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Sharaf B, Kuruoglu D, Cantwell SR, Alexander AE, Dickens HJ, Morris JM. EPPOCRATIS: Expedited Preoperative Point-of-Care Reduction of Fractures to Normalized Anatomy and Three-Dimensional Printing to Improve Surgical Outcomes. Plast Reconstr Surg 2022; 149:695-699. [PMID: 35196689 DOI: 10.1097/prs.0000000000008871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
SUMMARY Virtual surgical planning and three-dimensional printing have been invaluable tools in craniomaxillofacial surgery. From planning head and neck reconstruction to orthognathic surgery and secondary reconstruction of maxillofacial trauma, virtual surgical planning and three-dimensional printing allow the surgeon to rehearse the surgical plan and use patient-specific surgical guides for carrying out the plan accurately. However, the process of virtual surgical planning and three-dimensional printing requires time and coordination between the surgeon on one hand and the biomedical engineers and designers on the other hand. Outsourcing to third-party companies contributes to inefficiencies in this process. Advances in surgical planning software and three-dimensional printing technology have enabled the integration of virtual surgical planning and three-dimensional printing at the treating hospital, the point of care. This allows for expedited use of this process in semiurgent surgical cases and acute facial trauma cases by bringing the surgeon, radiologist, biomedical engineers, and designers to the point of care. In this article, the authors present the utility of EPPOCRATIS, expedited preoperative point of care reduction of fractures to normalized anatomy and three-dimensional printing to improve surgical outcomes, in the management of acute facial trauma.
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Affiliation(s)
- Basel Sharaf
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
| | - Doga Kuruoglu
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
| | - Sean R Cantwell
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
| | - Amy E Alexander
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
| | - Hunter J Dickens
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
| | - Jonathan M Morris
- From the Division of Plastic Surgery, Department of Surgery; Anatomic Modeling Laboratory; and Department of Radiology, Mayo Clinic
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Implementation of 3D Printing and Computer-Aided Design and Manufacturing (CAD/CAM) in Craniofacial Reconstruction. J Craniofac Surg 2022; 33:1714-1719. [DOI: 10.1097/scs.0000000000008561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/28/2022] [Indexed: 11/27/2022] Open
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Contemporary Review on Craniectomy and Cranioplasty; Part 2: Material Selection and Plate Manufacture. J Craniofac Surg 2021; 33:842-845. [PMID: 34334754 DOI: 10.1097/scs.0000000000008040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Cranioplasty materials include metals (ie, titanium); ceramics (ie, hydroxyapatite); polymers (ie, poly-methyl-metha-acrylate [PMMA]); and plastics (ie, polyether ether ketone). This paper aims to review their advantages and drawbacks. No ideal material currently exist, however, titanium implants are universally agreed to have lower infection rates than those reported for hydroxyapatite and PMMA implants; thus justifying their current wide use. These implants can be manufactured conventionally from medical grade titanium alloy Ti64 (titanium-aluminum-vanadium) in the form of plates ranging in thickness from 0.5 to 0.7 mm thick, or following the computer-aided design/manufacture principle. Surface finish of these implants is best achieved by electroplating.
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Wolfaardt JF, Brecht LE, Taft RM. The future of maxillofacial prosthodontics in North America: Part II - A survey. J Prosthet Dent 2021; 127:351-357. [PMID: 33431174 DOI: 10.1016/j.prosdent.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 01/25/2023]
Abstract
STATEMENT OF PROBLEM Head and neck care has been transformed by the introduction of advanced digital technologies that will continue to be important change drivers for maxillofacial prosthodontics. Insight into these changes is important in answering the question of whether maxillofacial prosthodontics is appropriately prepared to contribute effectively to future multidisciplinary care of the head and neck. PURPOSE The purpose of this survey was to gain insight into the perception of changes experienced by maxillofacial prosthodontists in relation to clinical practice. The findings of this survey may assist the future development of the subspecialty. MATERIAL AND METHODS An exploratory cross-sectional survey was conducted by using a convenience sample of members of the American Academy of Maxillofacial Prosthetics. The survey considered 10 domains and 31 questions. Fully completed surveys (164) provided a 59% response. Descriptive statistics used percentage responses to reduce and characterize perceptions across respondents. RESULTS Eighty-four percent of the respondents were from the United States. Results should be interpreted based on this cohort. Respondents reported a change in care delivered over the past 10 years (72%), with the most important causes of change attributed to surgery (60%) and advanced digital technologies (56%). Respondents perceived advanced digital technologies as being central to the future of maxillofacial prosthodontics (89%) and important in attracting younger colleagues (88%). Sixty-three percent believed training programs were not providing adequate education and training in the use of advanced digital technology. CONCLUSIONS The perception of maxillofacial prosthodontists regarding changes taking place in care delivery was that the most important changes in the past 10 years were attributed to surgery and advanced digital technologies, that persisting pressures related to few institutional positions, that the subspecialty was poorly visible, that remuneration for care was inadequate and referring disciplines did not understand the subspecialty, that advanced digital technologies were considered central to the future of maxillofacial prosthodontics and important to attract younger colleagues to the subspecialty, that barriers to advanced digital technology use included funding for equipment acquisition, institutional funding support, and remuneration for their use in care delivery, and that maxillofacial prosthodontic programs were not providing adequate education and training in advanced digital technologies.
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Affiliation(s)
- Johan F Wolfaardt
- Professor Emeritus, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Lawrence E Brecht
- Adjunct Clinical Associate Professor, Department of Prosthodontics, Director of Maxillofacial Prosthetics, Jonathan & Maxine Ferencz Advanced Education Program in Prosthodontics, NYU College of Dentistry, New York, NY; Director of Maxillofacial Prosthetics, Department of Otolaryngology, Division of Oral & Maxillofacial Surgery, Lenox Hill Hospital-Northwell Health, New York, NY
| | - Robert M Taft
- Professor, Comprehensive Dentistry Department, University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
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Custom-Made Porous Hydroxyapatite Cranioplasty in Patients with Tumor Versus Traumatic Brain Injury: A Single-Center Case Series. World Neurosurg 2020; 138:e922-e929. [PMID: 32272268 DOI: 10.1016/j.wneu.2020.03.144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cranioplasty is a common neurosurgical procedure with the goal of restoring skull integrity. Custom-made porous hydroxyapatite prostheses have long been used for cranial reconstruction in patients with traumatic brain injury. We present a large consecutive series of 2 groups of patients undergoing cranioplasty with hydroxyapatite custom bone and compare the adverse events (AEs) between the 2 groups. METHODS We examined a series of consecutive patients who underwent cranioplasty using custom-made porous hydroxyapatite implants following tumor resection and traumatic brain injury at a single center between March 2003 and May 2018. The implants were designed and produced according to the surgeon's specifications and based on the patient's computed tomography scan data obtained through a standardized protocol. AEs were recorded. RESULTS Information on 38 patients with tumor and 39 patients with traumatic brain injury was collected and analyzed. A significant difference in the timing of surgery was found between the 2 groups; single-stage surgery was performed in 84% of patients in the tumor versus 8% of those in the traumatic brain injury group (P < 0.0001). The rate of AEs was not significantly different between the 2 groups (P = 0.4309) and was not related to the timing of surgery. CONCLUSIONS Custom-made hydroxyapatite cranioplasty is a solution for cranial reconstruction in patients with cranial tumors. The low incidence of AEs in a consecutive series of patients with either trauma or tumors demonstrates that these prostheses represent a safe solution independent of the characteristics of cases.
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Developing an In-house Interdisciplinary Three-Dimensional Service: Challenges, Benefits, and Innovative Health Care Solutions. J Craniofac Surg 2018; 29:1870-1875. [PMID: 30052609 DOI: 10.1097/scs.0000000000004743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Three-dimensional printing (3DP) technologies have been employed in regular medical specialties. They span wide scope of uses, from creating 3D medical models to design and manufacture of Patient-specific implants and guidance devices which help to optimize medical treatments, patient education, and medical training. This article aims to provide an in-depth analysis of factors and aspects to consider when planning to setup a 3D service within a hospital serving various medical specialties. It will also describe challenges that might affect 3D service development and sustainability and describe representative cases that highlight some of the innovative approaches that are possible with 3D technology. Several companies can offer such 3DP service. They are often web based, time consuming, and requiring special call conference arrangements. Conversely, the establishment of in-house specialized hospital-based 3D services reduces the risks to personal information, while facilitating the development of local expertise in this technology. The establishment of a 3D facility requires careful consideration of multiple factors to enable the successful integration with existing services. These can be categorized under: planning, developing and sustaining 3D service; 3D service resources and networking workflow; resources and location; and 3D services quality and regulation management.
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MB S. Cranioplasty with preoperatively customized Polymethyl-methacrylate by using 3-Dimensional Printed Polyethylene Terephthalate Glycol Mold. ACTA ACUST UNITED AC 2018. [DOI: 10.29328/journal.jnnd.1001016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Volpe Y, Furferi R, Governi L, Uccheddu F, Carfagni M, Mussa F, Scagnet M, Genitori L. Surgery of complex craniofacial defects: A single-step AM-based methodology. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 165:225-233. [PMID: 30337077 DOI: 10.1016/j.cmpb.2018.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/17/2018] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE The purpose of the present paper is to pave the road to the systematic optimization of complex craniofacial surgical intervention and to validate a design methodology for the virtual surgery and the fabrication of cranium vault custom plates. Recent advances in the field of medical imaging, image processing and additive manufacturing (AM) have led to new insights in several medical applications. The engineered combination of medical actions and 3D processing steps, foster the optimization of the intervention in terms of operative time and number of sessions needed. Complex craniofacial surgical intervention, such as for instance severe hypertelorism accompanied by skull holes, traditionally requires a first surgery to correctly "resize" the patient cranium and a second surgical session to implant a customized 3D printed prosthesis. Between the two surgical interventions, medical imaging needs to be carried out to aid the design the skull plate. Instead, this paper proposes a CAD/AM-based one-in-all design methodology allowing the surgeons to perform, in a single surgical intervention, both skull correction and implantation. METHODS A strategy envisaging a virtual/mock surgery on a CAD/AM model of the patient cranium so as to plan the surgery and to design the final shape of the cranium plaque is proposed. The procedure relies on patient imaging, 3D geometry reconstruction of the defective skull, virtual planning and mock surgery to determine the hypothetical anatomic 3D model and, finally, to skull plate design and 3D printing. RESULTS The methodology has been tested on a complex case study. Results demonstrate the feasibility of the proposed approach and a consistent reduction of time and overall cost of the surgery, not to mention the huge benefits on the patient that is subjected to a single surgical operation. CONCLUSIONS Despite a number of AM-based methodologies have been proposed for designing cranial implants or to correct orbital hypertelorism, to the best of the authors' knowledge, the present work is the first to simultaneously treat osteotomy and titanium cranium plaque.
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Affiliation(s)
- Yary Volpe
- Department of Industrial Engineering of Florence, University of Florence (Italy), via di Santa Marta 3, 50139 Firenze, Italy
| | - Rocco Furferi
- Department of Industrial Engineering of Florence, University of Florence (Italy), via di Santa Marta 3, 50139 Firenze, Italy.
| | - Lapo Governi
- Department of Industrial Engineering of Florence, University of Florence (Italy), via di Santa Marta 3, 50139 Firenze, Italy
| | - Francesca Uccheddu
- Department of Industrial Engineering of Florence, University of Florence (Italy), via di Santa Marta 3, 50139 Firenze, Italy
| | - Monica Carfagni
- Department of Industrial Engineering of Florence, University of Florence (Italy), via di Santa Marta 3, 50139 Firenze, Italy
| | - Federico Mussa
- Department of Pediatric Surgery, Meyer Children's Hospital, Viale Pieraccini 24, 50141 Florence, Italy
| | - Mirko Scagnet
- Department of Pediatric Surgery, Meyer Children's Hospital, Viale Pieraccini 24, 50141 Florence, Italy
| | - Lorenzo Genitori
- Department of Pediatric Surgery, Meyer Children's Hospital, Viale Pieraccini 24, 50141 Florence, Italy
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Ghai S, Sharma Y, Jain N, Satpathy M, Pillai AK. Use of 3-D printing technologies in craniomaxillofacial surgery: a review. Oral Maxillofac Surg 2018; 22:249-259. [PMID: 29797107 DOI: 10.1007/s10006-018-0704-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/17/2018] [Indexed: 06/08/2023]
Abstract
Three-dimensional (3-D) printing is a method of manufacturing in which materials like plastic or metal are deposited onto one another in layers to produce a 3-D object. Because of the complex anatomy of craniomaxillofacial structures, full recovery of craniomaxillofacial tissues from trauma, surgeries, or congenital malformations is extremely challenging. 3-D printing of scaffolds, tissue analogs, and organs has been proposed as an exciting alternative to address some of these key challenges in craniomaxillofacial surgery. There are four broad types of 3-D printing surgical applications that can be used in craniomaxillofacial surgery: contour models (positive-space models to allow preapplication of hardware before surgery), guides (negative-space models of actual patient data to guide cutting and drilling), splints (negative-space models of virtual postoperative positions to guide final alignment), and implants (negative-space 3-D printed implantable materials or 3-D printed molds into which nonprintable materials are poured). 3-D printing technology is being successfully used for surgeries for head and neck malignancies, mandibular reconstruction, orthognathic surgeries, for mandibulectomies after osteoradionecrosis, orbital floor fracture surgeries, nasal reconstruction, and cranioplasties. The excitement behind 3-D printing continues to increase and hopefully will drive improvements in the technology and its surgical applications, especially in craniomaxillofacial region. This present review sets out to explore use of 3-D printing technologies in craniomaxillofacial surgery.
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Affiliation(s)
- Suhani Ghai
- Department of Oral and Maxillofacial Surgery, People's Dental Academy, People's University, Karond By-Pass, Bhanpur, Bhopal, 462037, India.
| | - Yogesh Sharma
- Department of Oral and Maxillofacial Surgery, People's Dental Academy, People's University, Karond By-Pass, Bhanpur, Bhopal, 462037, India
| | - Neha Jain
- Department of Oral and Maxillofacial Surgery, People's Dental Academy, People's University, Karond By-Pass, Bhanpur, Bhopal, 462037, India
| | - Mrinal Satpathy
- Department of Oral and Maxillofacial Surgery, People's Dental Academy, People's University, Karond By-Pass, Bhanpur, Bhopal, 462037, India
| | - Ajay Kumar Pillai
- Department of Oral and Maxillofacial Surgery, People's Dental Academy, People's University, Karond By-Pass, Bhanpur, Bhopal, 462037, India
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Autologous Bone Is Inferior to Alloplastic Cranioplasties: Safety of Autograft and Allograft Materials for Cranioplasties, a Systematic Review. World Neurosurg 2018; 117:443-452.e8. [DOI: 10.1016/j.wneu.2018.05.193] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/25/2018] [Accepted: 05/26/2018] [Indexed: 11/19/2022]
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Oh JH. Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing. Maxillofac Plast Reconstr Surg 2018; 40:2. [PMID: 29430438 PMCID: PMC5797724 DOI: 10.1186/s40902-018-0141-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 01/16/2018] [Indexed: 11/21/2022] Open
Abstract
With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.
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Affiliation(s)
- Ji-Hyeon Oh
- Department of Oral and MaxilloFacial Surgery, Dental Hospital, Gangneung-Wonju National University, Gangneung, South Korea
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Davey AV. The effect of manufacturing techniques on custom-made titanium cranioplasty plates: A pilot study. J Craniomaxillofac Surg 2017; 45:2017-2027. [PMID: 29096989 DOI: 10.1016/j.jcms.2017.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE This study investigated the effect of varying techniques on the surface characteristics of pressed titanium cranioplasty plates, commonly manufactured in laboratory practice. The aim was to highlight the variety of techniques currently used, assess these methods of manufacture and produce manufacturing recommendations. METHODS A questionnaire identified manufacturing methods commonly used by maxillofacial prosthetists. The plate surfaces were examined using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectrometry. The surface differences and titanium compositions were statistically analysed. RESULTS Bead blasting with aluminium oxide (Al2O3) showed a significant decrease (p < 0.001) in titanium surface composition, replaced by a large aluminium content. Trimming tool choice had a significant impact (p = 0.001) on surface contamination by smoothing wheel material deposition; however passivation and anodising techniques had no significant effect (p = 0.293 and p = 0.257, respectively) on the surface composition or roughness of titanium samples. CONCLUSIONS A large range of manufacturing techniques of titanium cranioplasty plates was confirmed and significant differences were found. Amongst other recommendations, bead blasting with Al2O3 is not recommended for commercially pure titanium implant surface finishing due to aluminium contamination. The recommendations outlined will minimise manufacturing time, reduce risk of complication (thus costs) and unify methods to enable a safe, reliable treatment.
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Affiliation(s)
- Amy V Davey
- Reconstructive Prosthetics North Bristol NHS Trust, Gate 24, Level 1, Brunel Building, Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB, UK.
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Hatamleh MM, Yeung E, Osher J, Huppa C. Novel Treatment Planning of Hemimandibular Hyperplasia by the Use of Three-Dimensional Computer-Aided-Design and Computer-Aided-Manufacturing Technologies. J Craniofac Surg 2017; 28:764-767. [DOI: 10.1097/scs.0000000000003438] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Cranioplasty remains a difficult procedure for all craniofacial surgeons, particularly when concerning the reconstruction of large lacunae in the skull. Considering the significant clinical and economic impact of the procedure, the search for materials and strategies to provide more comfortable and reliable surgical procedures is one of the most important challenges faced by modern craniofacial medicine.The purpose of this study was to compare the available data regarding the safety and clinical efficacy of materials and techniques currently used for the reconstruction of the skull. Accordingly, the scientific databases were searched for the following keywords autologous bone, biomaterials, cranial reconstruction, cranioplasty, hydroxyapatite, polyetheretherketone, polymethylmethacrylate, and titanium. This literature review emphasizes the benefits and weaknesses of each considered material commonly used for cranioplasty, especially in terms of infectious complications, fractures, and morphological outcomes.As regards the latter, this appears to be very similar among the different materials when custom three-dimensional modeling is used for implant development, suggesting that this criterion is strongly influenced by implant design. However, the overall infection rate can vary from 0% to 30%, apparently dependent on the type of material used, likely in virtue of the wide variation in their chemico-physical composition. Among the different materials used for cranioplasty implants, synthetics such as polyetheretherketone, polymethylmethacrylate, and titanium show a higher primary tear resistance, whereas hydroxyapatite and autologous bone display good biomimetic properties, although the latter has been ascribed a variable reabsorption rate of between 3% and 50%.In short, all cranioplasty procedures and materials have their advantages and disadvantages, and none of the currently available materials meet the criteria required for an ideal implant. Hence, the choice of cranioplasty materials is still essentially reliant on the surgeon's preference.
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Hoang D, Perrault D, Stevanovic M, Ghiassi A. Surgical applications of three-dimensional printing: a review of the current literature & how to get started. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:456. [PMID: 28090512 DOI: 10.21037/atm.2016.12.18] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Three dimensional (3D) printing involves a number of additive manufacturing techniques that are used to build structures from the ground up. This technology has been adapted to a wide range of surgical applications at an impressive rate. It has been used to print patient-specific anatomic models, implants, prosthetics, external fixators, splints, surgical instrumentation, and surgical cutting guides. The profound utility of this technology in surgery explains the exponential growth. It is important to learn how 3D printing has been used in surgery and how to potentially apply this technology. PubMed was searched for studies that addressed the clinical application of 3D printing in all surgical fields, yielding 442 results. Data was manually extracted from the 168 included studies. We found an exponential increase in studies addressing surgical applications for 3D printing since 2011, with the largest growth in craniofacial, oromaxillofacial, and cardiothoracic specialties. The pertinent considerations for getting started with 3D printing were identified and are discussed, including, software, printing techniques, printing materials, sterilization of printing materials, and cost and time requirements. Also, the diverse and increasing applications of 3D printing were recorded and are discussed. There is large array of potential applications for 3D printing. Decreasing cost and increasing ease of use are making this technology more available. Incorporating 3D printing into a surgical practice can be a rewarding process that yields impressive results.
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Affiliation(s)
- Don Hoang
- USC Plastic and Reconstructive Surgery, Los Angeles, CA, USA
| | - David Perrault
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Milan Stevanovic
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Alidad Ghiassi
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Matsumoto JS, Morris JM, Foley TA, Williamson EE, Leng S, McGee KP, Kuhlmann JL, Nesberg LE, Vrtiska TJ. Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic. Radiographics 2016; 35:1989-2006. [PMID: 26562234 DOI: 10.1148/rg.2015140260] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Radiologists will be at the center of the rapid technologic expansion of three-dimensional (3D) printing of medical models, as accurate models depend on well-planned, high-quality imaging studies. This article outlines the available technology and the processes necessary to create 3D models from the radiologist's perspective. We review the published medical literature regarding the use of 3D models in various surgical practices and share our experience in creating a hospital-based three-dimensional printing laboratory to aid in the planning of complex surgeries.
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Affiliation(s)
- Jane S Matsumoto
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Jonathan M Morris
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Thomas A Foley
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Eric E Williamson
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Shuai Leng
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Kiaran P McGee
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Joel L Kuhlmann
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Linda E Nesberg
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Terri J Vrtiska
- From the Division of Pediatric Radiology, Department of Radiology (J.S.M.); Division of Neuroradiology, Department of Radiology (J.M.M.); Division of Cardiovascular Radiology, Department of Radiology (T.A.F., E.E.W., T.J.V.); Division of Abdominal Imaging, Department of Radiology (E.E.W., T.J.V.); Division of Medical Physics, Department of Radiology (S.L., K.P.M.); Division of Engineering (J.L.K.); and Department of Radiology (L.E.N.), Mayo Clinic, 200 First Street SW, Rochester, MN 55905
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Alloderm Covering Over Titanium Cranioplasty May Minimize Contour Deformities in the Frontal Bone Position. J Craniofac Surg 2016; 27:1292-4. [DOI: 10.1097/scs.0000000000002796] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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