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Tanveer W, Ridwan-Pramana A, Molinero-Mourelle P, Forouzanfar T. Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Auricular Prostheses-Systematic Review. J Clin Med 2023; 12:5950. [PMID: 37762891 PMCID: PMC10532239 DOI: 10.3390/jcm12185950] [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: 08/03/2023] [Revised: 08/26/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This systematic review was aimed at gathering the clinical and technical applications of CAD/CAM technology for craniofacial implant placement and processing of auricular prostheses based on clinical cases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic data search was performed. Human clinical studies utilizing digital planning, designing, and printing systems for craniofacial implant placement and processing of auricular prostheses for prosthetic rehabilitation of auricular defects were included. Following a data search, a total of 36 clinical human studies were included, which were digitally planned and executed through various virtual software to rehabilitate auricular defects. Preoperative data were collected mainly through computed tomography scans (CT scans) (55 cases); meanwhile, the most common laser scanners were the 3dMDface System (3dMD LLC, Atlanta, Georgia, USA) (6 cases) and the 3 Shape scanner (3 Shape, Copenhagen, Denmark) (6 cases). The most common digital design software are Mimics Software (Mimics Innovation Suite, Materialize, Leuven, Belgium) (18 cases), Freeform software (Freeform, NC, USA) (13 cases), and 3 Shape software (3 Shape, Copenhagen, Denmark) (12 cases). Surgical templates were designed and utilized in 35 cases to place 88 craniofacial implants in auricular defect areas. The most common craniofacial implants were Vistafix craniofacial implants (Entific Medical Systems, Goteborg, Sweden) in 22 cases. A surgical navigation system was used to place 20 craniofacial implants in the mastoid bone. Digital applications of CAD/CAM technology include, but are not limited to, study models, mirrored replicas of intact ears, molds, retentive attachments, customized implants, substructures, and silicone prostheses. The included studies demonstrated a predictable clinical outcome, reduced the patient's visits, and completed the prosthetic rehabilitation in reasonable time and at reasonable cost. However, equipment costs and trained technical staff were highlighted as possible limitations to the use of CAD/CAM systems.
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Affiliation(s)
- Waqas Tanveer
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Angela Ridwan-Pramana
- Center for Special Care in Dentistry, Department of Maxillofacial Prosthodontics, Stichting Bijzondere Tandheelkunde, 1081 LA Amsterdam, The Netherlands;
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, CHE 3012 Bern, Switzerland;
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
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Cruz RLJ, Ross MT, Nightingale R, Pickering E, Allenby MC, Woodruff MA, Powell SK. An automated parametric ear model to improve frugal 3D scanning methods for the advanced manufacturing of high-quality prosthetic ears. Comput Biol Med 2023; 162:107033. [PMID: 37271110 DOI: 10.1016/j.compbiomed.2023.107033] [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: 12/13/2022] [Revised: 04/17/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
Ear prostheses are commonly used for restoring aesthetics to those suffering missing or malformed external ears. Traditional fabrication of these prostheses is labour intensive and requires expert skill from a prosthetist. Advanced manufacturing including 3D scanning, modelling and 3D printing has the potential to improve this process, although more work is required before it is ready for routine clinical use. In this paper, we introduce a parametric modelling technique capable of producing high quality 3D models of the human ear from low-fidelity, frugal, patient scans; significantly reducing time, complexity and cost. Our ear model can be tuned to fit the frugal low-fidelity 3D scan through; (a) manual tuning, or (b) our automated particle filter approach. This potentially enables low-cost smartphone photogrammetry-based 3D scanning for high quality personalised 3D printed ear prosthesis. In comparison to standard photogrammetry, our parametric model improves completeness, from (81 ± 5)% to (87 ± 4)%, with only a modest reduction in accuracy, with root mean square error (RMSE) increasing from (1.0 ± 0.2) mm to (1.5 ± 0.2) mm (relative to metrology rated reference 3D scans, n = 14). Despite this reduction in the RMS accuracy, our parametric model improves the overall quality, realism, and smoothness. Our automated particle filter method differs only modestly compared to manual adjustments. Overall, our parametric ear model can significantly improve quality, smoothness and completeness of 3D models produced from 30-photograph photogrammetry. This enables frugal high-quality 3D ear models to be produced for use in the advanced manufacturing of ear prostheses.
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Affiliation(s)
- Rena L J Cruz
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Maureen T Ross
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Renee Nightingale
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Edmund Pickering
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Mark C Allenby
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Maria A Woodruff
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia
| | - Sean K Powell
- QUT Centre for Biomedical Technologies, School of Mechanical, Medical, and Process Engineering, Faculty of Engineering, Queensland University of Technology (QUT), Brisbane, Qld, Australia.
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Bansod AV, Pisulkar SG, Dahihandekar C, Beri A. Rapid Prototyping in Maxillofacial Rehabilitation: A Review of Literature. Cureus 2022; 14:e28969. [PMID: 36237787 PMCID: PMC9548214 DOI: 10.7759/cureus.28969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/09/2022] [Indexed: 11/05/2022] Open
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Omari A, Frendø M, Sørensen MS, Andersen SAW, Frithioff A. The cutting edge of customized surgery: 3D-printed models for patient-specific interventions in otology and auricular management-a systematic review. Eur Arch Otorhinolaryngol 2022; 279:3269-3288. [PMID: 35166908 DOI: 10.1007/s00405-022-07291-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE 3D-printing (three-dimensional printing) is an emerging technology with promising applications for patient-specific interventions. Nonetheless, knowledge on the clinical applicability of 3D-printing in otology and research on its use remains scattered. Understanding these new treatment options is a prerequisite for clinical implementation, which could improve patient outcomes. This review aims to explore current applications of 3D-printed patient-specific otologic interventions, including state of the evidence, strengths, limitations, and future possibilities. METHODS Following the PRISMA statement, relevant studies were identified through Pubmed, EMBASE, the Cochrane Library, and Web of Science. Data on the manufacturing process and interventions were extracted by two reviewers. Study quality was assessed using Joanna Briggs Institute's critical appraisal tools. RESULTS Screening yielded 590 studies; 63 were found eligible and included for analysis. 3D-printed models were used as guides, templates, implants, and devices. Outer ear interventions comprised 73% of the studies. Overall, optimistic sentiments on 3D-printed models were reported, including increased surgical precision/confidence, faster manufacturing/operation time, and reduced costs/complications. Nevertheless, study quality was low as most studies failed to use relevant objective outcomes, compare new interventions with conventional treatment, and sufficiently describe manufacturing. CONCLUSION Several clinical interventions using patient-specific 3D-printing in otology are considered promising. However, it remains unclear whether these interventions actually improve patient outcomes due to lack of comparison with conventional methods and low levels of evidence. Further, the reproducibility of the 3D-printed interventions is compromised by insufficient reporting. Future efforts should focus on objective, comparative outcomes evaluated in large-scale studies.
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Affiliation(s)
- Adam Omari
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen Hearing and Balance Center, Copenhagen, Denmark.
| | - Martin Frendø
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen Hearing and Balance Center, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Region H, Copenhagen, Denmark
| | - Mads Sølvsten Sørensen
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen Hearing and Balance Center, Copenhagen, Denmark
| | - Steven Arild Wuyts Andersen
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen Hearing and Balance Center, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Region H, Copenhagen, Denmark
| | - Andreas Frithioff
- Department of Otorhinolaryngology-Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen Hearing and Balance Center, Copenhagen, Denmark
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, Region H, Copenhagen, Denmark
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Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11030973] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories.
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Qureshi UA, Calaguas S, Frank E, Inman J. Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery. Facial Plast Surg 2020; 36:760-767. [PMID: 33368133 DOI: 10.1055/s-0040-1721116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The field of facial plastic and reconstructive surgery is privy to a myriad of technological advancements. As innovation in areas such as imaging, computer applications, and biomaterials progresses at breakneck speed, the potential for clinical application is endless. This review of recent progress in the implementation of new technologies in facial plastic surgery highlights some of the most innovative and impactful developments in the past few years of literature. Patient-specific surgical modeling has become the gold standard for oncologic and posttraumatic reconstructive surgery, with demonstrated improvements in operative times, restoration of anatomical structure, and patient satisfaction. Similarly, reductions in revision rates with improvements in learner technical proficiency have been noted with the use of patient-specific models in free flap reconstruction. In the cosmetic realm, simulation-based rhinoplasty implants have drastically reduced operative times while concurrently raising patient postoperative ratings of cosmetic appearance. Intraoperative imaging has also seen recent expansion in its adoption driven largely by reports of eradication of postoperative imaging and secondary-often complicated-revision reconstructions. A burgeoning area likely to deliver many advances in years to come is the integration of bioprinting into reconstructive surgery. Although yet to clearly make the translational leap, the implications of easily generatable induced pluripotent stem cells in replacing autologous, cadaveric, or synthetic tissues in surgical reconstruction are remarkable.
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Affiliation(s)
| | - Shannon Calaguas
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Ethan Frank
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Jared Inman
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
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Farook TH, Barman A, Abdullah JY, Jamayet NB. Optimization of Prosthodontic Computer-Aided Designed Models: A Virtual Evaluation of Mesh Quality Reduction Using Open Source Software. J Prosthodont 2020; 30:420-429. [PMID: 33200429 DOI: 10.1111/jopr.13286] [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] [Accepted: 11/11/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Mesh optimization reduces the texture quality of 3D models in order to reduce storage file size and computational load on a personal computer. This study aims to explore mesh optimization using open source (free) software in the context of prosthodontic application. MATERIALS AND METHODS An auricular prosthesis, a complete denture, and anterior and posterior crowns were constructed using conventional methods and laser scanned to create computerized 3D meshes. The meshes were optimized independently by four computer-aided design software (Meshmixer, Meshlab, Blender, and SculptGL) to 100%, 90%, 75%, 50%, and 25% levels of original file size. Upon optimization, the following parameters were virtually evaluated and compared; mesh vertices, file size, mesh surface area (SA), mesh volume (V), interpoint discrepancies (geometric similarity based on virtual point overlapping), and spatial similarity (volumetric similarity based on shape overlapping). The influence of software and optimization on surface area and volume of each prosthesis was evaluated independently using multiple linear regression. RESULTS There were clear observable differences in vertices, file size, surface area, and volume. The choice of software significantly influenced the overall virtual parameters of auricular prosthesis [SA: F(4,15) = 12.93, R2 = 0.67, p < 0.001. V: F(4,15) = 9.33, R2 = 0.64, p < 0.001] and complete denture [SA: F(4,15) = 10.81, R2 = 0.67, p < 0.001. V: F(4,15) = 3.50, R2 = 0.34, p = 0.030] across optimization levels. Interpoint discrepancies were however limited to <0.1mm and volumetric similarity was >97%. CONCLUSION Open-source mesh optimization of smaller dental prostheses in this study produced minimal loss of geometric and volumetric details. SculptGL models were most influenced by the amount of optimization performed.
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Affiliation(s)
- Taseef Hasan Farook
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kubang Kerian, Kelantan, Kota Bharu 16150, Malaysia
| | - Aparna Barman
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kubang Kerian, Kelantan, Kota Bharu 16150, Malaysia
| | - Johari Yap Abdullah
- Craniofacial Imaging and Additive Manufacturing Laboratory, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kubang Kerian, Kelantan, Kota Bharu 16150, Malaysia
| | - Nafij Bin Jamayet
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kubang Kerian, Kelantan, Kota Bharu 16150, Malaysia.,Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Jalan Jalil Perkasa-19, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
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Matsuo M, Mine Y, Kawahara K, Murayama T. Accuracy Evaluation of a Three-Dimensional Model Generated from Patient-Specific Monocular Video Data for Maxillofacial Prosthetic Rehabilitation: A Pilot Study. J Prosthodont 2020; 29:712-717. [PMID: 32583571 DOI: 10.1111/jopr.13219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate if the combination of a monoscopic photogrammetry technique and smartphone-recorded monocular video data could be appropriately applied to maxillofacial prosthesis fabrication. MATERIALS AND METHODS Smartphone video and laser scanning data were recorded for five healthy volunteers (24.1 ± 0.7 years). Three-dimensional (3D) facial models were generated using photogrammetry software and a laser scanner. Smartphone-recorded video data were used to generate a photogrammetric 3D model. The videos were recorded at two resolutions: 1080 × 1920 (high resolution) and 720 × 1280 pixels (low resolution). The lengths of five nasal component parts (nose height, nasal dorsum length, nasal column length, nasal ala length, and nose breadth) were compared in the photogrammetric 3D models (as the test model) and the laser scanned 3D models (as the validation model) using reverse engineering software. RESULTS There was a significant difference in the nasal dorsum length between the test model and the validation model (high resolution; 95% confidence interval, 2.05-5.07, Low resolution; confidence interval, 2.19-5.69). In contrast to the nasal dorsum length, there were no significant differences in nose height, nose breadth, nasal ala length, and nasal column length. CONCLUSION Using smartphone-recorded video data and a photogrammetry technique may be a promising technique to apply in the maxillofacial prosthetic rehabilitation workflow.
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Affiliation(s)
- Moe Matsuo
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuichi Mine
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Translational Research Center, Hiroshima University, Hiroshima, Japan
| | - Kazuko Kawahara
- Department of Oral Biology & Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Murayama
- Department of Medical System Engineering, Division of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Cruz RLJ, Ross MT, Skewes J, Allenby MC, Powell SK, Woodruff MA. An advanced prosthetic manufacturing framework for economic personalised ear prostheses. Sci Rep 2020; 10:11453. [PMID: 32651436 PMCID: PMC7351946 DOI: 10.1038/s41598-020-67945-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/07/2020] [Indexed: 12/02/2022] Open
Abstract
Craniofacial prostheses are commonly used to restore aesthetics for those suffering from malformed, damaged, or missing tissue. Traditional fabrication is costly, uncomfortable for the patient, and laborious; involving several hours of hand-crafting by a prosthetist, with the results highly dependent on their skill level. In this paper, we present an advanced manufacturing framework employing three-dimensional scanning, computer-aided design, and computer-aided manufacturing to efficiently fabricate patient-specific ear prostheses. Three-dimensional scans were taken of ears of six participants using a structured light scanner. These were processed using software to model the prostheses and 3-part negative moulds, which were fabricated on a low-cost desktop 3D printer, and cast with silicone to produce ear prostheses. The average cost was approximately $3 for consumables and $116 for 2 h of labour. An injection method with smoothed 3D printed ABS moulds was also developed at a cost of approximately $155 for consumables and labour. This contrasts with traditional hand-crafted prostheses which range from $2,000 to $7,000 and take around 14 to 15 h of labour. This advanced manufacturing framework provides potential for non-invasive, low cost, and high-accuracy alternative to current techniques, is easily translatable to other prostheses, and has potential for further cost reduction.
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Affiliation(s)
- Rena L J Cruz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Maureen T Ross
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jacob Skewes
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mark C Allenby
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sean K Powell
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Maria A Woodruff
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Cruz RLJ, Ross MT, Powell SK, Woodruff MA. Advancements in Soft-Tissue Prosthetics Part A: The Art of Imitating Life. Front Bioeng Biotechnol 2020; 8:121. [PMID: 32300585 PMCID: PMC7145402 DOI: 10.3389/fbioe.2020.00121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/07/2020] [Indexed: 11/23/2022] Open
Abstract
Physical disfigurement due to congenital defects, trauma, or cancer causes considerable distress and physical impairment for millions of people worldwide; impacting their economic, psychological and social wellbeing. Since 3000 B.C., prosthetic devices have been used to address these issues by restoring both aesthetics and utility to those with disfigurement. Internationally, academic and industry researchers are constantly developing new materials and manufacturing techniques to provide higher quality and lower cost prostheses to those people who need them. New advanced technologies including 3D imaging, modeling, and printing are revolutionizing the way prostheses are now made. These new approaches are disrupting the traditional and manual art form of prosthetic production which are laborious and costly and are being replaced by more precise and quantitative processes which enable the rapid, low cost production of patient-specific prostheses. In this two part review, we provide a comprehensive report of past, present and emerging soft-tissue prosthetic materials and manufacturing techniques. In this review, part A, we examine, historically, the ideal properts of a polymeric material when applied in soft-tissue prosthetics. We also detail new research approaches to target specific tissues which commonly require aesthetic restoration (e.g. ear, nose and eyes) and discuss both traditional and advanced fabrication methods, from hand-crafted impression based approaches to advanced manufactured prosthetics. We discuss the chemistry and related details of most significant synthetic polymers used in soft-tissue prosthetics in Part B. As advanced manufacturing transitions from research into practice, the five millennia history of prosthetics enters a new age of economic, personalized, advanced soft tissue prosthetics and with this comes significantly improved quality of life for the people affected by tissue loss.
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Affiliation(s)
| | | | - Sean K. Powell
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Farook TH, Jamayet NB, Abdullah JY, Asif JA, Rajion ZA, Alam MK. Designing 3D prosthetic templates for maxillofacial defect rehabilitation: A comparative analysis of different virtual workflows. Comput Biol Med 2020; 118:103646. [PMID: 32174323 DOI: 10.1016/j.compbiomed.2020.103646] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To design and compare the outcome of commercial (CS) and open source (OS) software-based 3D prosthetic templates for rehabilitation of maxillofacial defects using a low powered personal computer setup. METHOD Medical image data for five types of defects were selected, segmented, converted and decimated to 3D polygon models on a personal computer. The models were transferred to a computer aided design (CAD) software which aided in designing the prosthesis according to the virtual models. Two templates were designed for each defect, one by an OS (free) system and one by CS. The parameters for analyses were the virtual volume, Dice similarity coefficient (DSC) and Hausdorff's distance (HD) and were executed by the OS point cloud comparison tool. RESULT There was no significant difference (p > 0.05) between CS and OS when comparing the volume of the template outputs. While HD was within 0.05-4.33 mm, evaluation of the percentage similarity and spatial overlap following the DSC showed an average similarity of 67.7% between the two groups. The highest similarity was with orbito-facial prostheses (88.5%) and the lowest with facial plate prosthetics (28.7%). CONCLUSION Although CS and OS pipelines are capable of producing templates which are aesthetically and volumetrically similar, there are slight comparative discrepancies in the landmark position and spatial overlap. This is dependent on the software, associated commands and experienced decision-making. CAD-based templates can be planned on current personal computers following appropriate decimation.
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Affiliation(s)
- Taseef Hasan Farook
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Nafij Bin Jamayet
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia.
| | - Johari Yap Abdullah
- Craniofacial Imaging and Design, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Jawaad Ahmed Asif
- Oral and Maxillofacial Surgery, School of Dental Sciences, Hospital Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Zainul Ahmad Rajion
- Kulliyah of Dentistry, Dept. of Oral Maxillofacial Surgery and Oral Diagnosis, IIUM, Bandar Indera Mahkota, 25200, Kuantan, Malaysia
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Roughley M. Pores, Pimples and Pathologies: 3D Capture and Detailing of the Human Skin for 3D Medical Visualisation and Fabrication. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:141-160. [DOI: 10.1007/978-3-030-47483-6_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Farook TH, Jamayet NB, Abdullah JY, Rajion ZA, Alam MK. A systematic review of the computerized tools and digital techniques applied to fabricate nasal, auricular, orbital and ocular prostheses for facial defect rehabilitation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:268-277. [PMID: 31610244 DOI: 10.1016/j.jormas.2019.10.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/29/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022]
Abstract
A systematic review was conducted in early 2019 to evaluate the articles published that dealt with digital workflow, CAD, rapid prototyping and digital image processing in the rehabilitation by maxillofacial prosthetics. The objective of the review was to primarily identify the recorded cases of orofacial rehabilitation made by maxillofacial prosthetics using computer assisted 3D printing. Secondary objectives were to analyze the methods of data acquisition recorded with challenges and limitations documented with various software in the workflow. Articles were searched from Scopus, PubMed and Google Scholar based on the predetermined eligibility criteria. Thirty-nine selected papers from 1992 to 2019 were then read and categorized according to type of prosthesis described in the papers. For nasal prostheses, Common Methods of data acquisition mentioned were computed tomography, photogrammetry and laser scanners. After image processing, computer aided design (CAD) was used to design and merge the prosthesis to the peripheral healthy tissue. Designing and printing the mold was more preferred. Moisture and muscle movement affected the overall fit especially for prostheses directly designed and printed. For auricular prostheses, laser scanning was most preferred. For unilateral defects, CAD was used to mirror the healthy tissue over to the defect side. Authors emphasized on the need of digital library for prostheses selection, especially for bilateral defects. Printing the mold and conventionally creating the prosthesis was most preferred due to issues of proper fit and color matching. Orbital prostheses follow a similar workflow as auricular prosthesis. 3D photogrammetry and laser scans were more preferred and directly printing the prosthesis was favored in various instance. However, ocular prostheses fabrication was recorded to be a challenge due to difficulties in appropriate volume reconstruction and inability to mirror healthy globe. Only successful cases of digitally designed and printed iris were noted.
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Affiliation(s)
- T H Farook
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia
| | - N B Jamayet
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia.
| | - J Y Abdullah
- School of Dental Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia
| | - Z A Rajion
- School of Dental Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia
| | - M K Alam
- College of Dentistry, Jouf University, Sakaka, KSA, Saudi Arabia
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14
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Ballo AM, Nguyen CT, Lee VSK. Digital Workflow of Auricular Rehabilitation: A Technical Report Using an Intraoral Scanner. J Prosthodont 2019; 28:596-600. [PMID: 30887663 DOI: 10.1111/jopr.13057] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 11/28/2022] Open
Abstract
Prosthodontic rehabilitation of a congenital or acquired defect of the ear is considered a challenging and skill-dependent procedure. This technical report describes a novel approach for direct digital scanning of the unaffected contralateral ear using an intraoral scanner and external markers. The obtained digital data of the ear was exported, digitally mirrored, and successfully positioned to a virtual model of a human head with a missing ear. This technique demonstrates the potential application of CAD/CAM in the design and fabrication of an auricular prosthesis for patients with a unilateral ear defect.
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Affiliation(s)
- Ahmed M Ballo
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Caroline T Nguyen
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Vincent S K Lee
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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15
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Jazayeri HE, Kang S, Masri RM, Kuhn L, Fahimipour F, Vanevenhoven R, Thompson G, Gheisarifar M, Tahriri M, Tayebi L. Advancements in craniofacial prosthesis fabrication: A narrative review of holistic treatment. J Adv Prosthodont 2018; 10:430-439. [PMID: 30584472 PMCID: PMC6302084 DOI: 10.4047/jap.2018.10.6.430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/28/2018] [Accepted: 08/13/2018] [Indexed: 01/17/2023] Open
Abstract
The treatment of craniofacial anomalies has been challenging as a result of technological shortcomings that could not provide a consistent protocol to perfectly restore patient-specific anatomy. In the past, wax-up and impression-based maneuvers were implemented to achieve this clinical end. However, with the advent of computer-aided design and computer-aided manufacturing (CAD/CAM) technology, a rapid and cost-effective workflow in prosthetic rehabilitation has taken the place of the outdated procedures. Because the use of implants is so profound in different facets of restorative dentistry, their placement for craniofacial prosthesis retention has also been widely popular and advantageous in a variety of clinical settings. This review aims to effectively describe the well-rounded and interdisciplinary practice of craniofacial prosthesis fabrication and retention by outlining fabrication, osseointegrated implant placement for prosthesis retention, a myriad of clinical examples in the craniofacial complex, and a glimpse of the future of bioengineering principles to restore bioactivity and physiology to the previously defected tissue.
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Affiliation(s)
- Hossein E Jazayeri
- Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Steve Kang
- Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Radi M Masri
- Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Lauren Kuhn
- Department of Oral Rehabilitation, Division of Endodontics, Medical University of South Carolina, Charleston, SC, USA
| | | | - Rabecca Vanevenhoven
- Division of Oral and Maxillofacial Surgery and Dentistry, New York Presbyterian Weill Cornell Medical Center, New York City, NY, USA
| | - Geoffrey Thompson
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Maryam Gheisarifar
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
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16
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Abstract
Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.
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Affiliation(s)
- Chya-Yan Liaw
- Instructive Biomaterials and Additive Manufacturing Laboratory, Otto H. York Department of Chemical, Biological and Pharmaceutical Engineering, and Department of Bioengineering, New Jersey Institute of Technology, Newark, United States of America
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17
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Ciocca L, Tarsitano A, Marchetti C, Scotti R. Updates on the Construction of an Eyeglass-Supported Nasal Prosthesis Using Computer-Aided Design and Rapid Prototyping Technology. J Prosthodont 2015; 25:61-5. [PMID: 26288248 DOI: 10.1111/jopr.12332] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 11/30/2022] Open
Abstract
This study was undertaken to design an updated connection system for an eyeglass-supported nasal prosthesis using rapid prototyping techniques. The substructure was developed with two main endpoints in mind: the connection to the silicone and the connection to the eyeglasses. The mold design was also updated; the mold was composed of various parts, each carefully designed to allow for easy release after silicone processing and to facilitate extraction of the prosthesis without any strain. The approach used in this study enabled perfect transfer of the reciprocal position of the prosthesis with respect to the eyeglasses, from the virtual to the clinical environment. Moreover, the reduction in thickness improved the flexibility of the prosthesis and promoted adaptation to the contours of the skin, even during functional movements. The method described here is a simplified and viable alternative to standard construction techniques for nasal prostheses and offers improved esthetic and functional results when no bone is available for implant-supported prostheses.
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Affiliation(s)
- Leonardo Ciocca
- Professor of Maxillofacial Prosthodontics, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Maxillofacial Surgeon, Researcher, Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Marchetti
- Professor and Dean of Maxillofacial Surgery, Faculty of Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Roberto Scotti
- Professor and Dean of Oral and Maxillofacial Prosthetic Rehabilitation, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
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18
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Chae MP, Rozen WM, McMenamin PG, Findlay MW, Spychal RT, Hunter-Smith DJ. Emerging Applications of Bedside 3D Printing in Plastic Surgery. Front Surg 2015; 2:25. [PMID: 26137465 PMCID: PMC4468745 DOI: 10.3389/fsurg.2015.00025] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/02/2015] [Indexed: 12/16/2022] Open
Abstract
Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.
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Affiliation(s)
- Michael P Chae
- 3D PRINT Laboratory, Department of Surgery, Peninsula Health , Frankston, VIC , Australia ; Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health , Frankston, VIC , Australia
| | - Warren M Rozen
- 3D PRINT Laboratory, Department of Surgery, Peninsula Health , Frankston, VIC , Australia ; Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health , Frankston, VIC , Australia
| | - Paul G McMenamin
- Department of Anatomy and Developmental Biology, Centre for Human Anatomy Education, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University , Clayton, VIC , Australia
| | - Michael W Findlay
- 3D PRINT Laboratory, Department of Surgery, Peninsula Health , Frankston, VIC , Australia ; Department of Surgery, Stanford University , Stanford, CA , USA
| | - Robert T Spychal
- 3D PRINT Laboratory, Department of Surgery, Peninsula Health , Frankston, VIC , Australia
| | - David J Hunter-Smith
- 3D PRINT Laboratory, Department of Surgery, Peninsula Health , Frankston, VIC , Australia ; Monash University Plastic and Reconstructive Surgery Group (Peninsula Clinical School), Peninsula Health , Frankston, VIC , Australia
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19
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Bi Y, Wu S, Zhao Y, Bai S. A new method for fabricating orbital prosthesis with a CAD/CAM negative mold. J Prosthet Dent 2014; 110:424-8. [PMID: 24358510 DOI: 10.1016/j.prosdent.2013.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The challenge of fabricating an orbital prosthesis is how to position the iris and pupil properly. Computer simulation can be a more effective and simpler approach to measuring and evaluating these features than the conventional method. However, transferring the optimal position of the iris determined in the virtual design procedure to the real definitive prosthesis can be difficult. The purpose of this article is to demonstrate a method of fabricating an orbital prosthesis with a negative mold designed and produced by a computer-aided design and computer-aided manufacturing technique. With this method, the iris can be designed in the most favorable position, and this position can be transferred to the silicone prosthesis correctly.
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Abstract
BACKGROUND AND AIM Digital technology is becoming more accessible for common use in medical applications; however, their expansion in prosthetic and orthotic laboratories is not large because of the persistent image of difficult applicability to real patients. This article aims to offer real example in the area of human facial prostheses. TECHNIQUE This article describes the utilization of optical digitization, computational modelling, rapid prototyping, mould fabrication and manufacturing of a nasal silicone prosthesis. This technical note defines the key points of the methodology and aspires to contribute to the introduction of a certified manufacturing procedure. DISCUSSION The results show that the used technologies reduce the manufacturing time, reflect patient's requirements and allow the manufacture of high-quality prostheses for missing facial asymmetric parts. The methodology provides a good position for further development issues and is usable for clinical practice. Clinical relevance Utilization of digital technologies in facial prosthesis manufacturing process can be a good contribution for higher patient comfort and higher production efficiency but with higher initial investment and demands for experience with software tools.
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Affiliation(s)
- David Palousek
- Institute of Machine and Industrial Design, Faculty of Mechanical Engineering, Brno University of Technology, Brno, Czech Republic
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21
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Bai SZ, Feng ZH, Gao R, Dong Y, Bi YP, Wu GF, Chen X. Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries. Mil Med Res 2014; 1:11. [PMID: 25722869 PMCID: PMC4340674 DOI: 10.1186/2054-9369-1-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 05/01/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The application of a maxillofacial prosthesis is an alternative to surgery in functional-aesthetic facial reconstruction. Computer aided design/computer aided manufacturing has opened up a new approach to the fabrication of maxillofacial prostheses. An intelligentized rapid simulative design and manufacturing system for prostheses was developed to facilitate the prosthesis fabrication procedure. METHODS The rapid simulation design and rapid fabrication system for maxillofacial prostheses consists of three components: digital impression, intelligentized prosthesis design, and rapid manufacturing. The patients' maxillofacial digital impressions were taken with a structured-light 3D scanner; then, the 3D model of the prostheses and their negative molds could be designed with specific software; lastly, with resin molds fabricated by the rapid prototyping machine, the prostheses could be produced directly and quickly. RESULTS Fifteen patients with maxillofacial defects received prosthesis rehabilitation provided by the established system. The total clinical time used for each patient was only 4 hours over 2 appointments on average. The contours of the prostheses coordinated properly with the appearance of the patients, and the uniform-thickness border sealed well to adjacent tissues. All of the patients were satisfied with their prostheses. CONCLUSIONS The rapid simulative rehabilitation system of maxillofacial defects is approaching completion. It could provide an advanced technological solution for the Army in cases of maxillofacial defect rehabilitation.
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Affiliation(s)
- Shi-Zhu Bai
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Zhi-Hong Feng
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Rui Gao
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Yan Dong
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Yun-Peng Bi
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Guo-Feng Wu
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
| | - Xi Chen
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, the Fourth Military Medical University, 145 Changlexi Road, Xi'an, Shaanxi, 710032 China
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22
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Ciocca L, Fantini M, De Crescenzio F, Persiani F, Scotti R. Computer-aided design and manufacturing construction of a surgical template for craniofacial implant positioning to support a definitive nasal prosthesis. Clin Oral Implants Res 2010; 22:850-6. [PMID: 21198902 DOI: 10.1111/j.1600-0501.2010.02066.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM To design a surgical template to guide the insertion of craniofacial implants for nasal prosthesis retention. MATERIALS AND METHODS The planning of the implant position was obtained using software for virtual surgery; the positions were transferred to a free-form computer-aided design modeling software and used to design the surgical guides. A rapid prototyping system was used to 3D-print a three-part template: a helmet to support the others, a starting guide to mark the skin before flap elevation, and a surgical guide for bone drilling. An accuracy evaluation between the planned and the placed final position of each implant was carried out by measuring the inclination of the axis of the implant (angular deviation) and the position of the apex of the implant (deviation at apex). RESULTS The implant in the glabella differed in angulation by 7.78°, while the two implants in the premaxilla differed by 1.86 and 4.55°, respectively. The deviation values at the apex of the implants with respect to the planned position were 1.17 mm for the implant in the glabella and 2.81 and 3.39 mm, respectively, for those implanted in the maxilla. CONCLUSIONS The protocol presented in this article may represent a viable way to position craniofacial implants for supporting nasal prostheses.
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Affiliation(s)
- Leonardo Ciocca
- Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Oral Science, Alma Mater Studiorum University of Bologna, Bologna, Italy.
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