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Hubacz JC, Gullard A, Sheridan RR, Versluis A. Accuracy and resolution of conventional and additively manufactured silicone elastomers as applied in maxillofacial therapies. J Prosthet Dent 2024:S0022-3913(24)00278-6. [PMID: 38704320 DOI: 10.1016/j.prosdent.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 05/06/2024]
Abstract
STATEMENT OF PROBLEM Silicone elastomers are becoming more readily available for additive manufacturing, which may be advantageous for fabricating maxillofacial prostheses. However, the properties of three-dimensionally (3D) printed silicone as compared with conventionally processed silicone have not been well studied. PURPOSE The purpose of this in vitro study was to compare the dimensional accuracy and surface resolution of additively manufactured with conventional room-temperature vulcanized (RTV) silicones. MATERIAL AND METHODS A custom aluminum mold was used to generate hand-spatulated specimens (A103 and VerSilTal-50F, n=20). A computer-aided design and computer-aided manufacturing workflow was used to generate additively manufactured specimens (Sil30 and TrueSil, n=20). Digital surface scans of each specimen were recorded; a scan of the mold served as the control. Surface dimensions were measured with a digital metrology software program, while digital overlays were made using a 3D processing software program. The surface resolution of the specimens was assessed by analyzing 4 topographical landmarks (flat surfaces, raised lines, domes, and scribed lines) with a visual qualitative grading scale. The data were analyzed with 1-way analysis of variance, followed by a Student-Newman-Keuls post hoc test (α=.05). RESULTS The specimens demonstrated statistical differences in trueness and precision (P<.001). The TrueSil specimens showed the largest deviation in measurements of trueness and precision (up to -1.374%). The other specimens yielded percentage mean differences that were more consistently within the range of the American Dental Association International Organization for Standardization standard for elastomers. The manually fabricated specimens yielded more consistently ideal ratings for resolution than did the additively manufactured ones, with the Sil30 specimens receiving the most Charlie (not clinically acceptable) ratings. CONCLUSIONS Numerical differences between each specimen and the control were considered negligible for maxillofacial applications. Notable discrepancies related to the quality of resolution, wherein the benchtop-manufactured specimens consistently generated better results compared with additively manufactured ones. Other factors, such as resiliency, odor, and cost, posed limitations in justifying the use of silicones in a direct-to-print workflow.
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Affiliation(s)
- Jenna C Hubacz
- Resident, Advanced Prosthodontics Program, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tenn
| | - Angela Gullard
- Assistant Professor and Implantology Director, Department of Prosthodontics, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tenn
| | - Ryan R Sheridan
- Director, Peterson Area Dental Laboratory, United States Air Force, Peterson Space Force Base, Colorado Springs, Colo.; and Military Consultant to the Air Force Surgeon General for Dental Laboratories, Air Force Medical Service, United States Air Force
| | - Antheunis Versluis
- Professor, Director of Biomaterials Research, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tenn.
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Fan Y, Wei H, Zhao R, Lin X, Bai S. Accuracy of implant placement using CAD-CAM tooth-supported surgical guides for an auricular prosthesis in vitro. J Prosthodont 2024; 33:70-76. [PMID: 36710294 DOI: 10.1111/jopr.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To evaluate the accuracy of tooth-supported surgical guides used to place implants in auricular prostheses. The accuracy (trueness and precision) of the implant positions was evaluated, and the difference between the surgical guide with and without retention of the external auditory canal (EAC) was compared. MATERIALS AND METHODS This study simulated implant placement in vitro for the treatment of right auricle malformation. Surgical guides and other casts were fabricated using additive manufacturing technology. The casts were divided into 2 groups according to the surgical guide, with 10 bone blocks in each group (with or without the EAC plug (Guides 1 and 2)). Three implant positions (Implants 1-3) were prepared for each bone block using surgical guides. Implant positions were registered using light-body silicone impressions combined with optical surface scans to measure the coronal, apical, depth, and angular deviations. Four deviations of trueness and precision were reported as the mean ± standard deviation, which was analyzed by Student's t-test. RESULTS Each group of 10 bone blocks with 30 implant positions was successfully prepared and digitally reproduced as implants. The accuracies of implant position with surgical guides were acceptable when compared with the preoperatively planned implant positions. Compared with the Guide 2 group, there was a significant difference in the apical, depth, and angular deviations of Guide 1 group in terms of precision (p = 0.001). There was a significant difference in the depth deviation of Implant 1 (p = 0.028) and apical deviation of Implant 2 (p < 0.001) compared two groups in terms of trueness. In terms of precision, there was a significant difference in the coronal (p = 0.002), apical (p = 0.001), and depth (p < 0.001) deviation of Implant 1; apical (p = 0.036) and angular (p < 0.001) deviation of Implant 2 also existed significant difference; the coronal deviation of Implant 3 (p = 0.018) also existed significant difference. Moreover, the group with the EAC plug showed lower deviation in precision and a smaller volume in the 95% confidence ellipsoid. CONCLUSION Both types of tooth-supported surgical guides can provide acceptable accuracy. A surgical guide with an EAC plug was considered to be more precise.
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Affiliation(s)
- Yiping Fan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, P. R. China
| | - Hongbo Wei
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Ruifeng Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Xiuwen Lin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, P. R. China
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Unkovskiy A, Spintzyk S, Kiemle T, Roehler A, Huettig F. Trueness and precision of skin surface reproduction in digital workflows for facial prosthesis fabrication. J Prosthet Dent 2023; 130:402-413. [PMID: 35256182 DOI: 10.1016/j.prosdent.2021.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How much skin surface details of facial prostheses can be transferred throughout the digital production chain has not been quantified. PURPOSE The purpose of this in vitro study was to quantify the amount of skin surface details transferred from the prosthesis virtual design through the prototype printing with various additive manufacturing (AM) methods to the definitive silicone prosthesis with an indirect mold-making approach. MATERIAL AND METHODS Twelve test blocks with embossed wrinkles of 0.05 to 0.8 mm and 12 test blocks with applied earlobe skin structures were printed with stereolithography (SLA), direct light processing (DLP), and PolyJet methods (n=4). DLP and SLA prototype specimens were duplicated in wax. All specimens were then transferred into medical-grade silicone. Rz values of the wrinkle test blocks and the root mean square error (RMSE) of the earlobe test blocks were evaluated by laser topography to determine the trueness and precision of each stage. RESULTS For the earlobe test blocks, the PolyJet method had superior trueness and precision of the final skin surface reproduction. The SLA method showed the poorest trueness, and the DLP method, the lowest precision. For the wrinkle test blocks, the PolyJet method had the best wrinkle profile reproduction level, followed by DLP and SLA. CONCLUSIONS The indirect mold-making approach of facial prostheses manufacturing may be associated with 7% of skin surface profile loss with SLA, up to 20% with DLP, and no detail loss with PolyJet.
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Affiliation(s)
- Alexey Unkovskiy
- Research Associate, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Sebastian Spintzyk
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Tobias Kiemle
- Research Associate, Department of Geosciences, University of Tuebingen, Tuebingen, Germany
| | - Ariadne Roehler
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Acting Deputy Head, Priv.-Doz, Department of Prosthodontics, Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
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Ali IE, Hattori M, Sumita YI. Effect of cut-out rescan procedures on the accuracy of an intraoral scanner used for digitizing an ear model: An in vitro study. J Prosthodont 2022. [PMID: 35964239 DOI: 10.1111/jopr.13591] [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: 05/06/2022] [Accepted: 08/07/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the impact of the rescanning of mesh holes of different diameters on the accuracy of an intraoral scanner (IOS) used to digitize an ear model. MATERIALS AND METHODS An ear model was digitized using an intraoral scanner (Medit i500) to obtain a reference mesh. A baseline experimental scan was created by editing a duplicate of the reference mesh using the cut-out tool of the IOS software. Three equal groups were created based on the diameter of the cut-out areas: 2-mm (G1), 5mm (G2), and 8-mm (G3) (n = 15). The cut-out areas were rescanned and a total of 45 digital files were exported. The discrepancy between the reference and the experimental digital scans was measured using the root mean square calculation (RMS). The data were analyzed by a Kruskal-Wallis test followed by a post hoc Dunn's test with Bonferroni correction. RESULTS The trueness values ranged from 19.53 to 27.13 μm. There were significant differences in the RMS error values among the groups tested (p<.001) and post hoc multiple comparisons showed significant differences between the G1 and G2 groups (p = .04), G1 and G3 groups (p<.001), and G2 and G3 groups (p = .004). Overall, the precision values ranged from 4.93 to 7.73 μm and significant differences in the RMS values were only found between the G1 and G2 groups (p = .014). CONCLUSIONS Mesh hole rescanning affected the scanning accuracy (trueness and precision) of the IOS tested. The larger the diameter of the mesh holes, the less the trueness of the IOS tested. The precision values seemed to be less affected compared with the trueness by the cut-out and rescanning procedures. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Islam E Ali
- Doctoral student, Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mariko Hattori
- Assistant Professor, Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka I Sumita
- Associate Professor, Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Lu D, Yang Y, Zhang P, Ma Z, Li W, Song Y, Feng H, Yu W, Ren F, Li T, Zeng H, Wang J. Development and Application of Three-Dimensional Bioprinting Scaffold in the Repair of Spinal Cord Injury. Tissue Eng Regen Med 2022; 19:1113-1127. [PMID: 35767151 DOI: 10.1007/s13770-022-00465-1] [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: 01/14/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 01/04/2023] Open
Abstract
Spinal cord injury (SCI) is a disabling and destructive central nervous system injury that has not yet been successfully treated at this stage. Three-dimensional (3D) bioprinting has become a promising method to produce more biologically complex microstructures, which fabricate living neural constructs with anatomically accurate complex geometries and spatial distributions of neural stem cells, and this is critical in the treatment of SCI. With the development of 3D printing technology and the deepening of research, neural tissue engineering research using different printing methods, bio-inks, and cells to repair SCI has achieved certain results. Although satisfactory results have not yet been achieved, they have provided novel ideas for the clinical treatment of SCI. Considering the potential impact of 3D bioprinting technology on neural studies, this review focuses on 3D bioprinting methods widely used in SCI neural tissue engineering, and the latest technological applications of bioprinting of nerve tissues for the repair of SCI are discussed. In addition to introducing the recent progress, this work also describes the existing limitations and highlights emerging possibilities and future prospects in this field.
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Affiliation(s)
- Dezhi Lu
- School of Medicine, Shanghai University, Shanghai, 200444, China
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yang Yang
- Department of Rehabilitation Medicine, Shandong Provincial Third Hospital, Shandong, 250000, China
| | - Pingping Zhang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Zhenjiang Ma
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Wentao Li
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yan Song
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Haiyang Feng
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Wenqiang Yu
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Fuchao Ren
- School of Rehabilitation Medicine, Weifang Medical University, Weifang, 261053, China
| | - Tao Li
- Department of Orthopaedics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
| | - Hong Zeng
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Jinwu Wang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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Salazar-Gamarra R, Cárdenas-Bocanegra A, Masch U, Da Costa Moraes CA, Seelaus R, Lopes Da Silva JV, Lauria Dib L. Color translation from monoscopic photogrammetry +ID Methodology into a Polyjet final 3D printed facial prosthesis. F1000Res 2022; 11:582. [PMID: 38434006 PMCID: PMC10904947 DOI: 10.12688/f1000research.111196.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 03/05/2024] Open
Abstract
Background: The artistic techniques necessary to fabricate facial prostheses mainly depend on individual skill and are not a resource easily reproduced. Digital technology has contributed to improved outcomes, often combining analog and new digital techniques in the same workflow. Methods: This article aims to present an innovative workflow to produce a final colored 3D printed and facial prosthesis by UV-map color translation into colored resin 3D printing. A modified +ID Methodology was used to obtain 3D models with the calibrated 3D printable patient's skin color. No hands-on physical molding, manual sculpture, or intrinsic silicone coloration was used. Results: The outcome resulted in acceptable aesthetics, adaptation, and an approximate color match after extrinsic coloration. The patient reported good comfort and acceptance. Conclusions: A direct resin 3D printed prosthesis may be a viable alternative, especially for rapid delivery as an immediate prosthesis or an option when there is no experienced anaplastogist to manufacture a conventional prosthesis.
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Affiliation(s)
- Rodrigo Salazar-Gamarra
- Norbert Wiener University - Digital Transformation Research Centre, Lima, 15046, Peru
- Plus Identity (+ID) Institute, São Paulo, 04057-000, Brazil
| | | | | | | | - Rosemary Seelaus
- The Craniofacial Center, Department of Surgery, University of Illinois at Chicago, Chicago, 60612, USA
| | | | - Luciano Lauria Dib
- Plus Identity (+ID) Institute, São Paulo, 04057-000, Brazil
- Paulista University, São Paulo, 04057-000, Brazil
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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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Unkovskiy A, Spintzyk S, Beuer F, Huettig F, Röhler A, Kraemer-Fernandez P. Accuracy of capturing nasal, orbital, and auricular defects with extra- and intraoral optical scanners and smartphone: An in vitro study. J Dent 2021; 117:103916. [PMID: 34875273 DOI: 10.1016/j.jdent.2021.103916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This in vitro study compares the scanning accuracy of various stationary and portable as well as extra- and intraoral devices for capturing oncological defects. METHODS A 3D-printed model of a nasal, orbital, and auricular defect, as well as one of an intact auricle, were digitalized (n = 7 per device) with a stationary optical scanner (Pritiface), a portable extraoral optical scanner (Artec Space Spider), two intraoral scanners (Trios 4 and Primescan), and a smartphone (iPhone 11 Pro). For the reference data, the defect models were digitalized using a laboratory scanner (D2000). For quantitative analysis, the root mean square error value for trueness and precision and mean deviations in millimeters were obtained for each defect type. The data were statistically analyzed using two-way ANOVA and Tukey multiple comparison test. For qualitative analysis, a colorimetric map was generated to display the deviation within the defect area and adjacent tissue. RESULTS Statistically significant interactions were found in the trueness and precision for defect and scanner type. CONCLUSION The Primescan and Artec Space Spider scanners showed the highest accuracy for most defect types. Primescan and Trios 4 failed to capture the orbital defect. The iPhone 11 Pro showed clinically acceptable trueness but inferior precision. CLINICAL SIGNIFICANCE The scanning devices may demonstrate varying accuracy, depending on the defect type. A portable extraoral optical scanner is an universal tool for the digitization of oncological defects. Alternatively, an intraoral scanner may be employed in maxillofacial prosthetics with some restrictions. Utilizing a smartphone in maxillofacial rehabilitation should be considered with caution, because it provides inconsistent accuracy.
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Affiliation(s)
- Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146 Moscow, Russian Federation.
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; ADMiRE Lab-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
| | - Ariadne Röhler
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
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Dashti H, Rajati Haghi H, Nakhaei M, Kiamanesh E. A combined digital technique to fabricate an implant-retained auricular prosthesis for rehabilitation of hemifacial microsomia. J Prosthet Dent 2021; 127:807-810. [PMID: 33454119 DOI: 10.1016/j.prosdent.2020.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 11/24/2022]
Abstract
Implant-retained auricular prostheses provide an excellent treatment option with better retention and stability than a conventionally retained prosthesis. This article presents a technique for auricular reconstruction for a patient with misplaced implants. The scanning process combined the use of an intraoral scanner and a facial scanner to enhance accuracy in space management for different parts of the auricular prosthesis and to reduce sculpting time.
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Affiliation(s)
- Hossein Dashti
- Assistant Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Rajati Haghi
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza Nakhaei
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Kiamanesh
- Graduate student, Resident of Prosthodontic, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Domingue D, Glenn NC, Vest A, White JR. Osseointegrated implant-retained auricular prosthesis constructed using cone-beam computed tomography and a prosthetically driven digital workflow: a case report. Clin Case Rep 2021; 9:37-45. [PMID: 33489131 PMCID: PMC7813007 DOI: 10.1002/ccr3.3386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/07/2020] [Accepted: 08/09/2020] [Indexed: 11/08/2022] Open
Abstract
Prosthetically driven workflows using CBCT, digital optical scanning, 3D-printed molds and frameworks, and dental implant component attachments to osseointegrated fixtures can produce anatomically accurate, esthetic, durable silicone ear replacements.
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Affiliation(s)
- Daniel Domingue
- Private PracticeImplantology and Restorative DentistryLafayetteLAUSA
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Abdollahi S, Markvicka EJ, Majidi C, Feinberg AW. 3D Printing Silicone Elastomer for Patient-Specific Wearable Pulse Oximeter. Adv Healthc Mater 2020; 9:e1901735. [PMID: 32548973 DOI: 10.1002/adhm.201901735] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/03/2020] [Indexed: 11/08/2022]
Abstract
Commercial pulse oximeters are used clinically to measure heart rate and blood oxygen saturation and traditionally made from rigid materials. However, these devices are unsuitable for continuous monitoring due to poor fit and mechanical mismatch. Soft materials that match the elastic properties of biological tissue provide improved comfort and signal-to-noise but typically require molding to manufacture, limiting the speed and ease of customizing for patient-specific anatomy. Here, freeform reversible embedding (FRE) 3D printing is used to create polydimethylsiloxane (PDMS) elastomer cuffs for use on the hand and foot. FRE enables printing liquid PDMS prepolymer in 3D geometries within a sacrificial hydrogel bath that provides support during cure. This serves as proof-of-concept for fabricating patient-specific pulse oximeters with pressure sensing, termed P3 -wearable. A sizing analysis establishes dimensional accuracy of FRE-printed PDMS compared to anatomical computer-aided design models. The P3 -wearable successfully outputs photoplethysmography (PPG) and pressure amplitude signals wirelessly to a tablet in real time and the PPG is used to calculate heart rate, blood oxygen content, and activity state. The results establish that FRE printing of PDMS can be used to fabricate patient-specific wearable devices and measure heart rate and blood oxygenation on par with commercial devices.
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Affiliation(s)
- Sara Abdollahi
- Department of Biomedical EngineeringCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
| | - Eric J. Markvicka
- Robotics InstituteCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
| | - Carmel Majidi
- Robotics InstituteCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
- Department of Mechanical EngineeringCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
| | - Adam W. Feinberg
- Department of Biomedical EngineeringCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
- Department of Materials Science and EngineeringCarnegie Mellon University 5000 Forbes Avenue Pittsburgh PA 15213 USA
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Advances in the Research of Bioinks Based on Natural Collagen, Polysaccharide and Their Derivatives for Skin 3D Bioprinting. Polymers (Basel) 2020; 12:polym12061237. [PMID: 32485901 PMCID: PMC7362214 DOI: 10.3390/polym12061237] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 12/22/2022] Open
Abstract
The skin plays an important role in protecting the human body, and wound healing must be set in motion immediately following injury or trauma to restore the normal structure and function of skin. The extracellular matrix component of the skin mainly consists of collagen, glycosaminoglycan (GAG), elastin and hyaluronic acid (HA). Recently, natural collagen, polysaccharide and their derivatives such as collagen, gelatin, alginate, chitosan and pectin have been selected as the matrix materials of bioink to construct a functional artificial skin due to their biocompatible and biodegradable properties by 3D bioprinting, which is a revolutionary technology with the potential to transform both research and medical therapeutics. In this review, we outline the current skin bioprinting technologies and the bioink components for skin bioprinting. We also summarize the bioink products practiced in research recently and current challenges to guide future research to develop in a promising direction. While there are challenges regarding currently available skin bioprinting, addressing these issues will facilitate the rapid advancement of 3D skin bioprinting and its ability to mimic the native anatomy and physiology of skin and surrounding tissues in the future.
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Chan B, Rudan JF, Mousavi P, Kunz M. Intraoperative integration of structured light scanning for automatic tissue classification: a feasibility study. Int J Comput Assist Radiol Surg 2020; 15:641-649. [PMID: 32144629 DOI: 10.1007/s11548-020-02129-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/17/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Structured light scanning is a promising inexpensive and accurate intraoperative imaging modality. Integration of these scanners in surgical workflows has the potential to enable rapid registration and augment preoperative imaging, in a practical and timely manner in the operating theatre. Previously, we have demonstrated the intraoperative feasibility of such scanners to capture anatomical surface information with high accuracy. The purpose of this study was to investigate the feasibility of automatically characterizing anatomical tissues from textural and spatial information captured by such scanners using machine learning. Assisted or automatic identification of relevant components of a captured scan is essential for effective integration of the technology in surgical workflow. METHODS During a clinical study, 3D surface scans for seven total knee arthroplasty patients were collected, and textural and spatial features for cartilage, bone, and ligament tissue were collected and annotated. These features were used to train and evaluate machine learning models. As part of our preliminary preparation, three fresh-frozen knee cadaver specimens were also used where 3D surface scans with texture information were collected during different dissection stages. The resulting models were manually segmented to isolate texture information for muscles, tendon, cartilage, and bone. This information, and detailed labels from dissections, provided an in-depth, finely annotated dataset for building machine learning classifiers. RESULTS For characterizing bone, cartilage, and ligament in the intraoperative surface models, random forest and neural network-based models achieved an accuracy of close to 80%, whereas an accuracy of close to 90% was obtained when only characterizing bone and cartilage. Average accuracy of 76-82% was reached for cadaver data in two-, three-, and four-class tissue separation. CONCLUSIONS The results of this project demonstrate the feasibility of machine learning methods to accurately classify multiple types of anatomical tissue. The ability to automatically characterize tissues in intraoperatively collected surface models would streamline the surgical workflow of using structured light scanners-paving the way to applications such as 3D documentation of surgery in addition to rapid registration and augmentation of preoperative imaging.
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Affiliation(s)
- Brandon Chan
- School of Computing, Queen's University, 557 Goodwin Hall, Kingston, ON, K7L 2N8, Canada
| | - John F Rudan
- Department of Surgery, Kingston Health Sciences Centre, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada
| | - Parvin Mousavi
- School of Computing, Queen's University, 557 Goodwin Hall, Kingston, ON, K7L 2N8, Canada.
| | - Manuela Kunz
- School of Computing, Queen's University, 557 Goodwin Hall, Kingston, ON, K7L 2N8, Canada.
- National Research Council Canada, 1200 Montreal Rd, Building M-50, Ottawa, ON, K1A 0R6, Canada.
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14
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Advances in bioprinting using additive manufacturing. Eur J Pharm Sci 2019; 143:105167. [PMID: 31778785 DOI: 10.1016/j.ejps.2019.105167] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 01/27/2023]
Abstract
Since its conception in the 1980's, several advances in the field of additive manufacturing have led to exploration of alternate as well as combination biomaterials. These progresses have directed the use of 3D printing in wider applications such as printing of dermal layers, cartilage, bone defects, and surgical implants. Furthermore, the incorporation of live and functional cells with or atop biomaterials has laid the foundation for its use in tissue engineering. The purpose of this review is to summarize the advances in 3D printing and bioprinting of several types of tissues such as skin, cartilage, bones, and cardiac valves. This review will address the current 3D technologies used in tissue construction and study the biomaterials being investigated. There are several requirements that need to be addressed, in order to reconstruct functional tissue such as mechanical strength, porosity of the replicate and cellular incorporation. Researchers have focused their studies to answer questions regarding these requirements.
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15
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Dimensional Accuracy and Mechanical Properties of Chopped Carbon Reinforced Polymers Produced by Material Extrusion Additive Manufacturing. MATERIALS 2019; 12:ma12233885. [PMID: 31775222 PMCID: PMC6926501 DOI: 10.3390/ma12233885] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022]
Abstract
Fused Filament Fabrication (FFF), classified under material extrusion additive manufacturing technologies, is a widely used method for fabricating thermoplastic parts with high geometrical complexity. To improve the mechanical properties of pure thermoplastic materials, the polymeric matrix may be reinforced by different materials such as carbon fibers. FFF is an advantageous process for producing polymer matrix composites because of its low cost of investment, high speed and simplicity as well as the possibility to use multiple nozzles with different materials. In this study, the aim was to investigate the dimensional accuracy and mechanical properties of chopped carbon-fiber-reinforced tough nylon produced by the FFF process. The dimensional accuracy and manufacturability limits of the process are evaluated using benchmark geometries as well as process-inherent effects like stair-stepping effect. The hardness and tensile properties of produced specimens in comparison to tough nylon without any reinforcement, as well as continuous carbon-reinforced specimens, were presented by taking different build directions and various infill ratios. The fracture surfaces of tensile specimens were observed using a Scanning Electron Microscope (SEM). The test results showed that there was a severe level of anisotropy in the mechanical properties, especially the modulus of elasticity, due to the insufficient fusion between deposited layers in the build direction. Moreover, continuous carbon-reinforced specimens exhibited very high levels of tensile strength and modulus of elasticity whereas the highest elongation was achieved by tough nylon without reinforcement. The failure mechanisms were found to be inter-layer porosity between successive tracks, as well as fiber pull out.
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Liu H, Bai S, Yu X, Zhao Y. Combined use of a facial scanner and an intraoral scanner to acquire a digital scan for the fabrication of an orbital prosthesis. J Prosthet Dent 2019; 121:531-534. [DOI: 10.1016/j.prosdent.2018.05.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/26/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022]
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Xu Y, Unkovskiy A, Klaue F, Rupp F, Geis-Gerstorfer J, Spintzyk S. Compatibility of a Silicone Impression/Adhesive System to FDM-Printed Tray Materials-A Laboratory Peel-off Study. MATERIALS 2018; 11:ma11101905. [PMID: 30301282 PMCID: PMC6213137 DOI: 10.3390/ma11101905] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/21/2018] [Accepted: 10/04/2018] [Indexed: 01/15/2023]
Abstract
Computer-aided design (CAD) and additive manufacturing (AM) have shown promise in facilitating the fabrication of custom trays. Due to the clinical requirements, custom tray materials should achieve good bonding to the impression/adhesive systems. This study evaluated the retention of three fused deposition modeling (FDM) custom tray materials to a silicone impression/adhesive system before and after gritblasting (GB) by peel-off test. CAD-designed experimental test blocks were printed by FDM using acrylonitrile butadiene styrene (ABS), polyethylene terephthalate glycol copolyester (PETG), and high impact polystyrene (HIPS), and the reference test blocks were made of a conventional light-curing resin (n = 11). Before and after GB, the surface topography of all tray materials was analysed, and the maximum strength of the test block peeled off from a silicone impression/adhesive system was measured. After GB, the arithmetic mean height (Sa) and the valley fluid retention index (Svi) of the four material groups declined (p < 0.05). The peel-off strength of each of the four material groups significantly decreased by GB (p < 0.05), but no statistical difference could be found among them before or after GB. In all peel-off tests, adhesive failure occurred at the adhesive-impression material interface. The results indicated ABS, HIPS, and PETG could provide sufficient adhesion to the adhesive as the conventional light-curing resin, and GB could reduce the roughness generated by FDM and weaken the bonding between the adhesive and the silicone impression.
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Affiliation(s)
- Yichen Xu
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, University Hospital Tuebingen, 72076 Tuebingen, Germany.
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow 119146, Russia.
| | - Felix Klaue
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Frank Rupp
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Juergen Geis-Gerstorfer
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Sebastian Spintzyk
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
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Unkovskiy A, Spintzyk S, Brom J, Huettig F, Keutel C. Direct 3D printing of silicone facial prostheses: A preliminary experience in digital workflow. J Prosthet Dent 2018; 120:303-308. [PMID: 29429837 DOI: 10.1016/j.prosdent.2017.11.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022]
Abstract
Direct silicone printing may be applied to the fabrication of maxillofacial prostheses, although its clinical feasibility is unknown. The present clinical report shows an early application of a directly printed silicone prosthesis for the rehabilitation of a nasal defect. Two extraoral scanning systems were used to capture the face and the defect. The virtual construction of the nasal prosthesis was performed with free-form software. Two prostheses were printed in silicone and post-processed by manual sealing and coloring. The clinical outcome was acceptable for an interim prosthesis; however, the marginal adaptation and color match were not satisfactory without further individualization.
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Affiliation(s)
- Alexey Unkovskiy
- Dentist, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany.
| | - Sebastian Spintzyk
- Material Science Engineer, Section of Medical Materials and Science, Tübingen University Hospital, Tübingen, Germany
| | - Joern Brom
- Anaplastologist, Brom Epithetik, Heidelberg, Germany
| | - Fabian Huettig
- Assistant Medical Director, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
| | - Constanze Keutel
- Senior Associate, Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
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