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Gao S, Nie T, Lin Y, Jiang L, Wang L, Wu J, Jiao Y. 3D printing tissue-engineered scaffolds for auricular reconstruction. Mater Today Bio 2024; 27:101141. [PMID: 39045312 PMCID: PMC11265588 DOI: 10.1016/j.mtbio.2024.101141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/25/2024] Open
Abstract
Congenital microtia is the most common cause of auricular defects, with a prevalence of approximately 5.18 per 10,000 individuals. Autologous rib cartilage grafting is the leading treatment modality at this stage of auricular reconstruction currently. However, harvesting rib cartilage may lead to donor site injuries, such as pneumothorax, postoperative pain, chest wall scarring, and deformity. Therefore, in the pursuit of better graft materials, biomaterial scaffolds with great histocompatibility, precise control of morphology, non-invasiveness properties are gradually becoming a new research hotspot in auricular reconstruction. This review collectively presents the exploit and application of 3D printing biomaterial scaffold in auricular reconstruction. Although the tissue-engineered ear still faces challenges before it can be widely applied to patients in clinical settings, and its long-term effects have yet to be evaluated, we aim to provide guidance for future research directions in 3D printing biomaterial scaffold for auricular reconstruction. This will ultimately benefit the translational and clinical application of cartilage tissue engineering and biomaterials in the treatment of auricular defects.
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Affiliation(s)
- Shuyi Gao
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, 510620, China
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
| | - Tianqi Nie
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, 510620, China
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
| | - Ying Lin
- Department of Otolaryngology Head and Neck Surgery, Guangzhou Red Cross Hospital (Guangzhou Red Cross Hospital of Jinan University), Jinan University, Guangzhou, 510240, China
- Institute of Otolaryngology Head and Neck Surgery, Jinan University, Guangzhou, 510240, China
| | - Linlan Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, 510620, China
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
| | - Liwen Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, 510620, China
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
| | - Jun Wu
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
- Bioscience and Biomedical Engineering Thrust, The Hong Kong University of Science and Technology (Guangzhou), Nansha, Guangzhou, 511400, China
- Division of Life Science, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Yuenong Jiao
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou Twelfth People's Hospital (The Affiliated Twelfth People's Hospital of Guangzhou Medical University), Guangzhou Medical University, Guangzhou, 510620, China
- Institute of Otorhinolaryngology, Head and Neck Surgery, Guangzhou Medical University, Guangzhou, 510620, China
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Patil R, Chandak A, Radke U, Bang K, Pande N. Improved Fabrication of Implant Retained Auricular Prosthesis with Digital Technologies. Indian J Otolaryngol Head Neck Surg 2023; 75:3903-3905. [PMID: 37974881 PMCID: PMC10646059 DOI: 10.1007/s12070-023-03980-2] [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: 05/16/2023] [Accepted: 06/12/2023] [Indexed: 11/19/2023] Open
Abstract
A 28-year-old male patient came to the prosthodontics department seeking replacement for his congenital defect left ear. With the use of digital technology, a silicone implant supported bar retained auricular prosthesis that is an exact match in size, shape, and orientation to the existing contralateral ear was made.
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Affiliation(s)
- Rohit Patil
- Department of Prosthodontics, VSPM's Dental College and Research Centre, Nagpur, Maharashtra India
| | - Anuj Chandak
- Department of Prosthodontics, VSPM's Dental College and Research Centre, Nagpur, Maharashtra India
| | - Usha Radke
- Department of Prosthodontics, VSPM's Dental College and Research Centre, Nagpur, Maharashtra India
| | - Kshitij Bang
- Department of Oral and Maxillofacial Surgery, VSPM's Dental College and Research Centre, Nagpur, Maharashtra India
| | - Neelam Pande
- Department of Prosthodontics, VSPM's Dental College and Research Centre, Nagpur, Maharashtra India
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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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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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Manju V, Babu A, Krishnapriya VN, Chandrashekar J. Rapid prototyping technology for silicone auricular prosthesis fabrication: A pilot study. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2021. [DOI: 10.4103/jhnps.jhnps_22_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bannink T, Bouman S, Wolterink R, van Veen R, van Alphen M. Implementation of 3D technologies in the workflow of auricular prosthetics: A method using optical scanning and stereolithography 3D printing. J Prosthet Dent 2020; 125:708-713. [PMID: 32611482 DOI: 10.1016/j.prosdent.2020.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
The fabrication of auricular prostheses is traditionally time consuming, and the definitive esthetic appearance is highly skill dependent. A method of creating the wax pattern for an auricular prosthesis by using optical scanning and 3D printing is described. A digital scan of the unaffected ear is used for computer-aided design and manufacturing of a mold for casting the wax pattern of the prosthesis. The process is efficient and increases the predictability of the esthetic outcome.
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Affiliation(s)
- Tjitske Bannink
- Graduate student, Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Technical Medical, University of Twente, Enschede, Amsterdam, the Netherlands
| | - Shirley Bouman
- Anaplastologist, Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rene Wolterink
- Anaplastologist, Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Robert van Veen
- Physician, Department of Head and Neck Oncology and Surgery, Verwelius 3D Lab, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Maarten van Alphen
- Technical Physician, Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands.
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Cevik P, Kocacikli M. Three-dimensional printing technologies in the fabrication of maxillofacial prosthesis: A case report. Int J Artif Organs 2019; 43:343-347. [DOI: 10.1177/0391398819887401] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: Patients with maxillofacial deformities always seek for aesthetic prosthesis. Recently, three-dimensional printing technologies have been used for dental treatments on such patients. Case report: A 24-year-old man reported to the Department of Prosthodontics for replacement of his missing right ear induced by a trauma. A magnet-retained auricular prosthesis was planned for the patient. Three-dimensional scanning was performed on the healthy side by using a three-dimensional optical scanner and the data were mirrored. The mirrored image was then imported to a software and a virtual model of the future prosthesis was obtained for the defect side. A three-dimensional printer was used to fabricate a negative mold for the mirrored image by using additive manufacturing. Initially, an impression of the defect side was made; then, the cast model was obtained in a dental flask. Magnets of the prosthesis were inserted to the acrylic resin framework on the cast model. Room temperature vulcanized silicone elastomer was mixed and poured into the three-dimensionally fabricated mold. Then, the flask was placed over the negative mold firmly. After polymerization of the silicone, the auricular prosthesis was delivered to the patient and the patient was instructed to clean the prosthesis daily. Conclusions: Three-dimensional printing technology was used for the fabrication of the patient’s missing ear. This method eliminated the conventional laboratory steps and reduced the number of stages of the fabrication of a silicone prosthesis. The negative mold of the defect side allowed us a direct fabrication of the silicone prosthesis without a need for waxing or flasking procedures.
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Affiliation(s)
- Pinar Cevik
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Mustafa Kocacikli
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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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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Low CM, Morris JM, Price DL, Matsumoto JS, Stokken JK, O’Brien EK, Choby G. Three-Dimensional Printing: Current Use in Rhinology and Endoscopic Skull Base Surgery. Am J Rhinol Allergy 2019; 33:770-781. [DOI: 10.1177/1945892419866319] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background In the discipline of rhinology and endoscopic skull base surgery (ESBS), 3-dimensional (3D) printing has found meaningful application in areas including preoperative surgical planning as well as in surgical education. However, its scope of use may be limited due to the perception among surgeons that there exists a prohibitively high initial investment in resources and time to acquire the requisite technical expertise. Nevertheless, given the ever decreasing cost of advancing technology coupled with the need to understand the complex spatial relationships of the paranasal sinuses and skull base, the use of 3D printing in rhinology and ESBS is poised to blossom. Objective Help the reader identify current or potential future uses of 3D printing technology relevant to their rhinologic clinical or educational practice. Methods A review of published literature relating to 3D printing in rhinology and ESBS was performed. Results Results were reviewed and organized into 5 overarching categories including an overview of the 3D printing process as well as applications of 3D printing including (1) surgical planning, (2) custom prosthetics and implants, (3) patient education, and (4) surgical teaching and assessment. Conclusion In the discipline of rhinology and ESBS, 3D printing finds use in the areas of presurgical planning, patient education, prosthesis creation, and trainee education. As this technology moves forward, these products will be more broadly available to providers in the clinical and educational setting. The possible applications are vast and have great potential to positively impact surgical training, patient satisfaction, and most importantly, patient outcomes.
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Affiliation(s)
- Christopher M. Low
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Jonathan M. Morris
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Daniel L. Price
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Jane S. Matsumoto
- Division of Pediatric Radiology, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Janalee K. Stokken
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Erin K. O’Brien
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Garret Choby
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Abstract
3D printing is an evolving technology that enables the creation of unique organic and inorganic structures with high precision. In urology, the technology has demonstrated potential uses in both patient and clinician education as well as in clinical practice. The four major techniques used for 3D printing are inkjet printing, extrusion printing, laser sintering, and stereolithography. Each of these techniques can be applied to the production of models for education and surgical planning, prosthetic construction, and tissue bioengineering. Bioengineering is potentially the most important application of 3D printing, as the ability to produce functional organic constructs might, in the future, enable urologists to replicate and replace abnormal tissues with neo-organs, improving patient survival and quality of life.
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Unkovskiy A, Spintzyk S, Axmann D, Engel EM, Weber H, Huettig F. Additive Manufacturing: A Comparative Analysis of Dimensional Accuracy and Skin Texture Reproduction of Auricular Prostheses Replicas. J Prosthodont 2017; 28:e460-e468. [PMID: 29125215 DOI: 10.1111/jopr.12681] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow. MATERIALS AND METHODS Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction. RESULTS The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)--compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)--compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative evaluation revealed slight shortcomings in skin reproduction for all methods: reproduction of skin details exceeding 0.192 mm in depth was feasible. CONCLUSION FDM showed the superior dimensional accuracy and best skin surface reproduction. Moreover, digital acquisition and CAD postprocessing seem to play a more important role in the outcome than the additive manufacturing method used.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Sebastian Spintzyk
- Medical Material Science and Technology, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Detlef Axmann
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Eva-Maria Engel
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Heiner Weber
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
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Chen Z, Luo C, Shang X, Han Y. [Application progress of digital technology in auricle reconstruction]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:1135-1140. [PMID: 29798575 PMCID: PMC8458414 DOI: 10.7507/1002-1892.201701023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 07/10/2017] [Indexed: 11/03/2022]
Abstract
Objective To review the application progress of digital technology in auricle reconstruction. Methods The recently published literature concerning the application of digital technology in auricle reconstruction was extensively consulted, the main technology and its specific application areas were reviewed. Results Application of digital technology represented by three-dimensional (3D) data acquisition, 3D reconstruction, and 3D printing is an important developing trend of auricle reconstruction. It can precisely guide auricle reconstruction through fabricating digital ear model, auricular guide plate, and costal cartilage imaging. Conclusion Digital technology can improve effectiveness and decrease surgical trauma in auricle reconstruction. 3D bioprinting of ear cartilage future has bright prospect and needs to be further researched.
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Affiliation(s)
- Zhaoyang Chen
- Department of Plastic & Reconstructive Surgery, Chinese PLA Medical School, Beijing, 100853, P.R.China
| | - Chuncai Luo
- Department of Radiology, Chinese PLA Medical School, Beijing, 100853, P.R.China
| | - Xiao Shang
- Xi'an University of Posts & Telecommunications, Xi'an Shaanxi, 710121, P.R.China
| | - Yan Han
- Department of Plastic & Reconstructive Surgery, Chinese PLA Medical School, Beijing, 100853,
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Ripley B, Levin D, Kelil T, Hermsen JL, Kim S, Maki JH, Wilson GJ. 3D printing from MRI Data: Harnessing strengths and minimizing weaknesses. J Magn Reson Imaging 2016; 45:635-645. [PMID: 27875009 DOI: 10.1002/jmri.25526] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 01/17/2023] Open
Abstract
3D printing facilitates the creation of accurate physical models of patient-specific anatomy from medical imaging datasets. While the majority of models to date are created from computed tomography (CT) data, there is increasing interest in creating models from other datasets, such as ultrasound and magnetic resonance imaging (MRI). MRI, in particular, holds great potential for 3D printing, given its excellent tissue characterization and lack of ionizing radiation. There are, however, challenges to 3D printing from MRI data as well. Here we review the basics of 3D printing, explore the current strengths and weaknesses of printing from MRI data as they pertain to model accuracy, and discuss considerations in the design of MRI sequences for 3D printing. Finally, we explore the future of 3D printing and MRI, including creative applications and new materials. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2017;45:635-645.
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Affiliation(s)
- Beth Ripley
- Department of Radiology, University of Washington, Seattle, Washington, USA.,Department of Radiology, VA Puget Sound Health Care System, Seattle WA 98108
| | - Dmitry Levin
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Tatiana Kelil
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Joshua L Hermsen
- Division of Cardiothoracic Surgery, Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Sooah Kim
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Jeffrey H Maki
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Gregory J Wilson
- Department of Radiology, University of Washington, Seattle, Washington, USA
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Tack P, Victor J, Gemmel P, Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016; 15:115. [PMID: 27769304 PMCID: PMC5073919 DOI: 10.1186/s12938-016-0236-4] [Citation(s) in RCA: 548] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/09/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. METHODS Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. RESULTS 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. CONCLUSION 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.
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Affiliation(s)
- Philip Tack
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Jan Victor
- Ghent University Hospital, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Paul Gemmel
- Departement of Economics & Business Administration, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium
| | - Lieven Annemans
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
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Salazar-Gamarra R, Seelaus R, da Silva JVL, da Silva AM, Dib LL. Monoscopic photogrammetry to obtain 3D models by a mobile device: a method for making facial prostheses. J Otolaryngol Head Neck Surg 2016; 45:33. [PMID: 27225795 PMCID: PMC4881215 DOI: 10.1186/s40463-016-0145-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/05/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study is to present the development of a new technique to obtain 3D models using photogrammetry by a mobile device and free software, as a method for making digital facial impressions of patients with maxillofacial defects for the final purpose of 3D printing of facial prostheses. Methods With the use of a mobile device, free software and a photo capture protocol, 2D captures of the anatomy of a patient with a facial defect were transformed into a 3D model. The resultant digital models were evaluated for visual and technical integrity. The technical process and resultant models were described and analyzed for technical and clinical usability. Results Generating 3D models to make digital face impressions was possible by the use of photogrammetry with photos taken by a mobile device. The facial anatomy of the patient was reproduced by a *.3dp and a *.stl file with no major irregularities. 3D printing was possible. Conclusions An alternative method for capturing facial anatomy is possible using a mobile device for the purpose of obtaining and designing 3D models for facial rehabilitation. Further studies must be realized to compare 3D modeling among different techniques and systems. Clinical implication Free software and low cost equipment could be a feasible solution to obtain 3D models for making digital face impressions for maxillofacial prostheses, improving access for clinical centers that do not have high cost technology considered as a prior acquisition.
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Affiliation(s)
- Rodrigo Salazar-Gamarra
- UNIP Postgraduate Dental School, Universidade Paulista, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil.
| | - Rosemary Seelaus
- The Craniofacial Center, University of Illinois at Chicago, 811 S Paulina St, Chicago, IL, 60612, USA
| | - Jorge Vicente Lopes da Silva
- Division of the Centro Tecnológico da Informação Renato Archer, Rodovia Dom Pedro I, Km 143, 6 - Amarais, Campinas, SP, 13069-901, Brazil
| | - Airton Moreira da Silva
- Centro Tecnológico da Informação Renato Archer Campinas, Rodovia Dom Pedro I, Km 143, 6 - Amarais, Campinas, SP, 13069-901, Brazil
| | - Luciano Lauria Dib
- UNIP Postgraduate Dental School, Universidade Paulista, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil.,Oncology Center, Hospital Alemão Oswaldo Cruz, Rua Afonso Braz, 525 - Cj. 81 Vila Nova Conceição, São Paulo, CEP 04511-011, SP, Brazil
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Abstract
Implant-retained auricular prostheses are a successful prosthetic treatment option for patients who are missing their ear(s) due to trauma, oncology, or birth defects. The prosthetic ear is aesthetically pleasing, composed of natural looking anatomical contours, shape, and texture along with good color that blends with surrounding existing skin. These outcomes can be optimized by the integration of digital technologies in the construction process. This report describes a sequential process of reconstructing a missing left ear by digital technologies. Two implants were planned for placement in the left mastoid region utilizing specialist biomedical software (Materialise, Belgium). The implant positions were determined underneath the thickest portion (of anti-helix area) left ear that is virtually simulated by means of mirror imaging of the right ear. A surgical stent recording the implant positions was constructed and used in implant fixtures placement. Implants were left for eight weeks, after which they were loaded with abutments and an irreversible silicone impression was taken to record their positions. The right existing ear was virtually segmented using the patient CT scan and then mirror imaged to produce a left ear, which was then printed using 3D printer (Z Corp, USA). The left ear was then duplicated in wax which was fitted over the defect side. Then, it was conventionally flasked. Skin color was digitalized using spectromatch skin color system (London, UK). The resultant silicone color was mixed as prescribed and then packed into the mold. The silicone was cured conventionally. Ear was trimmed and fitted and there was no need for any extrinsic coloring. The prosthetic ear was an exact match to the existing right ear in shape, skin color, and orientation due to the great advantages of technologies employed. Additionally, these technologies saved time and provided a base for reproducible results regardless of operator.
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Lincoln KP, Sun AYT, Prihoda TJ, Sutton AJ. Comparative Accuracy of Facial Models Fabricated Using Traditional and 3D Imaging Techniques. J Prosthodont 2015; 25:207-15. [PMID: 26381058 DOI: 10.1111/jopr.12358] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2015] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose of this investigation was to compare the accuracy of facial models fabricated using facial moulage impression methods to the three-dimensional printed (3DP) fabrication methods using soft tissue images obtained from cone beam computed tomography (CBCT) and 3D stereophotogrammetry (3D-SPG) scans. MATERIALS AND METHODS A reference phantom model was fabricated using a 3D-SPG image of a human control form with ten fiducial markers placed on common anthropometric landmarks. This image was converted into the investigation control phantom model (CPM) using 3DP methods. The CPM was attached to a camera tripod for ease of image capture. Three CBCT and three 3D-SPG images of the CPM were captured. The DICOM and STL files from the three 3dMD and three CBCT were imported to the 3DP, and six testing models were made. Reversible hydrocolloid and dental stone were used to make three facial moulages of the CPM, and the impressions/casts were poured in type IV gypsum dental stone. A coordinate measuring machine (CMM) was used to measure the distances between each of the ten fiducial markers. Each measurement was made using one point as a static reference to the other nine points. The same measuring procedures were accomplished on all specimens. All measurements were compared between specimens and the control. The data were analyzed using ANOVA and Tukey pairwise comparison of the raters, methods, and fiducial markers. RESULTS The ANOVA multiple comparisons showed significant difference among the three methods (p < 0.05). Further, the interaction of methods versus fiducial markers also showed significant difference (p < 0.05). The CBCT and facial moulage method showed the greatest accuracy. CONCLUSIONS 3DP models fabricated using 3D-SPG showed statistical difference in comparison to the models fabricated using the traditional method of facial moulage and 3DP models fabricated from CBCT imaging. 3DP models fabricated using 3D-SPG were less accurate than the CPM and models fabricated using facial moulage and CBCT imaging techniques.
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Affiliation(s)
- Ketu P Lincoln
- Department of Graduate Prosthodontics, USAF, Joint Base San Antonio-Lackland, TX
| | - Albert Y T Sun
- Department of Mechanical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Thomas J Prihoda
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX
| | - Alan J Sutton
- Department of Restorative Dentistry, University of Colorado School of Dental Medicine, Aurora, CO
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Abstract
Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.
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Affiliation(s)
- Qian Peng
- Xiangya Stomatological Hospital, Central South University , Changsha, Hunan 410008 , China
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Magnetic resonance imaging of the ear for patient-specific reconstructive surgery. PLoS One 2014; 9:e104975. [PMID: 25144306 PMCID: PMC4140740 DOI: 10.1371/journal.pone.0104975] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/06/2014] [Indexed: 11/22/2022] Open
Abstract
Introduction Like a fingerprint, ear shape is a unique personal feature that should be reconstructed with a high fidelity during reconstructive surgery. Ear cartilage tissue engineering (TE) advantageously offers the possibility to use novel 3D manufacturing techniques to reconstruct the ear, thus allowing for a detailed auricular shape. However it also requires detailed patient-specific images of the 3D cartilage structures of the patient’s intact contralateral ear (if available). Therefore the aim of this study was to develop and evaluate an imaging strategy for acquiring patient-specific ear cartilage shape, with sufficient precision and accuracy for use in a clinical setting. Methods and Materials Magnetic resonance imaging (MRI) was performed on 14 volunteer and six cadaveric auricles and manually segmented. Reproducibility of cartilage volume (Cg.V), surface (Cg.S) and thickness (Cg.Th) was assessed, to determine whether raters could repeatedly define the same volume of interest. Additionally, six cadaveric auricles were harvested, scanned and segmented using the same procedure, then dissected and scanned using high resolution micro-CT. Correlation between MR and micro-CT measurements was assessed to determine accuracy. Results Good inter- and intra-rater reproducibility was observed (precision errors <4% for Cg.S and <9% for Cg.V and Cg.Th). Intraclass correlations were good for Cg.V and Cg.S (>0.82), but low for Cg.Th (<0.23) due to similar average Cg.Th between patients. However Pearson’s coefficients showed that the ability to detect local cartilage shape variations is unaffected. Good correlation between clinical MRI and micro-CT (r>0.95) demonstrated high accuracy. Discussion and Conclusion This study demonstrated that precision and accuracy of the proposed method was high enough to detect patient-specific variation in ear cartilage geometry. The present study provides a clinical strategy to access the necessary information required for the production of 3D ear scaffolds for TE purposes, including detailed patient-specific shape. Furthermore, the protocol is applicable in daily clinical practice with existing infrastructure.
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Huotilainen E, Paloheimo M, Salmi M, Paloheimo KS, Björkstrand R, Tuomi J, Markkola A, Mäkitie A. Imaging requirements for medical applications of additive manufacturing. Acta Radiol 2014; 55:78-85. [PMID: 23901144 DOI: 10.1177/0284185113494198] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Additive manufacturing (AM), formerly known as rapid prototyping, is steadily shifting its focus from industrial prototyping to medical applications as AM processes, bioadaptive materials, and medical imaging technologies develop, and the benefits of the techniques gain wider knowledge among clinicians. This article gives an overview of the main requirements for medical imaging affected by needs of AM, as well as provides a brief literature review from existing clinical cases concentrating especially on the kind of radiology they required. As an example application, a pair of CT images of the facial skull base was turned into 3D models in order to illustrate the significance of suitable imaging parameters. Additionally, the model was printed into a preoperative medical model with a popular AM device. Successful clinical cases of AM are recognized to rely heavily on efficient collaboration between various disciplines - notably operating surgeons, radiologists, and engineers. The single main requirement separating tangible model creation from traditional imaging objectives such as diagnostics and preoperative planning is the increased need for anatomical accuracy in all three spatial dimensions, but depending on the application, other specific requirements may be present as well. This article essentially intends to narrow the potential communication gap between radiologists and engineers who work with projects involving AM by showcasing the overlap between the two disciplines.
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Affiliation(s)
| | | | - Mika Salmi
- BIT Research Centre, Aalto University, Espoo, Finland
| | | | | | - Jukka Tuomi
- BIT Research Centre, Aalto University, Espoo, Finland
| | - Antti Markkola
- Department of Radiology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Antti Mäkitie
- BIT Research Centre, Aalto University, Espoo, Finland
- Department of Otolaryngology – Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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Watson J, Hatamleh MM. Complete integration of technology for improved reproduction of auricular prostheses. J Prosthet Dent 2014; 111:430-6. [PMID: 24445032 DOI: 10.1016/j.prosdent.2013.07.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 07/12/2013] [Accepted: 07/13/2013] [Indexed: 11/18/2022]
Abstract
The accurate reproduction of the form and surface details of missing body structures is an essential part of any successful prosthetic rehabilitation. It helps mask the prosthesis and gives confidence to the patient. This clinical report details the integration of multiple in-house digital technologies of laser scanning, rapid prototyping, and digital color scanning and formulating to improve the shape, texture, orientation, and color of auricular prostheses for 3 patients with missing unilateral ears. A structured light laser scanner was used to digitize the patient's nondefect ear. The digitized data were then manipulated in specialist software and mirrored to reflect the opposing side. A rapid prototyping machine was used to manufacture a 3-dimensional (3D) model of the soft tissue required. This 3D mirrored ear model allowed the accurate reproduction of missing soft tissue. A color spectrometer was used to accurately reproduce the skin tones digitally and physically.
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Affiliation(s)
- Jason Watson
- Consultant Maxillofacial Prosthetist, Maxillofacial Department, Queens Medical Centre, Nottingham University Hospital Trust, Nottingham, Nottingham, UK.
| | - Muhanad M Hatamleh
- Maxillofacial Prosthetist, Maxillofacial Department, Queens Medical Centre; and Lecturer, School of Dentistry, University of Manchester, Manchester, UK
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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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Ferraz EG, Andrade LCS, dos Santos AR, Torregrossa VR, Rubira-Bullen IRF, Sarmento VA. Application of two segmentation protocols during the processing of virtual images in rapid prototyping: ex vivo study with human dry mandibles. Clin Oral Investig 2013; 17:2113-8. [DOI: 10.1007/s00784-013-0921-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 01/09/2013] [Indexed: 11/30/2022]
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Hatamleh MM, Watson J. Construction of an Implant-Retained Auricular Prosthesis with the Aid of Contemporary Digital Technologies: A Clinical Report. J Prosthodont 2012; 22:132-6. [DOI: 10.1111/j.1532-849x.2012.00916.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kolodney H, Swedenburg G, Taylor SS, Carron JD, Schlakman BN. The use of cephalometric landmarks with 3-dimensional volumetric computer modeling to position an auricular implant surgical template: a clinical report. J Prosthet Dent 2011; 106:284-9. [DOI: 10.1016/s0022-3913(11)60131-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Techniques of rapid prototyping were introduced in the 1980s in the field of engineering for the fabrication of a solid model based on a computed file. After its introduction in the biomedical field, several applications were raised for the fabrication of models to ease surgical planning and simulation in implantology, neurosurgery, and orthopedics, as well as for the fabrication of maxillofacial prostheses. Hence, the literature has described the evolution of rapid prototyping technique in health care, which allowed easier technique, improved surgical results, and fabrication of maxillofacial prostheses. Accordingly, a literature review on MEDLINE (PubMed) database was conducted using the keywords rapid prototyping, surgical planning, and maxillofacial prostheses and based on articles published from 1981 to 2010. After reading the titles and abstracts of the articles, 50 studies were selected owing to their correlations with the aim of the current study. Several studies show that the prototypes have been used in different dental-medical areas such as maxillofacial and craniofacial surgery; implantology; neurosurgery; orthopedics; scaffolds of ceramic, polymeric, and metallic materials; and fabrication of personalized maxillofacial prostheses. Therefore, prototyping has been an indispensable tool in several studies and helpful for surgical planning and fabrication of prostheses and implants.
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Clinical applications of physical 3D models derived from MDCT data and created by rapid prototyping. AJR Am J Roentgenol 2011; 196:W683-8. [PMID: 21606254 DOI: 10.2214/ajr.10.5681] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE In this article, we describe the production of physical models from CT data using rapid prototyping and present their clinical application. MDCT data acquisition of isotropic voxels and modern postprocessing techniques provide exquisite detail for clinicians and radiologists. CONCLUSION In recent years, rapid prototyping technologies have provided new possibilities to visualize complex anatomic structures through the generation of physical models that can be used to assist with diagnosis, surgical planning, prosthesis design, and patient communication.
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Liacouras P, Garnes J, Roman N, Petrich A, Grant GT. Designing and manufacturing an auricular prosthesis using computed tomography, 3-dimensional photographic imaging, and additive manufacturing: A clinical report. J Prosthet Dent 2011; 105:78-82. [DOI: 10.1016/s0022-3913(11)60002-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
PURPOSE OF REVIEW Technology has the potential to transform the fabrication process of facial prosthetics. The purpose of this review is to highlight the pertinent technological advances in computerized shade selection, three-dimensional digital photography, virtual surgical planning, surface scanning, and three-dimensional imaging to obtain the wax pattern. RECENT FINDINGS There have been a few reported studies documenting the effect of computerized color formulations for facial prosthesis. The technology is still in its infancy and may serve as a tool to manage metamerism and to complement the subjective clinical assessment of the clinician. Three-dimensional photography, surface scanning, and three-dimensional imaging have been used successfully in the fabrication of facial prostheses. Software programs which allow the clinician to plan virtually implant placement allows the treatment planning process to be much more prosthetically driven. Even with the technological advances, it is perhaps most important to remember the basics of proper preparation of the defect to accept the prosthesis. SUMMARY The incorporation of technology into the fabrication process of facial prostheses can potentially transform the treatment process from a time-consuming artistically driven process to being a reconstructive biotechnology process.
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Chrzan R, Miechowicz S, Urbanik A, Markowska O, Kudasik T. Individually Fitted Hearing Aid Device Manufactured Using Rapid Prototyping Based on Ear CT. Neuroradiol J 2009; 22:209-14. [DOI: 10.1177/197140090902200212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Accepted: 04/11/2009] [Indexed: 11/16/2022] Open
Abstract
Rapid prototyping is the technology of automatic freeform fabrication of physical objects from virtual CAD (computer aided design) models. For medical objects the models may be created using data from CT, MR or rotational angiography. We descriobe the case of a 83-year-old woman with essential bilateral hearing impairment as the effect of chronic otitis media. An individually fitted hearing aid was produced for the patient using stereolithography technology and vacuum casting based on data obtained during ear CT. Rapid prototyping may help in manufacturing individually adjusted biomedical prostheses, reducing the time of device production and improving its fitting.
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Affiliation(s)
- R. Chrzan
- Radiology Department, Collegium Medicum Jagiellonian University; Krakow, Poland
| | - S. Miechowicz
- Department of Mechanical Engineering, Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology; Rzeszow, Poland
| | - A. Urbanik
- Radiology Department, Collegium Medicum Jagiellonian University; Krakow, Poland
| | - O. Markowska
- Department of Mechanical Engineering, Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology; Rzeszow, Poland
| | - T. Kudasik
- Department of Mechanical Engineering, Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology; Rzeszow, Poland
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