379923 PMCID: PMC10876850 DOI: 10.3389/fvets.2024.1347107] [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: 11/30/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
Three-dimensional (3D) printed models can improve the understanding of the structural anatomic changes in cases of temporomandibular joint ankylosis and pseudoankylosis leading to closed jaw locking. Their use in pre-surgical planning and intraoperative guidance has been reported, contributing to the predictability and success of these surgery procedures, which can be quite complex, especially in small animal patients. The use and production of 3D tools and models remain challenging and are so far limited to institutions with high (economical and human) resources. This study aims to propose simplified workflows using open-source software to facilitate an in-house 3D printing process. To illustrate this, three cases of temporomandibular joint ankylosis and one of pseudoankylosis were reviewed, where in-house 3D printed models were used for client communication and surgical management. The 3D models were segmented from computed tomography and printed via stereolithography. They were used to support discussion with clients (n = 4), to allow surgeons to pre-surgical plan and practice (n = 4) and for intraoperative guidance during surgery (n = 2). Surgical cutting guides were produced in one case to improve precision and define more accurately osteotomy lines. It is essential to consider the initial time and financial investment required for establishing an in-house 3D printing production, particularly when there is a need to produce biocompatible tools, such as surgical cutting guides. However, efficient and streamlined workflows encourage the integration of this technology, by accelerating the printing process and reducing the steep learning curves, while open-source software enhances accessibility to these resources.
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Affiliation(s)
- Miguel R. Godinho
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Lisa A. Mestrinho
- Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Laboratório Associado para Ciência Animal e Veterinária (AL4AnimalS), Lisbon, Portugal
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4
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Isazadeh AR, Seikaly H, Westover L, Aalto D. Algorithmically designed flaps in tongue reconstruction: a feasibility analysis. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03062-w. [PMID: 38236478 DOI: 10.1007/s11548-024-03062-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
PURPOSE Despite the significance and complexity of tongue reconstruction surgery, a digital tool for flap design is currently lacking. This study investigates the effectiveness of employing inverse finite element method (IFEM) for meticulously designing the geometric characteristics of harvested tissue (free flap) for tongue reconstruction. METHODS In the case of an artificially simulated hemiglossectomy, IFEM algorithm was applied for algorithmic flap design. The method's effectiveness was evaluated by assessing flap deformation in a simplified virtual reconstruction, focusing on parameters such as stress, strain, and thickness. RESULTS The IFEM algorithm successfully generated an optimal flap design for the intended surgical removal. Analysis of the flap's overall surface area, deformation characteristics, and safety margins demonstrated the feasibility of the deformation. Notably, the stress and thickness assessments suggested that the flap's tension post-surgery would not adversely affect the mobility of the reconstructed tongue, suggesting a positive outcome for functional recovery. CONCLUSION The IFEM demonstrates significant potential as a tool for precise free flap design in tongue reconstruction surgeries. Its application could lead to improved surgical accuracy and better quality of life for patients undergoing such procedures.
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Affiliation(s)
- Amir Reza Isazadeh
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 6-129 Clinical Sciences Building, 11304 - 83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Hadi Seikaly
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Canada
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Lindsey Westover
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Canada
| | - Daniel Aalto
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 6-129 Clinical Sciences Building, 11304 - 83 Ave NW, Edmonton, AB, T6G 2G3, Canada.
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Canada.
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Zeller AN, Goetze E, Thiem DGE, Bartella AK, Seifert L, Beiglboeck FM, Kröplin J, Hoffmann J, Pabst A. A survey regarding the organizational aspects and quality systems of in-house 3D printing in oral and maxillofacial surgery in Germany. Oral Maxillofac Surg 2023; 27:661-673. [PMID: 35989406 DOI: 10.1007/s10006-022-01109-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/02/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The aim of the study was to get a cross-sectional overview of the current status of specific organizational procedures, quality control systems, and standard operating procedures for the use of three-dimensional (3D) printing to assist in-house workflow using additive manufacturing in oral and maxillofacial surgery (OMFS) in Germany. METHODS An online questionnaire including dynamic components containing 16-29 questions regarding specific organizational aspects, process workflows, quality controls, documentation, and the respective backgrounds in 3D printing was sent to OMF surgeons in university and non-university hospitals as well as private practices with and without inpatient treatment facilities. Participants were recruited from a former study population regarding 3D printing; all participants owned a 3D printer and were registered with the German Association of Oral and Maxillofacial Surgery. RESULTS Sixty-seven participants answered the questionnaires. Of those, 20 participants ran a 3D printer in-unit. Quality assurance measures were performed by 13 participants and underlying processes by 8 participants, respectively. Standard operating procedures regarding computer-aided design and manufacturing, post-processing, use, or storage of printed goods were non-existent in most printing units. Data segmentation as well as computer-aided design and manufacturing were conducted by a medical doctor in most cases (n = 19, n = 18, n = 8, respectively). Most participants (n = 8) stated that "medical device regulations did not have any influence yet, but an adaptation of the processes is planned for the future." CONCLUSION The findings demonstrated significant differences in 3D printing management in OMFS, especially concerning process workflows, quality control, and documentation. Considering the ever-increasing regulations for medical devices, there might be a necessity for standardized 3D printing recommendations and regulations in OMFS.
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Affiliation(s)
- Alexander-N Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Elisabeth Goetze
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstr. 11, 91054, Erlangen, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, University Hospital Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Lukas Seifert
- Department of Oral, Cranio Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60528, Frankfurt am Main, Germany
| | - Fabian M Beiglboeck
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Munster, Germany
- MAM Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestr. 16, 4123, Allschwil, Switzerland
| | - Juliane Kröplin
- Department of Oral and Maxillofacial Surgery, Helios Hospital Schwerin, Wismarsche Str. 393-397, 19049, Schwerin, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
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Hoene G, Moser N, Schminke B, Wiechens B, Leha A, Khromov T, Schliephake H, Brockmeyer P. Postoperative facial appearance of patients with extensive oral squamous cell carcinoma can be adequately preserved with in‑house virtually planned mandibular reconstruction. Mol Clin Oncol 2023; 19:97. [PMID: 37953859 PMCID: PMC10636699 DOI: 10.3892/mco.2023.2693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 11/14/2023] Open
Abstract
The present study aimed to assess the concordance of preoperative and postoperative hard and soft tissues in patients with advanced oral squamous cell carcinoma (OSCC) following virtual surgical planning (VSP) mandibular reconstruction. In the present study, a cohort of 32 patients with OSCC underwent in-house VSP, followed by guided mandibular reconstruction utilizing vascularized free tissue grafts sourced from the fibula or scapula. A morphometric analysis was conducted comparing preoperative and postoperative three-dimensional virtual models to evaluate discrepancies and identify potential risk factors associated with poor reconstruction outcomes. The outcome variables were the differences in root mean square (RMS) and mean surface distance (MSD) resulting from the application of an iterative closest point algorithm to the virtual data. The validity of soft tissue comparison data is limited due to its susceptibility to various confounding variables. The present study conducted a comprehensive re-evaluation of these variables. High tumor stage, positive N status and the use of adjuvant therapy contributed to more noticeable differences in preoperative and postoperative facial soft tissue appearance. The accuracy of postoperative bone reconstruction results was higher in patients who underwent neomandibular formation using a fibular graft compared with those who received a scapular graft. Preoperative and postoperative soft tissue analyses were conducted for comparison. The MSD showed a deviation of 3.2 mm (± 2.0 mm SD; range 1.3-9.5 mm), whereas the RMS was 5.3 (± 2.9 SD; range 2.1-14). In conclusion, in-house VSP and guided mandibular reconstructions can yield clinically accurate results, preserving patient appearance and offering the advantage of rapid feasibility.
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Affiliation(s)
- Georg Hoene
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Norman Moser
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Boris Schminke
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Bernhard Wiechens
- Department of Orthodontics, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Andreas Leha
- Institute of Medical Statistics, University Medical Center Goettingen, D-37073 Goettingen, Germany
| | - Tatjana Khromov
- Institute of Clinical Chemistry, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
| | - Phillipp Brockmeyer
- Department of Oral and Maxillofacial Surgery, University Medical Center Goettingen, D-37075 Goettingen, Germany
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7
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Gernandt S, Tomasella O, Scolozzi P, Fenelon M. Contribution of 3D printing for the surgical management of jaws cysts and benign tumors: A systematic review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101433. [PMID: 36914002 DOI: 10.1016/j.jormas.2023.101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is now a widely recognized surgical tool in oral and maxillofacial surgery. However, little is known about its benefits for the surgical management of benign maxillary and mandibular tumors and cysts. PURPOSE The objective of this systematic review was to assess the contribution of 3D printing in the management of benign jaw lesions. METHODS A systematic review, registered in PROSPERO, was conducted using PubMed and Scopus databases, up to December 2022, by following PRISMA guidelines. Studies reporting 3D printing applications for the surgical management of benign jaw lesions were considered. RESULTS This review included thirteen studies involving 74 patients. The principal use of 3D printing was to produce anatomical models, intraoperative surgical guides, or both, allowing for the successful removal of maxillary and mandibular lesions. The greatest reported benefits of printed models were the visualization of the lesion and its anatomical relationships to anticipate intraoperative risks. Surgical guides were designed as drilling locating guides or osteotomy cutting guides and contributed to decreasing operating time and improving the accuracy of the surgery. CONCLUSION Using 3D printing technologies to manage benign jaw lesions results in less invasive procedures by facilitating precise osteotomies, reducing operating times, and complications. More studies with higher levels of evidence are needed to confirm our results.
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Affiliation(s)
- Steven Gernandt
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Olivia Tomasella
- UFR des Sciences Odontologiques, Univ. Bordeaux, 33000 Bordeaux, France
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
| | - Mathilde Fenelon
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland; UFR des Sciences Odontologiques, Univ. Bordeaux, 33000 Bordeaux, France; Service de chirurgie orale, CHU de Bordeaux, France
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8
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Oleksy M, Dynarowicz K, Aebisher D. Rapid Prototyping Technologies: 3D Printing Applied in Medicine. Pharmaceutics 2023; 15:2169. [PMID: 37631383 PMCID: PMC10458921 DOI: 10.3390/pharmaceutics15082169] [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: 07/16/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Three-dimensional printing technology has been used for more than three decades in many industries, including the automotive and aerospace industries. So far, the use of this technology in medicine has been limited only to 3D printing of anatomical models for educational and training purposes, which is due to the insufficient functional properties of the materials used in the process. Only recent advances in the development of innovative materials have resulted in the flourishing of the use of 3D printing in medicine and pharmacy. Currently, additive manufacturing technology is widely used in clinical fields. Rapid development can be observed in the design of implants and prostheses, the creation of biomedical models tailored to the needs of the patient and the bioprinting of tissues and living scaffolds for regenerative medicine. The purpose of this review is to characterize the most popular 3D printing techniques.
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Affiliation(s)
- Małgorzata Oleksy
- Students English Division Science Club, Medical College of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Klaudia Dynarowicz
- Center for Innovative Research in Medical and Natural Sciences, Medical College of the University of Rzeszów, University of Rzeszów, 35-310 Rzeszów, Poland;
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, University of Rzeszów, 35-959 Rzeszów, Poland
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9
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Fuchs A, Bartolf-Kopp M, Böhm H, Straub A, Kübler AC, Linz C, Gbureck U. Composite grafts made of polycaprolactone fiber mats and oil-based calcium phosphate cement pastes for the reconstruction of cranial and maxillofacial defects. Clin Oral Investig 2023; 27:3199-3209. [PMID: 36864278 PMCID: PMC10264493 DOI: 10.1007/s00784-023-04932-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/23/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES Synthetic bone substitutes which can be adapted preoperatively and patient specific may be helpful in various bony defects in the field of oral- and maxillofacial surgery. For this purpose, composite grafts made of self-setting and oil-based calcium phosphate cement (CPC) pastes, which were reinforced with 3D-printed polycaprolactone (PCL) fiber mats were manufactured. MATERIALS AND METHODS Bone defect models were acquired using patient data from real defect situations of patients from our clinic. Using a mirror imaging technique, templates of the defect situation were fabricated via a commercially available 3D-printing system. The composite grafts were assembled layer by layer, aligned on top of these templates and fitted into the defect situation. Besides, PCL-reinforced CPC samples were evaluated regarding their structural and mechanical properties via X-ray diffraction (XRD), infrared (IR) spectroscopy, scanning electron microscopy (SEM), and 3-point-bending testing. RESULTS The process sequence including data acquisition, template fabrication, and manufacturing of patient specific implants proved to be accurate and uncomplicated. The individual implants consisting mainly of hydroxyapatite and tetracalcium phosphate displayed good processability and a high precision of fit. The mechanical properties of the CPC cements in terms of maximum force and stress load to material fatigue were not negatively affected by the PCL fiber reinforcement, whereas clinical handling properties increased remarkably. CONCLUSION PCL fiber reinforcement of CPC cements enables the production of very freely modelable three-dimensional implants with adequate chemical and mechanical properties for bone replacement applications. CLINICAL RELEVANCE The complex bone morphology in the region of the facial skull often poses a great challenge for a sufficient reconstruction of bony defects. A full-fledged bone replacement here often requires the replication of filigree three-dimensional structures partly without support from the surrounding tissue. With regard to this problem, the combination of smooth 3D-printed fiber mats and oil-based CPC pastes represents a promising method for fabricating patient specific degradable implants for the treatment of various craniofacial bone defects.
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Affiliation(s)
- Andreas Fuchs
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - Michael Bartolf-Kopp
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Hartmut Böhm
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Anton Straub
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Alexander C Kübler
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Christian Linz
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
- Department of Oral and Maxillofacial Plastic Surgery, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Uwe Gbureck
- Department for Functional Materials in Medicine and Dentistry, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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Wang X, Guo Q, He Y, Geng X, Wang C, Li Y, Li Z, Wang C, Qiu D, Tian H. A pH-neutral bioactive glass coated 3D-printed porous Ti6Al4V scaffold with enhanced osseointegration. J Mater Chem B 2023; 11:1203-1212. [PMID: 36515141 DOI: 10.1039/d2tb02129c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Osseointegration is vital for the success of non-degradable implants like those made of titanium alloys. In order to promote osseointegration, implants are made porous, providing space for bone ingrowth. Despite extensive optimization of the pore geometry and porosity, bone ingrowth into implants is still marginal; further modification to promote bone ingrowth as well as osseointegration becomes paramount. In this study, a pH neutral bioactive glass with the composition of 10.8% P2O5-54.2% SiO2-35% CaO (mol%; hereinafter referred to as PSC) was successfully coated on 3D-printed porous Ti6Al4V scaffolds using an in situ sol-gel method. This PSC coating is strongly bonded to the substrate and quickly induces the formation of hydroxyapatite on the scaffold surface upon contact with body fluid. In vitro, the PSC-coated Ti6Al4V scaffolds showed superior biocompatibility, cell proliferation promotion, cell adhesion, osteogenic differentiation and mineralization compared to their bare counterparts, implying better osseointegration. In vivo experiments confirmed this expectation; after being implanted, the coated scaffolds had more bone ingrowth and osseointegration, and consequently, higher push-out strength was achieved, proving the validity of the proposed concept in this study. In conclusion, PSC coating on 3D-printed porous Ti6Al4V scaffolds can improve osteogenesis, bone ingrowth, and osseointegration. Together with the versatility of this in situ sol-gel coating method, titanium alloy implants with better biological performances may be developed for immediate clinical applications.
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Affiliation(s)
- Xinguang Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Qirui Guo
- Beijing National Laboratory for Molecular Sciences, CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yizhen He
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Xiao Geng
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Cheng Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Yang Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Zijian Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
| | - Caimei Wang
- Beijing 3D Printing Orthopedic Application Engineering Technology Research Center, Beijing, 102200, China
| | - Dong Qiu
- Beijing National Laboratory for Molecular Sciences, CAS Research/Education Center for Excellence in Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hua Tian
- Department of Orthopedics, Peking University Third Hospital, Beijing, 100191, China. .,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, 100191, China
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Dobroś K, Hajto-Bryk J, Zarzecka J. Application of 3D-printed teeth models in teaching dentistry students: A scoping review. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:126-134. [PMID: 35108452 DOI: 10.1111/eje.12784] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 12/29/2021] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Both regular teaching of dentistry students and various training schemes for dentists primarily make use of the series teeth models, resin blocks or extracted teeth, whereas the 3D teeth models may well offer an alternative in this respect. METHODS PubMed and EMBASE were searched in September 2020. Eligibility of the studies was determined on whether they had made use of the 3D-printed teeth models in both pre- and post-graduate education in dentistry. RESULTS The final review embraced 15 studies. There were 659 (89.54%) student participants, and 77 (10.46%) dentists involved in those studies. Five studies addressed the prosthetic and surgical procedures, two-endodontics, one-paediatric dentistry and one-trauma management. The 3D-printed models were also used in the study focused on enhancing the students' manual dexterity, whilst making use of the PhantHome tool. DISCUSSION The 3D-printed teeth models developed for teaching purposes are used in various areas of dentistry. Their overall usefulness in acquiring the necessary hands-on skills for clinical work was acknowledged in all the studies under review, regardless of a specific procedure at issue. The 3D models effectively eliminate the hazard of cross-infection. Overall effectiveness of the soft tissue reproduction appears to be their weakest point indicated to date, especially in the surgical models. CONCLUSIONS The 3D-printed teeth models provide an alternative to the extracted ones, and the series teeth models in regular teaching practice. Participants of the studies under review thoroughly recommend introducing 3D models into any hands-on practice.
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Affiliation(s)
- Katarzyna Dobroś
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College
| | - Justyna Hajto-Bryk
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College
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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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Thatcher GP, Soukup JW. Virtual Surgical Planning and 3D Printing in Veterinary Dentistry and Oromaxillofacial Surgery. Vet Clin North Am Small Anim Pract 2021; 52:221-234. [PMID: 34838251 DOI: 10.1016/j.cvsm.2021.09.009] [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: 10/19/2022]
Abstract
Virtual surgical planning and three-dimensional (3D) printing are preoperative processes requiring the acquisition of high-quality imaging data. A surgical treatment plan is created and rehearsed virtually as the operator manipulates the 3D images of the patient within the software. When the operator is satisfied with the plan, including anticipated osteotomies, tumor excision margins, and reconstruction options, physical 3D prints can be produced. This article introduces the reader to the basic concepts involved in virtual surgical planning and 3D printing as well as their implementation in veterinary oromaxillofacial surgery.
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Affiliation(s)
- Graham P Thatcher
- University of Wisconsin-Madison, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA
| | - Jason W Soukup
- University of Wisconsin-Madison, School of Veterinary Medicine, 2015 Linden Drive, Madison, WI 53706, USA.
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Turek P, Pakla P, Budzik G, Lewandowski B, Przeszłowski Ł, Dziubek T, Wolski S, Frańczak J. Procedure Increasing the Accuracy of Modelling and the Manufacturing of Surgical Templates with the Use of 3D Printing Techniques, Applied in Planning the Procedures of Reconstruction of the Mandible. J Clin Med 2021; 10:jcm10235525. [PMID: 34884227 PMCID: PMC8658254 DOI: 10.3390/jcm10235525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
The application of anatomical models and surgical templates in maxillofacial surgery allows, among other benefits, the increase of precision and the shortening of the operation time. Insufficiently precise anastomosis of the broken parts of the mandible may adversely affect the functioning of this organ. Applying the modern mechanical engineering methods, including computer-aided design methods (CAD), reverse engineering (RE), and rapid prototyping (RP), a procedure used to shorten the data processing time and increase the accuracy of modelling anatomical structures and the surgical templates with the use of 3D printing techniques was developed. The basis for developing and testing this procedure was the medical imaging data DICOM of patients treated at the Maxillofacial Surgery Clinic of the Fryderyk Chopin Provincial Clinical Hospital in Rzeszów. The patients were operated on because of malignant tumours of the floor of the oral cavity and the necrosis of the mandibular corpus, requiring an extensive resection of the soft tissues and resection of the mandible. Familiarity with and the implementation of the developed procedure allowed doctors to plan the operation precisely and prepare the surgical templates and tools in terms of the expected accuracy of the procedures. The models obtained based on this procedure shortened the operation time and increased the accuracy of performance, which accelerated the patient’s rehabilitation in the further course of events.
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Affiliation(s)
- Paweł Turek
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, 35-959 Rzeszów, Poland; (G.B.); (Ł.P.); (T.D.)
- Correspondence:
| | - Paweł Pakla
- Department of Maxillofacial Surgery, Fryderyk Chopin Clinical Voivodeship Hospital No.1 in Rzeszów, 35-055 Rzeszów, Poland; (P.P.); (B.L.); (J.F.)
| | - Grzegorz Budzik
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, 35-959 Rzeszów, Poland; (G.B.); (Ł.P.); (T.D.)
| | - Bogumił Lewandowski
- Department of Maxillofacial Surgery, Fryderyk Chopin Clinical Voivodeship Hospital No.1 in Rzeszów, 35-055 Rzeszów, Poland; (P.P.); (B.L.); (J.F.)
- Collegium Medicum, University of Rzeszów, 35-315 Rzeszów, Poland
| | - Łukasz Przeszłowski
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, 35-959 Rzeszów, Poland; (G.B.); (Ł.P.); (T.D.)
| | - Tomasz Dziubek
- Faculty of Mechanical Engineering and Aeronautics, Rzeszów University of Technology, 35-959 Rzeszów, Poland; (G.B.); (Ł.P.); (T.D.)
| | - Sławomir Wolski
- Faculty of Mathematics and Applied Physics, Rzeszów University of Technology, 35-959 Rzeszów, Poland;
| | - Jan Frańczak
- Department of Maxillofacial Surgery, Fryderyk Chopin Clinical Voivodeship Hospital No.1 in Rzeszów, 35-055 Rzeszów, Poland; (P.P.); (B.L.); (J.F.)
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Application of Three-Dimensional Printed Customized Surgical Plates for Mandibular Reconstruction: Report of Consecutive Cases and Long-Term Postoperative Evaluation. J Craniofac Surg 2021; 32:e663-e667. [PMID: 34705369 DOI: 10.1097/scs.0000000000007835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT This study aims to evaluate the use of customized surgical plates in patients with mandibular defects concerning postoperative aesthetics and functional outcomes during the 2-year follow-up. Preoperative virtual surgical plans and patient-specific three-dimensional printed plates were tailored for consecutive patients. Preoperative preparation, surgical produces, postoperative aesthetics, and functional outcomes were described in detail. The average follow-up period was over 2 years. In the presented clinical cases, aesthetic and functional outcomes were reported to be satisfactory.
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Jiang W, Mei H, Zhao S. Applications of 3D Bio-Printing in Tissue Engineering and Biomedicine. J Biomed Nanotechnol 2021; 17:989-1006. [PMID: 34167615 DOI: 10.1166/jbn.2021.3078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In recent years, 3D bio-printing technology has developed rapidly and become an advanced bio-manufacturing technology. At present, 3D bio-printing technology has been explored in the fields of tissue engineering, drug testing and screening, regenerative medicine and clinical disease research and has achieved many research results. Among them, the application of 3D bio-printing technology in tissue engineering has been widely concerned by researchers, and it contributing many breakthroughs in the preparation of tissue engineering scaffolds. In the future, it is possible to print fully functional tissues or organs by using 3D bio-printing technology which exhibiting great potential development prospects in th applications of organ transplantation and human body implants. It is expected to solve thebiomedical problems of organ shortage and repair of damaged tissues and organs. Besides,3Dbio-printing technology will benefit human beings in more fields. Therefore, this paper reviews the current applications, research progresses and limitations of 3D bio-printing technology in biomedical and life sciences, and discusses the main printing strategies of 3D bio-printing technology. And, the research emphases, possible development trends and suggestions of the application of 3D bio-printing are summarized to provide references for the application research of 3D bio-printing.
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Affiliation(s)
- Wei Jiang
- College of Chemical Engineering, Huaqiao University, 668 Jimei Blvd., Xiamen, Fujian, 361021, China
| | - Haiying Mei
- College of Chemical Engineering, Huaqiao University, 668 Jimei Blvd., Xiamen, Fujian, 361021, China
| | - Shuyan Zhao
- College of Chemical Engineering, Huaqiao University, 668 Jimei Blvd., Xiamen, Fujian, 361021, China
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Charbonnier B, Hadida M, Marchat D. Additive manufacturing pertaining to bone: Hopes, reality and future challenges for clinical applications. Acta Biomater 2021; 121:1-28. [PMID: 33271354 DOI: 10.1016/j.actbio.2020.11.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
For the past 20 years, the democratization of additive manufacturing (AM) technologies has made many of us dream of: low cost, waste-free, and on-demand production of functional parts; fully customized tools; designs limited by imagination only, etc. As every patient is unique, the potential of AM for the medical field is thought to be considerable: AM would allow the division of dedicated patient-specific healthcare solutions entirely adapted to the patients' clinical needs. Pertinently, this review offers an extensive overview of bone-related clinical applications of AM and ongoing research trends, from 3D anatomical models for patient and student education to ephemeral structures supporting and promoting bone regeneration. Today, AM has undoubtably improved patient care and should facilitate many more improvements in the near future. However, despite extensive research, AM-based strategies for bone regeneration remain the only bone-related field without compelling clinical proof of concept to date. This may be due to a lack of understanding of the biological mechanisms guiding and promoting bone formation and due to the traditional top-down strategies devised to solve clinical issues. Indeed, the integrated holistic approach recommended for the design of regenerative systems (i.e., fixation systems and scaffolds) has remained at the conceptual state. Challenged by these issues, a slower but incremental research dynamic has occurred for the last few years, and recent progress suggests notable improvement in the years to come, with in view the development of safe, robust and standardized patient-specific clinical solutions for the regeneration of large bone defects.
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3D printing in pharmaceuticals: An emerging technology full of challenges. ANNALES PHARMACEUTIQUES FRANÇAISES 2020; 79:107-118. [PMID: 32853575 DOI: 10.1016/j.pharma.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022]
Abstract
Although in its infancy, when compared with the other sectors, year 2005 marked the rapid evolution of 3 Dimensional printing (3DP) technologies in pharma sector with a huge potential in the dosage form designing and personalisation of the medication. 3DP is an innovative and highly promising way for the instant manufacturing in contrast with the tailored made conventional manufacturing. Various 3DP technologies are categorized into the various areas on the basis of the type of material used, deposition techniques and the solidification/fusion techniques. 3DP technologies have multiple pharmaceutical applications including formulation of the precise and unique dosage forms, medical research, personalization of medicine, tissues engineering and surgical application. In the present article, we have accentuated the comparative merits and demerits of various 3DP technologies used in the pharmaceutical sector. An insight in to the challenges, apropos availability and the choice of the excipients, as well as the printer, regulatory and safety concern of the product is provided.
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Serrano C, Fontenay S, van den Brink H, Pineau J, Prognon P, Martelli N. Evaluation of 3D printing costs in surgery: a systematic review. Int J Technol Assess Health Care 2020; 36:1-7. [PMID: 32489157 DOI: 10.1017/s0266462320000331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The use of three-dimensional (3D) printing in surgery is expanding and there is a focus on comprehensively evaluating the clinical impact of this technology. However, although additional costs are one of the main limitations to its use, little is known about its economic impact. The purpose of this systematic review is to identify the costs associated with its use and highlight the first quantitative data available. METHODS A systematic literature review was conducted in the PubMed and Embase databases and in the National Health Service Economic Evaluation Database (NHS EED) at the University of York. Studies that reported an assessment of the costs associated with the use of 3D printing for surgical application and published between 2009 and 2019, in English or French, were included. RESULTS Nine studies were included in our review. Nine types of costs were identified, the three main ones being printing material costs (n = 6), staff costs (n = 3), and operating room costs (n = 3). The printing cost ranged from less than U.S. dollars (USD) 1 to USD 146 (in USD 2019 values) depending on the criteria used to calculate this cost. Three studies evaluated the potential savings generated by the use of 3D printing technology in surgery, based on operating time reduction. CONCLUSION This literature review highlights the lack of reliable economic data on 3D printing technology. Nevertheless, this review makes it possible to identify expenditures or items that should be considered in order to carry out more robust studies.
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Affiliation(s)
- Carole Serrano
- University Paris-Saclay, GRADES, Faculty of Pharmacy, 5 rue Jean-Baptiste Clément, 92290Châtenay-Malabry, France
| | - Sarah Fontenay
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015Paris, France
| | - Hélène van den Brink
- University Paris-Saclay, GRADES, Faculty of Pharmacy, 5 rue Jean-Baptiste Clément, 92290Châtenay-Malabry, France
| | - Judith Pineau
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015Paris, France
| | - Patrice Prognon
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015Paris, France
| | - Nicolas Martelli
- University Paris-Saclay, GRADES, Faculty of Pharmacy, 5 rue Jean-Baptiste Clément, 92290Châtenay-Malabry, France
- Pharmacy Department, Georges Pompidou European Hospital, AP-HP, 20 rue Leblanc, 75015Paris, France
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