1
|
Scherer-Quenzer AC, Beyers I, Kalisz A, Sauer ST, Zimmermann M, Wöckel A, Polat B, Schlaiss T, Schelbert S, Kiesel M. Evaluating the value of individualized 3D printed models for examination, diagnosis and treatment planning of cervical cancer. 3D Print Med 2024; 10:25. [PMID: 39066869 DOI: 10.1186/s41205-024-00229-8] [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: 03/25/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND 3D printing holds great potential of improving examination, diagnosis and treatment planning as well as interprofessional communication in the field of gynecological oncology. In the current manuscript we evaluated five individualized, patient-specific models of cervical cancer FIGO Stage I-III, created with 3D printing, concerning their value for translational oncology. METHODS Magnetic resonance imaging (MRI) of the pelvis was performed on a 3.0 Tesla MRI, including a T2-weighted isotropic 3D sequence. The MRI images were segmented and transferred to virtual 3D models via a custom-built 3D-model generation pipeline and printed by material extrusion. The 3D models were evaluated by all medical specialties involved in patient care of cervical cancer, namely surgeons, radiologists, pathologists and radiation oncologists. Information was obtained from evaluated profession-specific questionnaires which were filled out after inspecting all five models. The questionnaires included multiple-select questions, questions based on Likert scales (1 = "strongly disagree " or "not at all useful " up to 5 = "strongly agree " or "extremely useful ") and dichotomous questions ("Yes" or "No"). RESULTS Surgeons rated the models as useful during surgery (4.0 out of 5) and for patient communication (4.7 out of 5). Furthermore, they believed that the models had the potential to revise the patients' treatment plan (3.7 out of 5). Pathologists evaluated with mean ratings of 3.0 out of 5 for the usefulness of the models in diagnostic reporting and macroscopic evaluation. Radiologist acknowledged the possibility of providing additional information compared to imaging alone (3.7 out of 5). Radiation oncologists strongly supported the concept by rating the models highly for understanding patient-specific pathological characteristics (4.3 out of 5), assisting interprofessional communication (mean 4.3 out of 5) and communication with patients (4.7 out of 5). They also found the models useful for improving radiotherapy treatment planning (4.3 out of 5). CONCLUSION The study revealed that the 3D printed models were generally well-received by all medical disciplines, with radiation oncologists showing particularly strong support. Addressing the concerns and tailoring the use of 3D models to the specific needs of each medical speciality will be essential for realizing their full potential in clinical practice.
Collapse
Affiliation(s)
- Anne Cathrine Scherer-Quenzer
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany.
| | - Inga Beyers
- Institute of Electric Power Systems (IfES), Leibniz University Hannover, Appelstraße 9A, Hannover, 30167, Germany
| | - Adam Kalisz
- Department of Electrical, Electronic and Communication Engineering, Information Technology (LIKE), Friedrich-Alexander-University Erlangen-Nuernberg, Am Wolfsmantel 33, Erlangen, Germany
| | - Stephanie Tina Sauer
- Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Straße 6, Würzburg, 97080, Germany
| | - Marcus Zimmermann
- Department of Radiation Oncology, University Hospital Wuerzburg, Josef-Schneider-Str. 11, Würzburg, 97080, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| | - Bülent Polat
- Department of Radiation Oncology, University Hospital Wuerzburg, Josef-Schneider-Str. 11, Würzburg, 97080, Germany
| | - Tanja Schlaiss
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| | - Selina Schelbert
- Institute of Pathology, University of Wuerzburg, Josef-Schneider-Straße 2, Würzburg, 97080, Germany
| | - Matthias Kiesel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Josef-Schneider-Strasse 4, Würzburg, 97080, Germany
| |
Collapse
|
2
|
Perry RW, Mullish BH, Alexander JL, Shah R, Danckert NP, Blanco JM, Roberts L, Liu Z, Chrysostomou D, Radhakrishnan ST, Balarajah S, Barry R, Hicks LC, Williams HRT, Marchesi JR. 3D printed rectal swabs for assessing the gut microbiome, metabolome and inflammation. Sci Rep 2024; 14:16613. [PMID: 39026025 PMCID: PMC11258137 DOI: 10.1038/s41598-024-67457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Abstract
Investigating the gut microbiome and metabolome frequently requires faecal samples, which can be difficult to obtain. Previous studies have shown that rectal swabs are comparable to faecal samples for analysing gut microbiota composition and key metabolites. In this study, 3D printed rectal swabs were compared with conventional flocked swabs and faecal samples, due to the potential advantages 3D printing as a technique offers for swab production and development. 16S rRNA gene sequencing, qPCR and metabolite profiling (using 1H-NMR spectroscopy) were performed on swab and faecal samples from healthy participants. Faecal calprotectin and total protein analysis were performed on samples from inflammatory bowel disease (IBD) patients. There were no significant differences between both swab types and faecal samples when assessing key measures of alpha and beta diversity, and differences in the abundance of major phyla. There was a strong correlation between both swab types and faecal samples for all combined metabolites detected by NMR. In IBD patients, there was no significant difference in faecal calprotectin and total protein levels between both swab types and faecal samples. These data lead us to conclude that 3D printed swabs are equivalent to flocked swabs for the analysis of the gut microbiome, metabolome and inflammation.
Collapse
Affiliation(s)
- Robert W Perry
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - Benjamin H Mullish
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - James L Alexander
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Gastroenterology, St Marks Hospital, London, UK
| | - Raashi Shah
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Nathan P Danckert
- Department of Twin Research and Genetic Epidemiology, School of Life Course & Population Sciences, King's College London, London, UK
| | | | - Lauren Roberts
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Zhigang Liu
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Despoina Chrysostomou
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Shiva T Radhakrishnan
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Department of Gastroenterology, St Marks Hospital, London, UK
| | - Sharmili Balarajah
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Rachael Barry
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Lucy C Hicks
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Horace R T Williams
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Departments of Gastroenterology and Hepatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Julian R Marchesi
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
3
|
Song HS, Joh Y, Kim H. Conformity of Three Pre-Contoured Clavicular Plates Compared Using Personalized 3D-Printed Models of Clavicles from Patients. Life (Basel) 2024; 14:888. [PMID: 39063641 PMCID: PMC11277846 DOI: 10.3390/life14070888] [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: 06/22/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
The human clavicle's unique S-shaped, three-dimensional structure complicates fracture management. This study evaluated the anatomical conformity of pre-contoured anatomical plates using 3D-printed clavicle models. CT scans from 30 patients (15 males and 15 females) were used to create these models. Three brands of distal clavicle plate systems (Acumed, Synthes, and Arthrex) were tested for fit. Measurements included the distance from the distal end of the clavicle to the plate's lateral end, the gap between the clavicle and the plate, and the overhang distance. Results showed significant differences in clavicle length between sexes, with men having a mean length of 156.1 ± 7.6 mm and women 138.4 ± 4.3 mm, both with normal distribution (p > 0.05). The mean lateral distance was 7.9 ± 1.7 mm, and the mean medial gap was 3.6 ± 3.0 mm, showing no significant differences between products or sexes. The mean overhang distance was 5.8 ± 4.6 mm, with larger values in women for the Acumed (p = 0.037) and Arthrex (p = 0.000) plates. Overall, pre-contoured plates exhibited notable discrepancies, especially in shorter clavicles.
Collapse
Affiliation(s)
| | | | - Hyungsuk Kim
- Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea; (H.S.S.); (Y.J.)
| |
Collapse
|
4
|
Meesters AML, Assink N, IJpma FFA. Functional outcome of 2-D- and 3-D-guided corrective forearm osteotomies: a systematic review. J Hand Surg Eur Vol 2024; 49:843-851. [PMID: 37747738 PMCID: PMC11264531 DOI: 10.1177/17531934231201962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
We performed a systematic review to compare conventional (2-D) versus 3-D-guided corrective osteotomies regarding intraoperative results, patient-reported outcome measures, range of motion, incidence of complications and pain score. PubMed (MEDLINE), Embase and Cochrane CENTRAL were searched, and 53 articles were included, reporting 1257 patients undergoing forearm corrective osteotomies between 2010 and 2022. 3-D-guided surgery resulted in a greater improvement in median Disabilities of the Arm, Shoulder and Hand (DASH) score (28, SD 7 vs. 35, SD 5) and fewer complications (12% vs. 6%). Pain scores and range of motion were similar between 3-D-guided and conventional surgery. 3-D-guided corrective osteotomy surgery appears to improve patient-reported outcomes and reduce complications compared to conventional methods. However, due to the limited number of comparative studies and the heterogeneity of the studies, a large randomized controlled trial is needed to draw definitive conclusions.Level of evidence: III.
Collapse
Affiliation(s)
- Anne M. L. Meesters
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- 3D Lab, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Nick Assink
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- 3D Lab, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Frank F. A. IJpma
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
5
|
Zahid MJ, Mavani P, Awuah WA, Alabdulrahman M, Punukollu R, Kundu A, Mago A, Maher K, Adebusoye FT, Khan TN. Sculpting the future: A narrative review of 3D printing in plastic surgery and prosthetic devices. Health Sci Rep 2024; 7:e2205. [PMID: 38915353 PMCID: PMC11194296 DOI: 10.1002/hsr2.2205] [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: 01/17/2024] [Revised: 06/02/2024] [Accepted: 06/08/2024] [Indexed: 06/26/2024] Open
Abstract
Background and Aims The advent of 3D printing has revolutionized plastic surgery and prosthetic devices, providing personalized solutions for patients with traumatic injuries, deformities, and appearance-related conditions. This review offers a comprehensive overview of 3D printing's applications, advantages, limitations, and future prospects in these fields. Methods A literature search was conducted in PubMed, Google Scholar, and Scopus for studies on 3D printing in plastic surgery. Results 3D printing has significantly contributed to personalized medical interventions, with benefits like enhanced design flexibility, reduced production time, and improved patient outcomes. Using computer-aided design (CAD) software, precise models tailored to a patient's anatomy can be created, ensuring better fit, functionality, and comfort. 3D printing allows for intricate geometries, leading to improved aesthetic outcomes and patient-specific prosthetic limbs and orthoses. The historical development of 3D printing, key milestones, and breakthroughs are highlighted. Recent progress in bioprinting and tissue engineering shows promising applications in regenerative medicine and transplantation. The integration of AI and automation with 3D printing enhances surgical planning and outcomes. Emerging trends in patient-specific treatment planning and precision medicine are potential game-changers. However, challenges like technical considerations, economic implications, and ethical issues exist. Addressing these challenges and advancing research in materials, design processes, and long-term outcomes are crucial for widespread adoption. Conclusion The review underscores the increasing adoption of 3D printing in healthcare and its impact on plastic surgery and prosthetic devices. It emphasizes the importance of evaluating the current state and addressing knowledge gaps through future research to foster further advancements.
Collapse
Affiliation(s)
| | - Parit Mavani
- B. J. Medical CollegeAhmedabadIndia
- Department of SurgeryEmory University School of MedicineAtlantaGeorgiaUSA
| | | | | | | | - Arnab Kundu
- R.G. Kar Medical College and HospitalKolkataIndia
| | - Arpit Mago
- Jawaharlal Nehru medical CollegeBelgaumIndia
| | | | | | | |
Collapse
|
6
|
Zhao CX, Yam M. Role of patient specific 3D printed models in patient confidence, understanding and satisfaction of care in Singapore. J Orthop 2024; 52:28-32. [PMID: 38404701 PMCID: PMC10881444 DOI: 10.1016/j.jor.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Patient specific 3D models have been widely used for pre-op planning and intra-op guidance in orthopaedic surgery. These models however are not often used in pre-operative doctor-patient communication. This study evaluates the roles of customized 3D models in improving patient understanding, confidence, and satisfaction of patient care when they were used during preoperative counselling. Materials and methods A prospective survey was conducted on 33 orthopaedic trauma patients who were required to rate on a scale of 1-5, the effectiveness of patient specific 3D models in: 1) improving patient's understanding and, 2) helping patients cope with the condition, 3) boosting patients' confidence in the treatment and 4) in the surgeon; and on a scale of 0-10, their overall satisfaction. Subgroup analysis was done to compare ratings of patients by age and by education levels. Results Over 90% patients rated agree or strongly agree on customised 3D models' effectiveness in improving understanding of injury and boosting confidence in treatments and surgeons. 87% patients agreed or strongly agreed that the models enhanced patient self-efficacy. No significant correlation was identified between age and patients' perceived effectiveness of customised 3D models in improving patient care. Ratings on four areas evaluated by pre-secondary and post-secondary groups were comparable. Post-secondary group had significantly higher satisfaction level than the pre-secondary group. Conclusion Customized 3D models help patients visualise complex pathology to facilitate patients' understanding of their condition and treatment, resulting in improved self-efficacy, confidence, and overall satisfaction. The use of patient specific 3D models in pre-operative counselling allows greater patient involvement therefore prompting patient-centred healthcare. Age does not influence patients' perceived effectiveness of customised 3D models in improving patient care. Patients with higher education level are likely to experience higher satisfaction level due to their willingness to take responsibility for their care.
Collapse
Affiliation(s)
- Carol Xiaoshu Zhao
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Michael Yam
- Orthopaedic Department, Tan Tock Seng Hospital, 308433, Singapore
| |
Collapse
|
7
|
Schlund M, Al-Badri N, Nicot R. Visuospatial abilities and 3D-printed based learning. Surg Radiol Anat 2024; 46:927-931. [PMID: 38652251 DOI: 10.1007/s00276-024-03370-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The use of 3D-printing in every field of medicine is expanding, notably as an educational tool. The aim of this study was to assess how visuospatial abilities (VSA) of students may impact learning helped with 3D-printed models. METHODS Participants were undergraduate medical school students during their clinical rotation in oral and maxillofacial surgery in two French Universities. Students were included prospectively and consecutively from September 2021 to June 2023. First, a lecture about craniosynostosis was performed with the help of 3D-printed models of craniosynostotic skulls. Then, a mental rotation test (MRT) followed by a multiple-choice questions (MCQs) form about craniosynostosis presentations were submitted to the students. RESULTS Forty undergraduate students were finally included. Median MRT score was 15 (10.75;21) and median score to the MCQs was 13 (11.75;14). There was a significantly weak correlation between the MRT-A score and the score to the MCQs (rs = 0.364; p = 0.022). A simple linear regression was calculated to predict the result to the MCQs on MRT-A score [ (F(1,39) = 281.248; p < 0.0001), with a R2 of 0.878 ]. CONCLUSION This study showed that VSA has an impact on the recognition of complex clinical presentations, i.e. skulls with craniosynostosis. The correlation found between VSA and complex 3D shape recognition after learning aided with 3D-printed model is emphasizing the importance of VSA when using innovative technologies. Thus, VSA training should be envisioned during the curriculum.
Collapse
Affiliation(s)
- Matthias Schlund
- Service de Chirurgie Maxillo-Faciale et Stomatologie, Univ. Bordeaux, CHU Bordeaux, INSERM, BioTis, U1026, Bordeaux, 33000, France.
| | - Nour Al-Badri
- Service de Chirurgie Maxillo-Faciale et Stomatologie, Univ. Lille, CHU Lille, Lille, 59000, France
| | - Romain Nicot
- Service de Chirurgie Maxillo-Faciale et Stomatologie, Univ. Lille, CHU Lille, INSERM, U1008 - Advanced Durg Delivery Systems, Lille, 59000, France
| |
Collapse
|
8
|
Goetze E, Zeller AN, Pabst A. Approaching 3D printing in oral and maxillofacial surgery - suggestions for structured clinical standards. Oral Maxillofac Surg 2024; 28:795-802. [PMID: 38214873 DOI: 10.1007/s10006-024-01208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE With respect to the European Union 2017 amendment of the Medical Device Regulations (MDR), this overview article presents recommendations concerning medical 3D printing in oral and maxillofacial surgery (OMFS). METHODS The MDR were screened for applicability of the rules to medical in-house 3D printing. Applicable regulations were summarized and compared to the status of medical use of 3D printing in OMFS in Germany. Recommendations were made for MDR concerning medical 3D printing. RESULTS In-house printed models, surgical guides, and implants fall under the category of Class I-III, depending on their invasive and active properties. In-house medical 3D printing for custom-made medical devices is possible under certain prerogatives: (1) the product is not being used in another facility, (2) appropriate quality systems are applied, (3) the reason for omitting commercial products is documented, (4) information about its use is supplied to the responsible authority, (5) there is a publicly accessible declaration of origin, identification, and conformity to the MDR, (6) there are records of manufacturing site, process and performance data, (7) all products are produced according to the requirements proclaimed before, and (8) there is an evaluation of clinical use and correction of possible issues. CONCLUSION Several aspects must be addressed for in house medical 3D printing, according to the MDR. Devising MDR related to medical 3D printing is a growing challenge. The implementation of recommendations in OMFS could help practitioners to overcome the challenges and become aware of the in-house production and application of 3D printed devices.
Collapse
Affiliation(s)
- Elisabeth Goetze
- Department of Oral and Maxillofacial Surgery, University Hospital Zurich, Rämistr. 100, 8091, Zurich, Switzerland
| | - Alexander-N Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
| |
Collapse
|
9
|
Liang H, Chen B, Duan S, Yang L, Xu R, Zhang H, Sun M, Zhou X, Liu H, Wen H, Cai Z. Treatment of complex limb fractures with 3D printing technology combined with personalized plates: a retrospective study of case series and literature review. Front Surg 2024; 11:1383401. [PMID: 38817945 PMCID: PMC11137251 DOI: 10.3389/fsurg.2024.1383401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
Background In recent years, 3D printing technology has made significant strides in the medical field. With the advancement of orthopedics, there is an increasing pursuit of high surgical quality and optimal functional recovery. 3D printing enables the creation of precise physical models of fractures, and customized personalized steel plates can better realign and more comprehensively and securely fix fractures. These technologies improve preoperative diagnosis, simulation, and planning for complex limb fractures, providing patients with better treatment options. Patients and methods Five typical cases were selected from a pool of numerous patients treated with 3D printing technology combined with personalized custom steel plates at our hospital. These cases were chosen to demonstrate the entire process of printing 3D models and customizing individualized steel plates, including details of the patients' surgeries and treatment procedures. Literature reviews were conducted, with a focus on highlighting the application of 3D printing technology combined with personalized custom steel plates in the treatment of complex limb fractures. Results 3D printing technology can produce accurate physical models of fractures, and personalized custom plates can achieve better fracture realignment and more comprehensive and robust fixation. These technologies provide patients with better treatment options. Conclusion The use of 3D printing models and personalized custom steel plates can improve preoperative diagnosis, simulation, and planning for complex limb fractures, realizing personalized medicine. This approach helps reduce surgical time, minimize trauma, enhance treatment outcomes, and improve patient functional recovery.
Collapse
Affiliation(s)
- Hairui Liang
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Beibei Chen
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Siyu Duan
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Lei Yang
- School of Pharmacy, Inner Mongolia Medical University, Inner Mongolia Autonomous Region, Shenyang, China
| | - Rongda Xu
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - He Zhang
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Ming Sun
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Xueting Zhou
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Hanfei Liu
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Hang Wen
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
| | - Zhencun Cai
- Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China
- Key Laboratory of Human Ethnic Specificity and Phenomics of Critical Illness in Liaoning Province, Shenyang Medical College, Shenyang, China
| |
Collapse
|
10
|
Ortega-Yago A, Ferràs-Tarragó J, de la Calva-Ceinos C, Baeza-Oliete J, Angulo-Sánchez MA, Baixauli-García I, Arguelles-Linares F, Amaya-Valero JV, Baixauli-García F, Medina-Bessó P. [Translated article] Mechanical resistance of polylactic acid bone matrices developed by 3D printing for the reconstruction of bone defects. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T262-T270. [PMID: 38253238 DOI: 10.1016/j.recot.2024.01.016] [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: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Bone defects are one of the main limitations in orthopaedic surgery and traumatology. For this reason, multiple bone replacement systems have been developed, either by prosthetic implant or by substitution with osteoforming substances, whose limitations are their survival and lack of structurality, respectively. The objective of this work is the generation of a new material for the creation of biologically active structures that have sufficient tensile strength to maintain the structure during remodelling. MATERIAL AND METHODS A new filament based on the fusion of natural polylactide acid (PLA) powder was designed for the generation of pieces by means of fused deposition modelling (FDM) on which to carry out tensile mechanical tests of osteosynthesis material. A total of 13 groups with different cortical thickness, filling and layer height were carried out, with 10 tensile tests in each group, defining the tensile breaking limit for each group. The regression lines for each group and their mechanical resistance to traction on the filament used were determined. RESULTS The filament ratio per contact surface unit with the osteosynthesis used was the main determinant of the mechanical resistance to traction, either at the expense of the increase in cortical thickness or by the increase in the percentage of cancellous bone filling. Layer height had a minor effect on tensile strength. The regression value was high for cortical thickness and cancellous filling, being elements with a predictable biomechanical behaviour. CONCLUSIONS The new methodology allows the creation of personalised neutral and implantable PLA bone matrices for the reconstruction of large bone defects by means of 3D printing by FDM with a mechanical resistance to traction greater than that of current biological support structures.
Collapse
Affiliation(s)
- A Ortega-Yago
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - J Ferràs-Tarragó
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain.
| | - C de la Calva-Ceinos
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - J Baeza-Oliete
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - M A Angulo-Sánchez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - I Baixauli-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - F Arguelles-Linares
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - J V Amaya-Valero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - F Baixauli-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - P Medina-Bessó
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| |
Collapse
|
11
|
Kahsai EA, O'Connor B, Khoo KJ, Ogunleye TD, Telfer S, Hagen MS. Improving Patient Understanding of Femoroacetabular Impingement Syndrome With Three-Dimensional Models. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202405000-00006. [PMID: 38722846 PMCID: PMC11081616 DOI: 10.5435/jaaosglobal-d-24-00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION Three-dimensional (3D) printed models may help patients understand complex anatomic pathologies such as femoroacetabular impingement syndrome (FAIS). We aimed to assess patient understanding and satisfaction when using 3D printed models compared with standard imaging modalities for discussion of FAIS diagnosis and surgical plan. METHODS A consecutive series of 76 new patients with FAIS (37 patients in the 3D model cohort and 39 in the control cohort) from a single surgeon's clinic were educated using imaging and representative 3D printed models of FAI or imaging without models (control). Patients received a voluntary post-visit questionnaire that evaluated their understanding of the diagnosis, surgical plan, and visit satisfaction. RESULTS Patients in the 3D model cohort reported a significantly higher mean understanding of FAIS (90.0 ± 11.5 versus 79.8 ± 14.9 out of 100; P = 0.001) and surgery (89.5 ± 11.6 versus 81.0 ± 14.5; P = 0.01) compared with the control cohort. Both groups reported high levels of satisfaction with the visit. CONCLUSION In this study, the use of 3D printed models in clinic visits with patients with FAIS improved patients' perceived understanding of diagnosis and surgical treatment.
Collapse
Affiliation(s)
- Ermyas A. Kahsai
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Bailey O'Connor
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Kevin J. Khoo
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Temi D. Ogunleye
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Scott Telfer
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| | - Mia S. Hagen
- From the Department of Orthopaedics and Sports Medicine, The University of Washington, Seattle, WA
| |
Collapse
|
12
|
Ortega-Yago A, Ferràs-Tarragó J, de la Calva-Ceinos C, Baeza-Oliete J, Angulo-Sánchez MA, Baixauli-García I, Arguelles-Linares F, Amaya-Valero JV, Baixauli-García F, Medina-Bessó P. Mechanical resistance of polylactic acid bone matrices developed by 3D printing for the reconstruction of bone defects. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:262-270. [PMID: 36754255 DOI: 10.1016/j.recot.2023.02.001] [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: 12/15/2022] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Bone defects are one of the main limitations in orthopedic surgery and traumatology. For this reason, multiple bone replacement systems have been developed, either by prosthetic implant or by substitution with osteoforming substances, whose limitations are their survival and lack of structurality, respectively. The objective of this work is the generation of a new material for the creation of biologically active structures that have sufficient tensile strength to maintain the structure during remodeling. MATERIAL AND METHODS A new filament based on the fusion of natural polylactide acid (PLA) powder was designed for the generation of pieces by means of fused deposition modeling (FDM) on which to carry out tensile mechanical tests of osteosynthesis material. A total of 13 groups with different cortical thickness, filling and layer height were carried out, with 10 tensile tests in each group, defining the tensile breaking limit for each group. The regression lines for each group and their mechanical resistance to traction on the filament used were determined. RESULTS The filament ratio per contact surface unit with the osteosynthesis used was the main determinant of the mechanical resistance to traction, either at the expense of the increase in cortical thickness or by the increase in the percentage of cancellous bone filling. Layer height had a minor effect on tensile strength. The regression value was high for cortical thickness and cancellous filling, being elements with a predictable biomechanical behavior. CONCLUSIONS The new methodology allows the creation of personalized neutral and implantable PLA bone matrices for the reconstruction of large bone defects by means of 3D printing by FDM with a mechanical resistance to traction greater than that of current biological support structures.
Collapse
Affiliation(s)
- A Ortega-Yago
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - J Ferràs-Tarragó
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España.
| | - C de la Calva-Ceinos
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - J Baeza-Oliete
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - M A Angulo-Sánchez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - I Baixauli-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - F Arguelles-Linares
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - J V Amaya-Valero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - F Baixauli-García
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| | - P Medina-Bessó
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España; Departamento de Fisiología, Universidad de Valencia, Valencia, España
| |
Collapse
|
13
|
Menozzi GC, Depaoli A, Ramella M, Alessandri G, Frizziero L, De Rosa A, Soncini F, Sassoli V, Rocca G, Trisolino G. High-Temperature Polylactic Acid Proves Reliable and Safe for Manufacturing 3D-Printed Patient-Specific Instruments in Pediatric Orthopedics-Results from over 80 Personalized Devices Employed in 47 Surgeries. Polymers (Basel) 2024; 16:1216. [PMID: 38732685 PMCID: PMC11085401 DOI: 10.3390/polym16091216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: Orthopedic surgery has been transformed by 3D-printed personalized instruments (3DP-PSIs), which enhance precision and reduce complications. Hospitals are adopting in-house 3D printing facilities, using cost-effective methods like Fused Deposition Modeling (FDM) with materials like Polylactic acid (PLA) to create 3DP-PSI. PLA's temperature limitations can be overcome by annealing High-Temperature PLA (ann-HTPLA), enabling steam sterilization without compromising properties. Our study examines the in vivo efficacy of ann-HTPLA 3DP-PSI in pediatric orthopedic surgery. (2) Methods: we investigated safety and efficacy using ann-HTPLA 3DP-PSI produced at an "in-office" 3D-printing Point-of-Care (3DP-PoC) aimed at correcting limb deformities in pediatric patients. Data on 3DP-PSI dimensions and printing parameters were collected, along with usability and complications. (3) Results: Eighty-three ann-HTPLA 3DP-PSIs were utilized in 33 patients (47 bone segments). The smallest guide used measured 3.8 cm3, and the largest measured 58.8 cm3. Seventy-nine PSIs (95.2%; 95% C.I.: 88.1-98.7%) demonstrated effective use without issues. Out of 47 procedures, 11 had complications, including 2 infections (4.3%; 95% CI: 0.5-14.5%). Intraoperative use of 3DP-PSIs did not significantly increase infection rates or other complications. (4) Conclusions: ann-HTPLA has proven satisfactory usability and safety as a suitable material for producing 3DP-PSI in an "in-office" 3DP-PoC.
Collapse
Affiliation(s)
- Grazia Chiara Menozzi
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (M.R.); (G.R.)
| | - Alessandro Depaoli
- Rizzoli Sicilia Department, IRCCS Istituto Ortopedico Rizzoli, 90011 Bagheria, Italy;
| | - Marco Ramella
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (M.R.); (G.R.)
| | - Giulia Alessandri
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.D.R.)
| | - Leonardo Frizziero
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.D.R.)
| | - Adriano De Rosa
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.A.); (L.F.); (A.D.R.)
| | - Francesco Soncini
- Unit of Hygiene, Epidemiology and Emergency Management, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Valeria Sassoli
- Pharmacy Service, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Gino Rocca
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (M.R.); (G.R.)
| | - Giovanni Trisolino
- Unit of Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (G.C.M.); (M.R.); (G.R.)
| |
Collapse
|
14
|
Sourvanos D, Sun H, Zhu TC, Dimofte A, Byrd B, Busch TM, Cengel KA, Neiva R, Fiorellini JP. Three-dimensional printing of the human lung pleural cavity model for PDT malignant mesothelioma. Photodiagnosis Photodyn Ther 2024; 46:104014. [PMID: 38346466 DOI: 10.1016/j.pdpdt.2024.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The primary aim was to investigate emerging 3D printing and optical acquisition technologies to refine and enhance photodynamic therapy (PDT) dosimetry in the management of malignant pleural mesothelioma (MPM). MATERIALS AND METHODS A rigorous digital reconstruction of the pleural lung cavity was conducted utilizing 3D printing and optical scanning methodologies. These reconstructions were systematically assessed against CT-derived data to ascertain their accuracy in representing critical anatomic features and post-resection topographical variations. RESULTS The resulting reconstructions excelled in their anatomical precision, proving instrumental translation for precise dosimetry calculations for PDT. Validation against CT data confirmed the utility of these models not only for enhancing therapeutic planning but also as critical tools for educational and calibration purposes. CONCLUSION The research outlined a successful protocol for the precise calculation of light distribution within the complex environment of the pleural cavity, marking a substantive advance in the application of PDT for MPM. This work holds significant promise for individualizing patient care, minimizing collateral radiation exposure, and improving the overall efficiency of MPM treatments.
Collapse
Affiliation(s)
- Dennis Sourvanos
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA; Center for Innovation and Precision Dentistry (CiPD), School of Dental Medicine, School of Engineering, University of Pennsylvania, PA, USA.
| | - Hongjing Sun
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Andreea Dimofte
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Brook Byrd
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Keith A Cengel
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Joseph P Fiorellini
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| |
Collapse
|
15
|
Callan KT, Anderson A, Kim R, Goldin A, Noori N. Management of Recurrent Giant Cell Tumor of Distal Tibia With Intramedullary Hindfoot Fusion Nail and Trabecular Metal Implant Construct. Cureus 2024; 16:e57922. [PMID: 38725737 PMCID: PMC11081638 DOI: 10.7759/cureus.57922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Reconstruction options for giant cell tumors (GCTs) of bone are limited and challenging due to the amount of structural compromise and the high recurrence rates. This is especially true for GCTs of the foot and ankle, as the area is vital for weight bearing and function. The typical treatment for GCTs is currently excision, curettage, and cementation, although that is not always effective. A 36-year-old otherwise healthy female presented with an original diagnosis of a large aneurysmal bone cyst (ABC) of the distal tibia that had recurred despite two previous attempts at treatment with resection and cementation. She was treated with surgical resection of the lesion, reconstruction, and ankle and subtalar joint arthrodesis with a tibiotalocalcaneal intramedullary nail in combination with a trabecular metal cone. The final pathology of the intraoperative samples was consistent with GCT. Postoperatively, she recovered well, and her imaging was consistent with a successful fusion. This case report provides evidence that tibiotalocalcaneal fusion with a unique combination of hindfoot nail and trabecular metal cone construct in a single procedure is a successful option for the treatment of large, recurrent GCT lesions in the distal tibia.
Collapse
Affiliation(s)
- Kylie T Callan
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Amanda Anderson
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Ryan Kim
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Amanda Goldin
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| | - Naudereh Noori
- Orthopedic Surgery, University of California Irvine Medical Center, Orange, USA
| |
Collapse
|
16
|
Cho HJ, Lloyd T, Zammit A, Pattavilakom Sadasivan A, Wagels M, Sutherland A. Radiologically derived 3D virtual models for neurosurgical planning. J Clin Neurosci 2024; 123:23-29. [PMID: 38518385 DOI: 10.1016/j.jocn.2024.03.020] [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: 02/16/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 03/24/2024]
Abstract
Three dimensional (3D) virtual models for neurosurgery have demonstrated substantial clinical utility, especially for neuro-oncological cases. Computer-aided design (CAD) modelling of radiological images can provide realistic and high-quality 3D models which neurosurgeons may use pre-operatively for surgical planning. 3D virtual models are useful as they are the basis for other models that build off this design. 3D virtual models are quick to segment but can also be easily added to normal neurosurgical and radiological workflow without disruption. Three anatomically complex neuro-oncology cases that were referred from a single institution by three different neurosurgeons were segmented and 3D virtual models were created for pre-operative surgical planning. A face-to-face interview was performed with the surgeons after the models were delivered to gauge the usefulness of the model in pre-surgical planning. All three neurosurgeons found that the 3D virtual model was useful for presurgical planning. Specifically, the virtual model helped in planning operative positioning, understanding spatial relationship between lesion and surrounding critical anatomy and identifying anatomy that will be encountered intra-operatively in a sequential manner. It provided benefit in Multidisciplinary team (MDT) meetings and patient education for shared decision making.3D virtual models are beneficial for pre-surgical planning and patient education for shared decision making for neurosurgical neuro-oncology cases. We believe this could be further expanded to other surgical specialties. The integration of 3D virtual models into normal workflow as the initial step will provide an easier transition into modalities that build off the virtual models such as printed, virtual, augmented and mixed reality models.
Collapse
Affiliation(s)
- Hyun-Jae Cho
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia.
| | - Thomas Lloyd
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Radiology, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Adrian Zammit
- The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Neurosurgery, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Ananthababu Pattavilakom Sadasivan
- The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia; Department of Neurosurgery, The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Michael Wagels
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Allison Sutherland
- Australian Centre for Complex Integration of Surgical Solutions (ACCISS), Woolloongabba, QLD 4102, Australia; Translational Research Institute, Woolloongabba, QLD 4102, Australia; The Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| |
Collapse
|
17
|
Huang AZB, Mobbs RJ. Application of three-dimensional printed biomodels in endoscopic spinal surgery. JOURNAL OF SPINE SURGERY (HONG KONG) 2024; 10:1-7. [PMID: 38567013 PMCID: PMC10982922 DOI: 10.21037/jss-23-103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/07/2024] [Indexed: 04/04/2024]
Abstract
Background Three-dimensional printing (3DP) is increasingly used to individualise surgery and may be an effective tool for representing patient anatomy. Current literature on patient-specific anatomical models (biomodels) for minimally invasive spinal surgery is a limited number of case series and cohort studies. However, studies investigating 3DP in other specialties have reported multiple benefits. Methods This prospective study considered a series of patients (n=33) undergoing elective endoscopic spinal surgery, including combinations of microdiscectomy (n=27), foraminotomy (n=7), and laminectomy (n=3). These surgeries were conducted at vertebral levels ranging from L2/3 to L5/S1. The surgeon then recorded the impact on preoperational planning, intraoperative decision-making and accelerating the learning curve with a qualitative questionnaire. Results There were benefits to planning in 54.5% of cases (n=18), improved intraoperative decision-making in 60.6% of cases (n=20). These benefits were reported more frequently earlier in the cases, with improvements to learning reported in 60% of the first five cases and not in subsequent cases. The surgeon commented that the biomodels were more useful on. Conclusions The rates of preoperative and intraoperative benefits are consistent with existing studies, and the early benefit to the learning curve may be suitable for applications to surgical training. Additional research is required to determine the practicality of biomodels and their impact on patient outcomes for endoscopic spinal surgery.
Collapse
Affiliation(s)
- Aaron Z. B. Huang
- NeuroSpine Surgery Research Group (NSURG), Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Ralph J. Mobbs
- NeuroSpine Surgery Research Group (NSURG), Randwick, Australia
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
- Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia
- NeuroSpine Clinic, Prince of Wales Private Hospital, Sydney, Australia
| |
Collapse
|
18
|
Borham E, Abuel-Ela HA, Mohamed IS, Fouad YA. Treatment of excessive gingival display using conventional esthetic crown lengthening versus computer guided esthetic crown lengthening: (a randomized clinical trial). BMC Oral Health 2024; 24:317. [PMID: 38461241 PMCID: PMC10925018 DOI: 10.1186/s12903-024-04080-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 02/27/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Surgical guides have been proposed in an attempt to reach more predictable outcomes for esthetic crown lengthening. The objective of the present study was to evaluate the effectiveness of esthetic crown lengthening using 3D-printed surgical guides in the management of excessive gingival display due to altered passive eruption type 1B. MATERIALS AND METHODS Sixteen patients diagnosed with altered passive eruption type 1B, were divided into two groups. In the control group, the procedure was carried out conventionally, and in the study group, a dual surgical guide was used. The parameters of wound healing (swelling, color, probing depth, bleeding index, and plaque index), pain scores, gingival margin stability, and operating time were assessed at 1 week, 2 weeks, 3 months, and 6 months postoperatively. RESULTS There was no statistically significant difference in terms of wound healing, pain scores, and gingival margin stability between both groups at different time intervals (P = 1), however, there was a statistical difference between both groups in terms of operating time with the study group being significantly lower (P < 0.001). CONCLUSION Digitally assisted esthetic crown lengthening helps shorten the operating time and reduces the possibility of human errors during the measurements. This will be useful in helping practitioners achieve better results. PRACTICAL IMPLICATIONS The conventional method remains to be the gold standard. However, shorter operating time and lower margins for errors will help reduce costs as the chair side time is reduced as well as the possibility for a second surgery is lower. This will improve patient satisfaction as well.
Collapse
Affiliation(s)
- Eman Borham
- Assistant Lecturer of Oral Medicine and Periodontology, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Hala Ahmed Abuel-Ela
- Professor of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University and Misr International University, Cairo, Egypt
| | - Islam Shawky Mohamed
- Lecturer of Oral and Maxillofacial Radiology, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Yasmine Ahmed Fouad
- Lecturer of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University and Misr International University, Cairo, Egypt.
- Omarat Misr ELTameer Sheraton Heliopolis, 16 Abd ELHameed Badawy, Cairo, Egypt.
| |
Collapse
|
19
|
Periferakis A, Periferakis AT, Troumpata L, Dragosloveanu S, Timofticiuc IA, Georgatos-Garcia S, Scheau AE, Periferakis K, Caruntu A, Badarau IA, Scheau C, Caruntu C. Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction. Biomimetics (Basel) 2024; 9:154. [PMID: 38534839 DOI: 10.3390/biomimetics9030154] [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: 01/26/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
Collapse
Affiliation(s)
- Argyrios Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Aristodemos-Theodoros Periferakis
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Elkyda, Research & Education Centre of Charismatheia, 17675 Athens, Greece
| | - Lamprini Troumpata
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics and Traumatology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Orthopaedics, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Iosif-Aliodor Timofticiuc
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Spyrangelos Georgatos-Garcia
- Tilburg Institute for Law, Technology, and Society (TILT), Tilburg University, 5037 DE Tilburg, The Netherlands
- Corvers Greece IKE, 15124 Athens, Greece
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Konstantinos Periferakis
- Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece
- Pan-Hellenic Organization of Educational Programs (P.O.E.P.), 17236 Athens, Greece
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Ioana Anca Badarau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Radiology and Medical Imaging, "Foisor" Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| |
Collapse
|
20
|
Wegner M, Dusse F, Beeser F, Leister N, Lefarth M, Finke SR, Böttiger BW, Dorweiler B, Stoll SE. Comparing Simulation Training of Bronchoscopy-Guided Percutaneous Dilatational Tracheostomy Using Conventional Versus 3D Printed Simulators (TRAC-Sim Study). J Intensive Care Med 2024:8850666241232918. [PMID: 38403970 DOI: 10.1177/08850666241232918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background: Individual implementation rate of bronchoscopy-guided percutaneous dilatational tracheostomy (PDT) varies among intensivists. Simulation training (ST) can increase the safety of medical procedures by reducing stress levels of the performing team. The aim of this study was to evaluate the benefit of ST in PDT regarding procedural time, quality of performance, and percepted feelings of safety of the proceduralist and to compare conventional simulators (CSIM) with simulators generated from 3D printers (3DSIM). Methods: We conducted a prospective, single-center, randomized, blinded cross-over study comparing the benefit of CSIM versus 3DSIM for ST of PDT. Participants underwent a standardized theoretical training and were randomized to ST with CSIM (group A) or 3DSIM (group B). After ST, participants' performance was assessed by two blinded examiners on a porcine trachea regarding time required for successful completion of PDT and correct performance (assessed by a performance score). Percepted feelings of safety were assessed before and after ST. This was followed by a second training and second assessment of the same aspects with crossed groups. Results: 44 participants were included: 24 initially trained with CSIM (group A) and 20 with 3DSIM (group B). Correctness of the PDT performance increased significantly in group B (p < .01) and not significantly in group A (p = .14). Mean procedural time required for performing a PDT after their second ST compared to the first assessment (p < .01) was lower with no difference between group A and group B and irrespective of the participants' previous experience regarding PDT, age, and sex. Moreover, percepted feelings of safety increased after the first ST in both groups (p < .001). Conclusions: ST can improve procedural skills, procedural time, and percepted feelings of safety of the proceduralist in simulated PDT.
Collapse
Affiliation(s)
- Moritz Wegner
- Department of Vascular and Endovascular Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Fabian Dusse
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Finnard Beeser
- Department of Vascular and Endovascular Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Nicolas Leister
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Marian Lefarth
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Simon-Richard Finke
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Bernd W Böttiger
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Bernhard Dorweiler
- Department of Vascular and Endovascular Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Sandra Emily Stoll
- Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| |
Collapse
|
21
|
Lee M, Noh S, Shin JB, Kwak J, Jeong C. Evaluation of Fused Deposition Modeling Materials for 3D-Printed Container of Dosimetric Polymer Gel. Gels 2024; 10:146. [PMID: 38391476 PMCID: PMC10888196 DOI: 10.3390/gels10020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Accurate dosimetric verification is becoming increasingly important in radiotherapy. Although polymer gel dosimetry may be useful for verifying complex 3D dose distributions, it has limitations for clinical application due to its strong reactivity with oxygen and other contaminants. Therefore, it is important that the material of the gel storage container blocks reaction with external contaminants. In this study, we tested the effect of air and the chemical permeability of various polymer-based 3D printing materials that can be used as gel containers. A methacrylic acid, gelatin, and tetrakis (hydroxymethyl) phosphonium chloride gel was used. Five types of printing materials that can be applied to the fused deposition modeling (FDM)-type 3D printer were compared: acrylonitrile butadiene styrene (ABS), co-polyester (CPE), polycarbonate (PC), polylactic acid (PLA), and polypropylene (PP) (reference: glass vial). The map of R2 (1/T2) relaxation rates for each material, obtained from magnetic resonance imaging scans, was analyzed. Additionally, response histograms and dose calibration curves from the R2 map were evaluated. The R2 distribution showed that CPE had sharper boundaries than the other materials, and the profile gradient of CPE was also closest to the reference vial. Histograms and dose calibration showed that CPE provided the most homogeneous and the highest relative response of 83.5%, with 8.6% root mean square error, compared with the reference vial. These results indicate that CPE is a reasonable material for the FDM-type 3D printing gel container.
Collapse
Affiliation(s)
- Minsik Lee
- Department of Radiation Oncology, Kangwon National University Hospital, 157 Baengnyeong-ro, Chuncheon-si 24290, Republic of Korea
| | - Seonyeong Noh
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jun-Bong Shin
- Department of Radiation Oncology, Kangwon National University Hospital, 157 Baengnyeong-ro, Chuncheon-si 24290, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Chiyoung Jeong
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| |
Collapse
|
22
|
Kyser AJ, Fotouh B, Mahmoud MY, Frieboes HB. Rising role of 3D-printing in delivery of therapeutics for infectious disease. J Control Release 2024; 366:349-365. [PMID: 38182058 PMCID: PMC10923108 DOI: 10.1016/j.jconrel.2023.12.051] [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: 10/03/2023] [Revised: 12/18/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
Modern drug delivery to tackle infectious disease has drawn close to personalizing medicine for specific patient populations. Challenges include antibiotic-resistant infections, healthcare associated infections, and customizing treatments for local patient populations. Recently, 3D-printing has become a facilitator for the development of personalized pharmaceutic drug delivery systems. With a variety of manufacturing techniques, 3D-printing offers advantages in drug delivery development for controlled, fine-tuned release and platforms for different routes of administration. This review summarizes 3D-printing techniques in pharmaceutics and drug delivery focusing on treating infectious diseases, and discusses the influence of 3D-printing design considerations on drug delivery platforms targeting these diseases. Additionally, applications of 3D-printing in infectious diseases are summarized, with the goal to provide insight into how future delivery innovations may benefit from 3D-printing to address the global challenges in infectious disease.
Collapse
Affiliation(s)
- Anthony J Kyser
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Bassam Fotouh
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA.
| | - Mohamed Y Mahmoud
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Department of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Cairo University, Egypt.
| | - Hermann B Frieboes
- Department of Bioengineering, University of Louisville Speed School of Engineering, Louisville, KY 40202, USA; Center for Predictive Medicine, University of Louisville, Louisville, KY 40202, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY 40202, USA; UofL Health - Brown Cancer Center, University of Louisville, KY 40202, USA.
| |
Collapse
|
23
|
Tsai AY, Greene AC. 3D printing in pediatric surgery. Semin Pediatr Surg 2024; 33:151385. [PMID: 38242062 DOI: 10.1016/j.sempedsurg.2024.151385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Pediatric surgery presents a unique challenge, requiring a specialized approach due to the intricacies of compact anatomy and the presence of distinct congenital features in young patients. Surgeons are tasked with making decisions that not only address immediate concerns but also consider the evolving needs of children as they grow. The advent of three-dimensional (3D) printing has emerged as a valuable tool to facilitate a personalized medical approach. This paper starts by outlining the basics of 3D modeling and printing. We then delve into the transformative role of 3D printing in pediatric surgery, elucidating its applications, benefits, and challenges. The paper concludes by envisioning the future prospects of 3D printing, foreseeing advancements in personalized treatment approaches, improved patient outcomes, and the continued evolution of this technology as an indispensable asset in the pediatric surgical arena.
Collapse
Affiliation(s)
- Anthony Y Tsai
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States.
| | - Alicia C Greene
- Division of Pediatric Surgery, Assistant Professor of Surgery and Pediatrics, Penn State Children's Hospital, 500 University Drive, Hershey, PA 17033, United States
| |
Collapse
|
24
|
Oldhoff MGE, Assink N, Kraeima J, de Vries JPPM, Ten Duis K, Meesters AML, IJpma FFA. 3D-assisted corrective osteotomies of the distal radius: a comparison of pre-contoured conventional implants versus patient-specific implants. Eur J Trauma Emerg Surg 2024; 50:37-47. [PMID: 38261077 PMCID: PMC10924012 DOI: 10.1007/s00068-023-02415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/25/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE There is a debate whether corrective osteotomies of the distal radius should be performed using a 3D work-up with pre-contoured conventional implants (i.e., of-the-shelf) or patient-specific implants (i.e., custom-made). This study aims to assess the postoperative accuracy of 3D-assisted correction osteotomy of the distal radius using either implant. METHODS Twenty corrective osteotomies of the distal radius were planned using 3D technologies and performed on Thiel embalmed human cadavers. Our workflow consisted of virtual surgical planning and 3D printed guides for osteotomy and repositioning. Subsequently, left radii were fixated with patient-specific implants, and right radii were fixated with pre-contoured conventional implants. The accuracy of the corrections was assessed through measurement of rotation, dorsal and radial angulation and translations with postoperative CT scans in comparison to their preoperative virtual plan. RESULTS Twenty corrective osteotomies were executed according to their plan. The median differences between the preoperative plan and postoperative results were 2.6° (IQR: 1.6-3.9°) for rotation, 1.4° (IQR: 0.6-2.9°) for dorsal angulation, 4.7° (IQR: 2.9-5.7°) for radial angulation, and 2.4 mm (IQR: 1.3-2.9 mm) for translation of the distal radius, thus sufficient for application in clinical practice. There was no significant difference in accuracy of correction when comparing pre-contoured conventional implants with patient-specific implants. CONCLUSION 3D-assisted corrective osteotomy of the distal radius with either pre-contoured conventional implants or patient-specific implants results in accurate corrections. The choice of implant type should not solely depend on accuracy of the correction, but also be based on other considerations like the availability of resources and the preoperative assessment of implant fitting.
Collapse
Affiliation(s)
- Miriam G E Oldhoff
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nick Assink
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joep Kraeima
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jean-Paul P M de Vries
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kaj Ten Duis
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne M L Meesters
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank F A IJpma
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| |
Collapse
|
25
|
Di Giacomo GDAP, Cury PR, da Silva AM, da Silva JVL, Ajzen SA. Surgical guides for flapless dental implant placement and immediate definitive prosthesis installation by using selective laser melting and sintering for 3D metal and polymer printing: A clinical report. J Prosthet Dent 2024; 131:177-179. [PMID: 35965133 DOI: 10.1016/j.prosdent.2022.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Integration between the phases of computer-based guided dental implant surgery can be used to optimize oral rehabilitation. Two new surgical guides prepared by using the 3D metal and polymer printing technology are presented for immediate implant loading and definitive fixed prosthesis construction in flapless dental implant surgery. Nine implants and 2 fixed prostheses were installed in 2 completely edentulous adult patients by using a metallopolymer surgical guide with a metal central bar attached to a polymer seal or a metal guide. Virtual planning was used to design the 3D printed surgical guides, which were then constructed by using selective laser sintering (SLM) and selective laser melting (SLS). The 3D printed surgical guides oriented the surgical placement of the implants and were welded to the abutments and attached to the denture framework. The technique allowed implants and prostheses to be installed on the same day.
Collapse
Affiliation(s)
- Giovanni de A P Di Giacomo
- Researcher, Department of Diagnostic Imaging, School of Medicine, Federal University of São Paulo, São Paulo, Brazil; Researcher, Three-Dimensional Technology Division, Renato Archer Information Technology Center, Campinas, Brazil
| | - Patricia R Cury
- Professor, Department of Periodontics, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.
| | - Airton M da Silva
- Researcher, Three-Dimensional Technology Division, Renato Archer Information Technology Center, Campinas, Brazil
| | - Jorge V L da Silva
- Director, Three-Dimensional Technology Division, Renato Archer Information Technology Center, Campinas, Brazil
| | - Sergio A Ajzen
- Professor, Department of Diagnostic Imaging, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| |
Collapse
|
26
|
Iqbal H, Fernandes Q, Idoudi S, Basineni R, Billa N. Status of Polymer Fused Deposition Modeling (FDM)-Based Three-Dimensional Printing (3DP) in the Pharmaceutical Industry. Polymers (Basel) 2024; 16:386. [PMID: 38337275 DOI: 10.3390/polym16030386] [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: 12/17/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Additive manufacturing (AM) or 3D printing (3DP) is arguably a versatile and more efficient way for the production of solid dosage forms such as tablets. Of the various 3DP technologies currently available, fused deposition modeling (FDM) includes unique characteristics that offer a range of options in the production of various types of tablets. For example, amorphous solid dispersions (ASDs), enteric-coated tablets or poly pills can be produced using an appropriate drug/polymer combination during FDM 3DP. The technology offers the possibility of evolving personalized medicines into cost-effective production schemes at pharmacies and hospital dispensaries. In this review, we highlight key FDM features that may be exploited for the production of tablets and improvement of therapy, with emphasis on gastrointestinal delivery. We also highlight current constraints that must be surmounted to visualize the deployment of this technology in the pharmaceutical and healthcare industries.
Collapse
Affiliation(s)
- Heba Iqbal
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Queenie Fernandes
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Sourour Idoudi
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Renuka Basineni
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Nashiru Billa
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| |
Collapse
|
27
|
Zakręcki A, Cieślik J, Bazan A, Turek P. Innovative Approaches to 3D Printing of PA12 Forearm Orthoses: A Comprehensive Analysis of Mechanical Properties and Production Efficiency. MATERIALS (BASEL, SWITZERLAND) 2024; 17:663. [PMID: 38591508 PMCID: PMC10856665 DOI: 10.3390/ma17030663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 04/10/2024]
Abstract
This research paper aims to explore the mechanical characteristics of polyamide PA12 (PA12) as a 3D material printed utilizing Selective Laser Sintering (SLS) and HP MultiJet Fusion (HP MJF) technologies in order to design and manufacture forearm orthoses. The study assessed the flowability of the materials used and compared the mechanical performance of PA12 with each other using tensile, flexure, and impact tests in five different fabrication orientations: X, Y, Z, tilted 45° XZ, and tilted 45° YZ. The results of the study provide, firstly-the data for testing the quality of the applied polyamide powder blend and, secondly-the data for the design of the orthosis geometry from the aspect of its strength parameters and the safety of construction. The mechanical parameters of SLS specimens had less variation than MJF specimens in a given orientation. The difference in tensile strength between the 3D printing technologies tested was 1.8%, and flexural strength was 4.7%. A process analysis of the forearm orthoses revealed that the HP MJF 5200 system had a higher weekly production capacity than the EOS P396 in a production variance based on obtaining maximum strength parameters and a variance based on maximizing economic efficiency. The results suggest that medical device manufacturers can use additive manufacturing technologies to produce prototypes and small-batch parts for medical applications. This paper pioneers using 3D printing technology with Powder Bed Fusion (PBF) methods in designing and manufacturing forearm orthoses as a low- to medium-volume product. The applied solution addresses the problem of medical device manufacturers with regard to the analysis of production costs and mechanical properties when using 3D printing for certified medical devices.
Collapse
Affiliation(s)
- Andrzej Zakręcki
- Department of Manufacturing Systems, Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology in Cracow, 30-059 Cracow, Poland;
- Mediprintic sp. z o.o., 39-300 Mielec, Poland
| | - Jacek Cieślik
- Department of Manufacturing Systems, Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology in Cracow, 30-059 Cracow, Poland;
| | - Anna Bazan
- Department of Manufacturing Techniques and Automation, Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology, 35-959 Rzeszow, Poland; (A.B.); (P.T.)
| | - Paweł Turek
- Department of Manufacturing Techniques and Automation, Faculty of Mechanical Engineering and Aeronautics, Rzeszow University of Technology, 35-959 Rzeszow, Poland; (A.B.); (P.T.)
| |
Collapse
|
28
|
He H, Fan L, Lü G, Li X, Li Y, Zhang O, Chen Z, Yuan H, Pan C, Wang X, Kuang L. Myth or fact: 3D-printed off-the-shelf prosthesis is superior to titanium mesh cage in anterior cervical corpectomy and fusion? BMC Musculoskelet Disord 2024; 25:96. [PMID: 38279132 PMCID: PMC10811816 DOI: 10.1186/s12891-024-07213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/17/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND To find out if three-dimensional printing (3DP) off-the-shelf (OTS) prosthesis is superior to titanium mesh cages in anterior cervical corpectomy and fusion (ACCF) when treating single-segment degenerative cervical spondylotic myelopathy (DCSM). METHODS DCSM patients underwent ACCF from January 2016 to January 2019 in a single center were included. Patients were divided into the 3DP group (28) and the TMC group (23). The hospital stays, operation time, intraoperative blood loss, and the cost of hospitalization were compared. The Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI) were recorded pre-operatively, 1 day, 3, 6, 12, and 24 months post-operatively. Radiological data was measured to evaluate fusion, subsidence, and cervical lordosis. Patients were sent with SF-36 to assess their health-related quality of life (HRQoL). RESULTS The differences in operative time, intraoperative blood loss, and hospital stay were not statistically significant between groups (p > 0.05). Postoperative dysphagia occurred in 2 cases in the 3DP group and 3 cases in the TMC group, which all relieved one week later. The difference in improvement of JOA and NDI between the two groups was not statistically significant (p > 0.05). No hardware failure was found and bony fusion was achieved in all cases except one in the 3DP group. The difference in cervical lordosis (CL), fused segmental angle (FSA), mean vertebral height (MVH), and subsidence rates between groups at each follow-up time point was not statistically significant and the results of the SF-36 were similar (p > 0.05). The total cost was higher in the 3DP group with its higher graft cost (p < 0.05). CONCLUSION In treating single-segment DCSM with ACCF, both 3DP OTS prosthesis and TMC achieved satisfactory outcomes. However, the more costly 3DP OTS prosthesis was not able to reduce subsidence as it claimed.
Collapse
Affiliation(s)
- Haoyu He
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Lei Fan
- Department of Spinal Surgery, Third Hospital of Changsha, Changsha, Hunan Province, China
| | - Guohua Lü
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xinyi Li
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Yunchao Li
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Ou Zhang
- Department of Medical Education, California University of Science and Medicine, Colton, CA, USA
| | - Zejun Chen
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Hui Yuan
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Changyu Pan
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xiaoxiao Wang
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Lei Kuang
- Department of Spinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
| |
Collapse
|
29
|
Hu C, Qiu B, Cen C, Luo Q, Cao Y. 3D printing assisted MIPO for treatment of complex middle-proximal humeral shaft fractures. BMC Musculoskelet Disord 2024; 25:93. [PMID: 38267894 PMCID: PMC10809673 DOI: 10.1186/s12891-024-07202-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND This study was designed to explore the clinical efficacy of 3-dimensional (3D) printing assisted minimally invasive percutaneous plate osteosynthesis (MIPO) technique by comparing the clinical outcomes with traditional open reduction and internal plating fixation (ORIF) for treating complex middle-proximal humerus fractures (AO 12C fracture type). MATERIALS AND METHODS The data of 42 participants who received a complicated middle-proximal humerus fracture from the beginning of 2018 to the end of 2022 were retrospectively analyzed. All patients were assigned to two groups: MIPO with detailed preoperative planning assisted by 3D printing technique (MIPO group), and traditional ORIF (ORIF group). RESULTS This study included 21 patients in the ORIF group and 21 patients in the MIPO group. All patients were followed-up for at least one year (mean: 16.12 ± 4.13 months), and no difference was observed in the range of shoulder joint motion (ROM), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores and Constant scores between the two groups. However, the occurrence of complications (surgical incision site infection, implant loosening, bone nonunion and radial nerve palsy) in ORIF group was remarkably higher compared to the MIPO group. All the cases achieved bone union within the MIPO group. Significant differences were found in surgical time, intraoperative blood loss and fracture healing time between the two groups. CONCLUSION Preoperative 3D printing assisted MIPO technique exhibits obvious advantages in high operational efficiency and low occurrence of complications, which is worthy of clinical application for treating complex middle-proximal humeral shaft fractures.
Collapse
Affiliation(s)
- Chaoran Hu
- Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, Guizhou, China
| | - Bing Qiu
- Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, Guizhou, China
| | - Chaode Cen
- Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, Guizhou, China
| | - Qin Luo
- Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, Guizhou, China
| | - Yongfei Cao
- Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, Guizhou, China.
| |
Collapse
|
30
|
Assink N, ten Duis K, de Vries JPPM, Witjes MJH, Kraeima J, Doornberg JN, IJpma FFA. 3D surgical planning including patient-specific drilling guides for tibial plateau fractures. Bone Jt Open 2024; 5:46-52. [PMID: 38240277 PMCID: PMC10797644 DOI: 10.1302/2633-1462.51.bjo-2023-0130.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
Aims Proper preoperative planning benefits fracture reduction, fixation, and stability in tibial plateau fracture surgery. We developed and clinically implemented a novel workflow for 3D surgical planning including patient-specific drilling guides in tibial plateau fracture surgery. Methods A prospective feasibility study was performed in which consecutive tibial plateau fracture patients were treated with 3D surgical planning, including patient-specific drilling guides applied to standard off-the-shelf plates. A postoperative CT scan was obtained to assess whether the screw directions, screw lengths, and plate position were performed according the preoperative planning. Quality of the fracture reduction was assessed by measuring residual intra-articular incongruence (maximum gap and step-off) and compared to a historical matched control group. Results A total of 15 patients were treated with 3D surgical planning in which 83 screws were placed by using drilling guides. The median deviation of the achieved screw trajectory from the planned trajectory was 3.4° (interquartile range (IQR) 2.5 to 5.4) and the difference in entry points (i.e. plate position) was 3.0 mm (IQR 2.0 to 5.5) compared to the 3D preoperative planning. The length of 72 screws (86.7%) were according to the planning. Compared to the historical cohort, 3D-guided surgery showed an improved surgical reduction in terms of median gap (3.1 vs 4.7 mm; p = 0.126) and step-off (2.9 vs 4.0 mm; p = 0.026). Conclusion The use of 3D surgical planning including drilling guides was feasible, and facilitated accurate screw directions, screw lengths, and plate positioning. Moreover, the personalized approach improved fracture reduction as compared to a historical cohort.
Collapse
Affiliation(s)
- Nick Assink
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Kaj ten Duis
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | | | - Max J. H. Witjes
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Joep Kraeima
- 3D Lab, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Job N. Doornberg
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Flinders University, Adelaide, Australia
| | - Frank F. A. IJpma
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|
31
|
Anzillotti G, Guazzoni E, Conte P, Di Matteo V, Kon E, Grappiolo G, Loppini M. Using Three-Dimensional Printing Technology to Solve Complex Primary Total Hip Arthroplasty Cases: Do We Really Need Custom-Made Guides and Templates? A Critical Systematic Review on the Available Evidence. J Clin Med 2024; 13:474. [PMID: 38256607 PMCID: PMC10816635 DOI: 10.3390/jcm13020474] [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: 12/14/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
The burden of osteoarthritis (OA) is around 300 million people affected worldwide, with the hip representing a commonly affected joint. Total hip arthroplasty (THA) has been used with notable success as a definitive treatment to improve pain and function in hip OA patients. The recent advent of new technologies, such as 3D printing, has pushed the application of these new concepts toward applications for the well-known THA. Currently, the evidence on the use of 3D printing to aid complex primary THA cases is still scarce. METHODS An extensive literature review was conducted to retrieve all articles centered on the use of 3D printing in the setting of primary THA. RESULTS A total of seven studies were included in the present systematic review. Four studies investigated the use of 3D-printed surgical guides to be used during surgery. The remaining three studies investigated the benefit of the use of 3D-printed templates of the pelvis to simulate the surgery. CONCLUSIONS The use of 3D printing could be a promising aid to solve difficult primary total hip arthroplasty cases. However, the general enthusiasm in the field is not supported by high-quality studies, hence preventing us from currently recommending its application in everyday practice.
Collapse
Affiliation(s)
- Giuseppe Anzillotti
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
| | - Edoardo Guazzoni
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Fondazione Livio Sciutto Onlus, Campus Savona, Università Degli Studi di Genova, 17100 Savona, Italy
| | - Pietro Conte
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
| | - Vincenzo Di Matteo
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
- Faculty of Medicine and Surgery, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Elizaveta Kon
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Department of Traumatology, Orthopaedics and Disaster Surgery, Sechenov University, Moscow 119991, Russia
| | - Guido Grappiolo
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Fondazione Livio Sciutto Onlus, Campus Savona, Università Degli Studi di Genova, 17100 Savona, Italy
| | - Mattia Loppini
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.A.); (E.G.); (P.C.); (V.D.M.); (E.K.); (G.G.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
- Fondazione Livio Sciutto Onlus, Campus Savona, Università Degli Studi di Genova, 17100 Savona, Italy
| |
Collapse
|
32
|
Kveller C, Jakobsen AM, Larsen NH, Lindhardt JL, Baad-Hansen T. First experiences of a hospital-based 3D printing facility - an analytical observational study. BMC Health Serv Res 2024; 24:28. [PMID: 38178068 PMCID: PMC10768152 DOI: 10.1186/s12913-023-10511-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE To identify the clinical impact and potential benefits of in-house 3D-printed objects through a questionnaire, focusing on three principal areas: patient education; interdisciplinary cooperation; preoperative planning and perioperative execution. MATERIALS AND METHODS Questionnaires were sent from January 2021 to August 2022. Participants were directed to rate on a scale from 1 to 10. RESULTS The response rate was 43%. The results of the rated questions are averages. 84% reported using 3D-printed objects in informing the patient about their condition/procedure. Clinician-reported improvement in patient understanding of their procedure/disease was 8.1. The importance of in-house placement was rated 9.2. 96% reported using the 3D model to confer with colleagues. Delay in treatment due to 3D printing lead-time was 1.8. The degree with which preoperative planning was altered was 6.9. The improvement in clinician perceived preoperative confidence was 8.3. The degree with which the scope of the procedure was affected, in regard to invasiveness, was 5.6, wherein a score of 5 is taken to mean unchanged. Reduction in surgical duration was rated 5.7. CONCLUSION Clinicians report the utilization of 3D printing in surgical specialties improves procedures pre- and intraoperatively, has a potential for increasing patient engagement and insight, and in-house location of a 3D printing center results in improved interdisciplinary cooperation and allows broader access with only minimal delay in treatment due to lead-time.
Collapse
Affiliation(s)
- Christian Kveller
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Anders M Jakobsen
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Nicoline H Larsen
- Department of Dentistry, Section for Oral and Maxillofacial Surgery, Aarhus University, Aarhus, Denmark
| | - Joakim L Lindhardt
- Department of Plastic and Breast Surgery, 3D Innovation, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Baad-Hansen
- Department of Orthopedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
| |
Collapse
|
33
|
Sun X, Sun G, He B, Wang Z, Shi L. Application of 3D visualization technology based on hematoma edge key points setting for emergency hypertensive cerebral hemorrhage surgery in primary hospitals. J Clin Neurosci 2024; 119:39-44. [PMID: 37979309 DOI: 10.1016/j.jocn.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE This study aims to explore the application potential of 3D visualization technology based in emergency hypertensive cerebral hemorrhage surgery in primary hospitals. The specific goal is to use 3DSlicer software to perform 3D reconstruction and body surface projection on patients with hypertensive cerebral hemorrhage, provide accurate hematoma location information, help surgeons determine the specific location of hematoma on the body surface, and reduce the expansion of surgical incisions. METHODS 3D reconstruction technology based on 3DSlicer software was employed to process CT images of patients with cerebral hemorrhage. By segmenting and reconstructing the images, a 3D model of the hematoma was generated and projected onto the patient's body surface. Utilizing the functionalities of 3DSlicer software in conjunction with the surgeon's anatomical knowledge, accurate hematoma positioning on the body surface was achieved. RESULTS 23 patients were enrolled in this study, and underwent successful surgical evacuation. The implementation of 3D visualization technology using 3DSlicer software is expected to provide precise hematoma localization information for emergency hypertensive intracerebral hemorrhage surgery in primary hospitals. This approach will enable surgeons to accurately determine the appropriate surgical incision, thereby minimizing unnecessary trauma and improving the overall success rate of surgery. CONCLUSION This study demonstrates the potential application of 3D visualization technology based on 3DSlicer software in emergency hypertensive cerebral hemorrhage surgery within primary hospitals. By utilizing 3DSlicer software for hematoma localization, accurate information support can be provided to assist surgeons in managing patients with hypertensive cerebral hemorrhage.
Collapse
Affiliation(s)
- Xuyang Sun
- Department of Neurosurgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou 215300, PR China
| | - Guan Sun
- Department of Neurosurgery, The Yancheng Clinical College of Xuzhou Medical University, The First people's Hospital of Yancheng, Yancheng, PR China.
| | - Bao He
- Department of Neurosurgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou 215300, PR China
| | - Zhimin Wang
- Department of Neurosurgery, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, PR China
| | - Lei Shi
- Department of Neurosurgery, Affiliated Kunshan Hospital of Jiangsu University, Suzhou 215300, PR China.
| |
Collapse
|
34
|
Jiménez-Garrido C, Idiart RP, Meschian-Coretti S, Montañez-Heredia E. Is Previously Implanted Osteosynthesis Material an Obstacle for the Use of Customized Guides?: A Case Report. JBJS Case Connect 2024; 14:01709767-202403000-00024. [PMID: 38306443 DOI: 10.2106/jbjs.cc.23.00520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
CASE We present the case of a 46-year-old patient with asymmetric deformity in the posterior tibial slope after previous high tibial osteotomy surgeries with the presence of a medial osteotomy plate. A customized cutting guide was designed to fit on the plate to perform a single surgery and avoid possible soft-tissue complications after multiple surgeries. CONCLUSIONS The presence of a previous internal fixation device may affect the manufacture of 3-dimensional cutting guides. However, in this case, the previously placed osteosynthesis plate was used as an aid for creating the guide.
Collapse
Affiliation(s)
- Carlos Jiménez-Garrido
- Department of Orthopedic Surgery and Traumatology, QuironSalud Hospital Málaga, Málaga, Spain
| | | | - Stephan Meschian-Coretti
- Department of Orthopedic Surgery and Traumatology, QuironSalud Hospital Málaga, Málaga, Spain
- Vithas Xanit International Hospital, Benalmádena, Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Elvira Montañez-Heredia
- Vithas Xanit International Hospital, Benalmádena, Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| |
Collapse
|
35
|
Polak S, Beever L, Wade A, Fukuoka M, Worth AJ. Biomechanical comparison of titanium alloy additively manufactured and conventionally manufactured plate-screw constructs. N Z Vet J 2024; 72:17-27. [PMID: 37772312 DOI: 10.1080/00480169.2023.2264805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
AIM To biomechanically compare the bending stiffness, strength, and cyclic fatigue of titanium additively manufactured (AM) and conventionally manufactured (CM) limited contact plates (LCP) of equivalent dimensions using plate-screw constructs. METHODS Twenty-four 1.5/2.0-mm plate constructs (CM: n = 12; AM: n = 12) were placed under 4-point bending conditions. Data were collected during quasi-static single cycle to failure and cyclic fatigue testing until implants plastically deformed or failed. Bending stiffness, bending structural stiffness, and bending strength were determined from load-displacement curves. Fatigue life was determined as number of cycles to failure. Median test variables for each method were compared using the Wilcoxon rank sum test within each group. Fatigue data was also analysed by the Kaplan-Meier estimator of survival function. RESULTS There was no evidence for a difference in bending stiffness and bending structural stiffness between AM and CM constructs. However, AM constructs exhibited greater bending strength (median 3.07 (min 3.0, max 3.4) Nm) under quasi-static 4-point bending than the CM constructs (median 2.57 (min 2.5, max 2.6) Nm, p = 0.006). Number of cycles to failure under dynamic 4-point bending was higher for the CM constructs (median 164,272 (min 73,557, max 250,000) cycles) than the AM constructs (median 18,704 (min 14,427, max 33,228) cycles; p = 0.02). Survival analysis showed that 50% of AM plates failed by 18,842 cycles, while 50% CM plates failed by 78,543 cycles. CONCLUSION AND CLINICAL RELEVANCE Additively manufactured titanium implants, printed to replicate a conventional titanium orthopaedic plate, were more prone to failure in a shorter fatigue period despite being stronger in single cycle to failure. Patient-specific implants made using this process may be brittle and therefore not comparable to CM orthopaedic implants. Careful selection of their use on a case/patient-specific basis is recommended.
Collapse
Affiliation(s)
- S Polak
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - L Beever
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A Wade
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - M Fukuoka
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A J Worth
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| |
Collapse
|
36
|
Ganta GK, Mosca RC, Varsani R, Murthy VR, Cheruvu K, Lu M, Arany PR. Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review. Dent J (Basel) 2023; 12:8. [PMID: 38248216 PMCID: PMC10814723 DOI: 10.3390/dj12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The popularity of implants is increasing with the aging population requiring oral-dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
Collapse
Affiliation(s)
- Gopala Krishna Ganta
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
- Intercare Community Health Network, Bangor, MI 49013, USA
| | - Rodrigo Crespo Mosca
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Ridham Varsani
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Venkata Ramana Murthy
- Department of Maxillofacial Surgery, Anil Nirukonda Dental College, Visakhapatnam 531162, India
| | - Kamala Cheruvu
- Department of Orthodontics, Gandhi Institute of Technology and Management Dental College, Visakhapatnam 530045, India
| | - Michael Lu
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Praveen R. Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| |
Collapse
|
37
|
Liang H, Zhang H, Chen B, Yang L, Xu R, Duan S, Cai Z. 3D printing technology combined with personalized plates for complex distal intra-articular fractures of the trimalleolar ankle. Sci Rep 2023; 13:22667. [PMID: 38114629 PMCID: PMC10730506 DOI: 10.1038/s41598-023-49515-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
This study investigated the effectiveness of 3D printing technology in combination with personalized custom-made steel plates in the treatment of complex distal intra-articular trimalleolar fractures, with the aim of providing a new approach to improve ankle joint function in patients. The 48 patients with complex distal intra-articular trimalleolar fractures included in the study were randomly divided into two groups: the personalized custom-made steel plate group (n = 24) and the conventional steel plate group (n = 24). A comparison was made between the two groups in terms of preoperative preparation time, hospitalization duration, surgical time, fracture reduction and internal fixation time, intraoperative fluoroscopy instances, surgical incision length, fracture healing time, follow-up duration, degree of fracture reduction, ankle joint functional recovery, and the occurrence of complications. The personalized steel plate group exhibited longer preoperative preparation time and hospitalization duration compared to the conventional steel plate group (p < 0.001). However, the personalized steel plate group demonstrated significantly shorter surgical duration, time for fracture reduction and internal fixation, reduced intraoperative fluoroscopy frequency, and a shorter overall surgical incision length (p < 0.001). Both groups displayed similar fracture healing times and follow-up durations (p > 0.05). The personalized steel plate group showed a higher rate of successful fracture reduction (87.5% vs. 79.2%, p > 0.05) and a lower incidence of complications (8.3% vs. 20.8%, p = 0.22), although these differences did not reach statistical significance. Furthermore, the personalized steel plate group exhibited superior ankle joint function scores during follow-up compared to the conventional steel plate group (p < 0.05). By utilizing 3D printing technology in conjunction with personalized custom-made steel plates, personalized treatment plans are provided for patients with complex comminuted tri-malleolar ankle fractures, enabling safer, more efficient, and satisfactory orthopedic surgeries.
Collapse
Affiliation(s)
- Hairui Liang
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - He Zhang
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Beibei Chen
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Lei Yang
- School of Pharmacy, Inner Mongolia Medical University, 5 Xinhua Street, Hohhot, 010107, Inner Mongolia Autonomous Region, China
| | - Rongda Xu
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Siyu Duan
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China
| | - Zhencun Cai
- Department of Orthopedics Surgery, Central Hospital Afliated to Shenyang Medical College, 5 Nanqi West Road, Shenyang, 110075, Liaoning, China.
| |
Collapse
|
38
|
Velarde K, Cafino R, Isla A, Ty KM, Palmer XL, Potter L, Nadorra L, Pueblos LV, Velasco LC. Virtual surgical planning in craniomaxillofacial surgery: a structured review. Comput Assist Surg (Abingdon) 2023; 28:2271160. [PMID: 37862041 DOI: 10.1080/24699322.2023.2271160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the development of this review. This paper aims to provide a comprehensive review of the findings of the studies by conducting an integrated approach to synthesize the literature related to the use of VSP in craniomaxillofacial surgery. Twenty-nine related articles were selected as a sample and synthesized thoroughly. These papers were grouped assigning to the four subdisciplines of craniomaxillofacial surgery: orthognathic surgery, reconstructive surgery, trauma surgery and implant surgery. The following variables - treatment time, the accuracy of VSP, clinical outcome, cost, and cost-effectiveness - were also examined. Results revealed that VSP offers advantages in craniomaxillofacial surgery over the traditional method in terms of duration, predictability and clinical outcomes. However, the cost aspect was not discussed in most papers. This structured literature review will thus provide current findings and trends and recommendations for future research on the usage of VSP in craniomaxillofacial surgery.
Collapse
Affiliation(s)
- Kaye Velarde
- Mindanao State University-Iligan Institute of Technology, Iligan City, The Philippines
| | - Rentor Cafino
- Zamboanga City Medical Center, Zamboanga City, The Philippines
| | - Armando Isla
- Mercy Community Hospital, Iligan City, The Philippines
| | - Karen Mae Ty
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, The Philippines
| | | | | | - Larry Nadorra
- Department of Health - Center for Health Development, Cagayan de Oro City, The Philippines
| | | | - Lemuel Clark Velasco
- Mindanao State University-Iligan Institute of Technology, Iligan City, The Philippines
- Premiere Research Institute of Science and Mathematics - Center for Computational Analytics and Modelling
| |
Collapse
|
39
|
Korolj A, Kohler RH, Scott E, Halabi EA, Lucas K, Carlson JCT, Weissleder R. Perfusion Window Chambers Enable Interventional Analyses of Tumor Microenvironments. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2304886. [PMID: 37870204 DOI: 10.1002/advs.202304886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/29/2023] [Indexed: 10/24/2023]
Abstract
Intravital microscopy (IVM) allows spatial and temporal imaging of different cell types in intact live tissue microenvironments. IVM has played a critical role in understanding cancer biology, invasion, metastases, and drug development. One considerable impediment to the field is the inability to interrogate the tumor microenvironment and its communication cascades during disease progression and therapeutic interventions. Here, a new implantable perfusion window chamber (PWC) is described that allows high-fidelity in vivo microscopy, local administration of stains and drugs, and longitudinal sampling of tumor interstitial fluid. This study shows that the new PWC design allows cyclic multiplexed imaging in vivo, imaging of drug action, and sampling of tumor-shed materials. The PWC will be broadly useful as a novel perturbable in vivo system for deciphering biology in complex microenvironments.
Collapse
Affiliation(s)
- Anastasia Korolj
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA, 02115, USA
| | - Rainer H Kohler
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
| | - Ella Scott
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
| | - Elias A Halabi
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
| | - Kilean Lucas
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
| | - Jonathan C T Carlson
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
- Cancer Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, 185 Cambridge St, CPZN 5206, Boston, MA, 02114, USA
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA, 02115, USA
- Cancer Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| |
Collapse
|
40
|
Bunch PM, Ertl-Wagner BB, Gibbs WN, Lev S, Lev MH. "Best of" ASNR 2023 (Chicago) and "Sneak Peek" of ASNR 2024 (Las Vegas). AJNR Am J Neuroradiol 2023:ajnr.A8061. [PMID: 38049993 DOI: 10.3174/ajnr.a8061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Affiliation(s)
- Paul M Bunch
- Department of RadiologyWake Forest University School of MedicineWinston Salem, North Carolina
| | - Birgit B Ertl-Wagner
- Department of Diagnostic ImagingThe Hospital for Sick ChildrenToronto, Ontario, Canada
- Department of Medical ImagingUniversity of TorontoToronto, Ontario, Canada
| | - Wende N Gibbs
- Department of NeuroradiologyBarrow Neurological InstitutePhoenix, Arizona
| | - Steven Lev
- Department of RadiologyNassau University Medical CenterEast Meadow, New York
| | - Michael H Lev
- Department of RadiologyMassachusetts General Hospital/Harvard Medical SchoolBoston, Massachusetts
| |
Collapse
|
41
|
S S, R G AP, Bajaj G, John AE, Chandran S, Kumar VV, Ramakrishna S. A review on the recent applications of synthetic biopolymers in 3D printing for biomedical applications. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:62. [PMID: 37982917 PMCID: PMC10661719 DOI: 10.1007/s10856-023-06765-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/01/2023] [Indexed: 11/21/2023]
Abstract
3D printing technology is an emerging method that gained extensive attention from researchers worldwide, especially in the health and medical fields. Biopolymers are an emerging class of materials offering excellent properties and flexibility for additive manufacturing. Biopolymers are widely used in biomedical applications in biosensing, immunotherapy, drug delivery, tissue engineering and regeneration, implants, and medical devices. Various biodegradable and non-biodegradable polymeric materials are considered as bio-ink for 3d printing. Here, we offer an extensive literature review on the current applications of synthetic biopolymers in the field of 3D printing. A trend in the publication of biopolymers in the last 10 years are focused on the review by analyzing more than 100 publications. Their application and classification based on biodegradability are discussed. The various studies, along with their practical applications, are elaborated in the subsequent sections for polyethylene, polypropylene, polycaprolactone, polylactide, etc. for biomedical applications. The disadvantages of various biopolymers are discussed, and future perspectives like combating biocompatibility problems using 3D printed biomaterials to build compatible prosthetics are also discussed and the potential application of using resin with the combination of biopolymers to build customized implants, personalized drug delivery systems and organ on a chip technologies are expected to open a new set of chances for the development of healthcare and regenerative medicine in the future.
Collapse
Affiliation(s)
- Shiva S
- School of BioSciences and Technology, Department of Biotechnology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
- Centre for Nanotechnology and Sustainability, National University of Singapore, Singapore, 117575, Singapore
| | - Asuwin Prabu R G
- School of BioSciences and Technology, Department of Biotechnology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Gauri Bajaj
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Amy Elsa John
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Sharan Chandran
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
| | - Vishnu Vijay Kumar
- Centre for Nanotechnology and Sustainability, National University of Singapore, Singapore, 117575, Singapore
- Department of Ocean Engineering, Indian Institute of Technology Madras, Chennai, 600036, India
- Department of Mechanical and Industrial Engineering, Gadjah Mada University, Yogyakarta, 55281, Indonesia
- Department of Aerospace Engineering, Jain deemed to be University, Bangalore, India
| | - Seeram Ramakrishna
- Centre for Nanotechnology and Sustainability, National University of Singapore, Singapore, 117575, Singapore
| |
Collapse
|
42
|
Cervi E, Bissacco D, Ginestra PS. Varicose vein three-dimensional printing model from duplex scan analysis images. J Vasc Surg Venous Lymphat Disord 2023; 11:1289-1290. [PMID: 37863553 DOI: 10.1016/j.jvsv.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/12/2023] [Accepted: 06/08/2023] [Indexed: 10/22/2023]
Affiliation(s)
- Edoardo Cervi
- Division of Vascular Surgery, Vein Clinic Brescia, Brescia, Italy.
| | - Daniele Bissacco
- Division of Vascular Surgery, Vein Clinic Brescia, Brescia, Italy
| | - Paola Serena Ginestra
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| |
Collapse
|
43
|
Pérez-Davila S, Potel-Alvarellos C, Carballo R, González-Rodríguez L, López-Álvarez M, Serra J, Díaz-Rodríguez P, Landín M, González P. Vancomycin-Loaded 3D-Printed Polylactic Acid-Hydroxyapatite Scaffolds for Bone Tissue Engineering. Polymers (Basel) 2023; 15:4250. [PMID: 37959930 PMCID: PMC10648244 DOI: 10.3390/polym15214250] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
The regeneration of bone remains one of the main challenges in the biomedical field, with the need to provide more personalized and multifunctional solutions. The other persistent challenge is related to the local prevention of infections after implantation surgery. To fulfill the first one and provide customized scaffolds with complex geometries, 3D printing is being investigated, with polylactic acid (PLA) as the biomaterial mostly used, given its thermoplastic properties. The 3D printing of PLA in combination with hydroxyapatite (HA) is also under research, to mimic the native mechanical and biological properties, providing more functional scaffolds. Finally, to fulfill the second one, antibacterial drugs locally incorporated into biodegradable scaffolds are also under investigation. This work aims to develop vancomycin-loaded 3D-printed PLA-HA scaffolds offering a dual functionality: local prevention of infections and personalized biodegradable scaffolds with osseointegrative properties. For this, the antibacterial drug vancomycin was incorporated into 3D-printed PLA-HA scaffolds using three loading methodologies: (1) dip coating, (2) drop coating, and (3) direct incorporation in the 3D printing with PLA and HA. A systematic characterization was performed, including release kinetics, Staphylococcus aureus antibacterial/antibiofilm activities and cytocompatibility. The results demonstrated the feasibility of the vancomycin-loaded 3D-printed PLA-HA scaffolds as drug-releasing vehicles with significant antibacterial effects for the three methodologies. In relation to the drug release kinetics, the (1) dip- and (2) drop-coating methodologies achieved burst release (first 60 min) of around 80-90% of the loaded vancomycin, followed by a slower release of the remaining drug for up to 48 h, while the (3) 3D printing presented an extended release beyond 7 days as the polymer degraded. The cytocompatibility of the vancomycin-loaded scaffolds was also confirmed.
Collapse
Affiliation(s)
- Sara Pérez-Davila
- CINTECX, Universidade de Vigo, Grupo Novos Materiais, 36310 Vigo, Spain (M.L.-Á.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
| | - Carmen Potel-Alvarellos
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
- Laboratorio de Microbiología, Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain
| | - Raquel Carballo
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
- Laboratorio de Microbiología, Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain
| | - Laura González-Rodríguez
- CINTECX, Universidade de Vigo, Grupo Novos Materiais, 36310 Vigo, Spain (M.L.-Á.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
| | - Miriam López-Álvarez
- CINTECX, Universidade de Vigo, Grupo Novos Materiais, 36310 Vigo, Spain (M.L.-Á.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
| | - Julia Serra
- CINTECX, Universidade de Vigo, Grupo Novos Materiais, 36310 Vigo, Spain (M.L.-Á.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
| | - Patricia Díaz-Rodríguez
- Pharmacology, Pharmacy, and Pharmaceutical Technology Department, I+D Farma (GI-1645), Faculty of Pharmacy, Institute of Materials, iMATUS and Health Research Institute of Santiago de Compositela (IDIS), University of Santiago de Compostela, 15705 Santiago de Compostela, Spain; (P.D.-R.); (M.L.)
| | - Mariana Landín
- Pharmacology, Pharmacy, and Pharmaceutical Technology Department, I+D Farma (GI-1645), Faculty of Pharmacy, Institute of Materials, iMATUS and Health Research Institute of Santiago de Compositela (IDIS), University of Santiago de Compostela, 15705 Santiago de Compostela, Spain; (P.D.-R.); (M.L.)
| | - Pío González
- CINTECX, Universidade de Vigo, Grupo Novos Materiais, 36310 Vigo, Spain (M.L.-Á.)
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain; (C.P.-A.)
| |
Collapse
|
44
|
Regner AM, DeLeon M, Gibbons KD, Howard S, Nesbitt DQ, Lujan TJ, Fitzpatrick CK, Farach-Carson MC, Wu D, Uzer G. Increased deformations are dispensable for cell mechanoresponse in engineered bone analogs mimicking aging bone marrow. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.24.559187. [PMID: 37905032 PMCID: PMC10614733 DOI: 10.1101/2023.09.24.559187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Aged individuals and astronauts experience bone loss despite rigorous physical activity. Bone mechanoresponse is in-part regulated by mesenchymal stem cells (MSCs) that respond to mechanical stimuli. Direct delivery of low intensity vibration (LIV) recovers MSC proliferation in senescence and simulated microgravity models, indicating that age-related reductions in mechanical signal delivery within bone marrow may contribute to declining bone mechanoresponse. To answer this question, we developed a 3D bone marrow analog that controls trabecular geometry, marrow mechanics and external stimuli. Validated finite element (FE) models were developed to quantify strain environment within hydrogels during LIV. Bone marrow analogs with gyroid-based trabeculae of bone volume fractions (BV/TV) corresponding to adult (25%) and aged (13%) mice were printed using polylactic acid (PLA). MSCs encapsulated in migration-permissive hydrogels within printed trabeculae showed robust cell populations on both PLA surface and hydrogel within a week. Following 14 days of LIV treatment (1g, 100 Hz, 1 hour/day), type-I collagen and F-actin were quantified for the cells in the hydrogel fraction. While LIV increased all measured outcomes, FE models predicted higher von Mises strains for the 13% BV/TV groups (0.2%) when compared to the 25% BV/TV group (0.1%). Despite increased strains, collagen-I and F-actin measures remained lower in the 13% BV/TV groups when compared to 25% BV/TV counterparts, indicating that cell response to LIV does not depend on hydrogel strains and that bone volume fraction (i.e. available bone surface) directly affects cell behavior in the hydrogel phase independent of the external stimuli. Overall, bone marrow analogs offer a robust and repeatable platform to study bone mechanobiology.
Collapse
Affiliation(s)
- Alexander M Regner
- Mechanical and Biomedical Engineering Department, Boise State University
| | - Maximilien DeLeon
- Department of Diagnostic and Biomedical Sciences, UTHealth Houston School of Dentistry
- Department of Bioengineering, Rice University
- Department of Biosciences, Rice University
| | - Kalin D. Gibbons
- Mechanical and Biomedical Engineering Department, Boise State University
| | - Sean Howard
- Mechanical and Biomedical Engineering Department, Boise State University
| | | | - Trevor J. Lujan
- Mechanical and Biomedical Engineering Department, Boise State University
| | | | - Mary C Farach-Carson
- Department of Diagnostic and Biomedical Sciences, UTHealth Houston School of Dentistry
- Department of Bioengineering, Rice University
- Department of Biosciences, Rice University
| | - Danielle Wu
- Department of Diagnostic and Biomedical Sciences, UTHealth Houston School of Dentistry
- Department of Bioengineering, Rice University
- Department of Biosciences, Rice University
| | - Gunes Uzer
- Mechanical and Biomedical Engineering Department, Boise State University
| |
Collapse
|
45
|
Altarazi A, Jadaan L, McBain AJ, Haider J, Kushnerev E, Yates JM, Alhotan A, Silikas N, Devlin H. 3D-printed nanocomposite denture base resin: The effect of incorporating TiO 2 nanoparticles on the growth of Candida albicans. J Prosthodont 2023. [PMID: 37837403 DOI: 10.1111/jopr.13784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/23/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023] Open
Abstract
PURPOSE To develop a biocompatible denture base resin/TiO2 nanocomposite material with antifungal characteristics that is suitable for 3D-printing denture bases. MATERIALS AND METHODS TiO2 nanoparticles (NPs) with a 0.10, 0.25, 0.50, and 0.75 weight percent (wt.%) were incorporated into a commercially available 3D-printed resin material. The resulting nanocomposite material was analyzed using Lactate dehydrogenase (LDH) and AlamarBlue (AB) assays for biocompatibility testing with human gingival fibroblasts (HGF). The composite material was also tested for its antifungal efficacy against Candida albicans. Fourier transform infrared (FTIR) and Energy Dispersive X-ray Spectroscopy (EDX) mapping were conducted to assess the surface coating and the dispersion of the NPs. RESULTS LDH and AB assays confirmed the biocompatibility of the material showing cell proliferation at a rate of nearly 100% at day 10, with a cytotoxicity of less than 13% of the cells at day 10. The concentrations of 0.10, 0.25, and 0.50 wt.% caused a significant reduction (p < 0.05) in the number of candida cells attached to the surface of the specimens (p < 0.05), while 0.75 wt.% did not show any significant difference compared to the control (no TiO2 NPs) (p > 0.05). FTIR and EDX analysis confirmed the presence of TiO2 NPs within the nanocomposite material with a homogenous dispersion for 0.10 and 0.25 wt.% groups and an aggregation of the NPs within the material at higher concentrations. CONCLUSION The addition of TiO2 NPs into 3D-printed denture base resin proved to have an antifungal effect against Candida albicans. The resultant nanocomposite material was a biocompatible material with HGFs and was successfully used for 3D printing.
Collapse
Affiliation(s)
- Ahmed Altarazi
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- Restorative Dental Science, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Layali Jadaan
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Andrew J McBain
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Julfikar Haider
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- Department of Engineering, Manchester Metropolitan University, Manchester, UK
| | - Evgeny Kushnerev
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Manchester, Manchester, UK
| | - Julian M Yates
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Manchester, Manchester, UK
| | - Abdulaziz Alhotan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nick Silikas
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Hugh Devlin
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- School of Dentistry, University of Jordan, Jordan, Saudi Arabia
| |
Collapse
|
46
|
Fitzgerald CW, Hararah M, Mclean T, Woods R, Dogan S, Tabar V, Ganly I, Matros E, Cohen MA. Virtual Surgical Planning and Three-Dimensional Models for Precision Sinonasal and Skull Base Surgery. Cancers (Basel) 2023; 15:4989. [PMID: 37894356 PMCID: PMC10605567 DOI: 10.3390/cancers15204989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Sinonasal and skull base malignancies represent a rare, heterogenous group of pathologies with an incidence of 0.556 per 100,000 persons in the population. Given the numerous critical anatomic structures located adjacent to the sinonasal cavity and skull base, surgery for tumors in this region requires careful pre-operative planning with the assistance of radiological imaging and intraoperative image guidance technologies to reduce the risk of complications. Virtual surgical planning (VSP) and three-dimensional models (3DMs) are adjunctive technologies which assist clinicians to better visualize patient anatomy using enhanced digital radiological images and physical stereolithographic models based on patients' personal imaging. This review summarizes our institutional experience with VSP and 3DMs in sinonasal and skull base surgical oncology. A clinical case series is used to thematically illustrate the application of VSP and 3DMs in surgical ablation, reconstruction, patient communication, medical education, and interdisciplinary teamwork in sinonasal and skull base surgery.
Collapse
Affiliation(s)
- Conall W. Fitzgerald
- Department of Surgery, Head & Neck Division, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (C.W.F.)
| | - Mohammad Hararah
- Department of Plastic & Microvascular Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Tim Mclean
- Department of Surgery, Head & Neck Division, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (C.W.F.)
| | - Robbie Woods
- Department of Surgery, Head & Neck Division, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (C.W.F.)
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA;
| | - Viviane Tabar
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Ian Ganly
- Department of Surgery, Head & Neck Division, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (C.W.F.)
| | - Evan Matros
- Department of Plastic & Microvascular Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Marc A. Cohen
- Department of Surgery, Head & Neck Division, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; (C.W.F.)
| |
Collapse
|
47
|
Cai YL, Nan F, Tang GT, Ma Y, Ren Y, Xiong XZ, Zhou RX, Li FY, Cheng NS, Jiang X. Fabrication of 3D printed PCL/PEG artificial bile ducts as supportive scaffolds to promote regeneration of extrahepatic bile ducts in a canine biliary defect model. J Mater Chem B 2023; 11:9443-9458. [PMID: 37727116 DOI: 10.1039/d3tb01250f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
In this study, a 3D porous poly(ε-caprolactone)/polyethylene glycol (PCL/PEG) composite artificial tubular bile duct was fabricated for extrahepatic bile duct regeneration. PCL/PEG composite scaffolds were fabricated by 3D printing, and the molecular structure, mechanical properties, thermal properties, morphology, and in vitro biocompatibility were characterized for further application as artificial bile ducts. A bile duct defect model was established in beagle dogs for in vivo implantation. The results demonstrated that the implanted PE1 ABD, serving as a supportive scaffold, effectively stimulated the regeneration of a new bile duct comprising CK19-positive and CK7-positive epithelial cells within 30 days. Remarkably, after 8 months, the newly formed bile duct exhibited an epithelial layer resembling the normal structure. Furthermore, the study revealed collagen deposition, biliary muscular formation, and the involvement of microvessels and fibroblasts in the regenerative process. In contrast, the anastomotic area without ABD implantation displayed only partial restoration of the epithelial layer, accompanied by fibroblast proliferation and subsequent bile duct fibrosis. These findings underscore the limited inherent repair capacity of the bile duct and underscore the beneficial role of the PE1 ABD artificial tubular bile duct in promoting biliary regeneration.
Collapse
Affiliation(s)
- Yu-Long Cai
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fang Nan
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Guo-Tao Tang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yuan Ma
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yi Ren
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xian-Ze Xiong
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Rong-Xing Zhou
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fu-Yu Li
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nan-Sheng Cheng
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xia Jiang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| |
Collapse
|
48
|
Laskay NMB, George JA, Knowlin L, Chang TP, Johnston JM, Godzik J. Optimizing Surgical Performance Using Preoperative Virtual Reality Planning: A Systematic Review. World J Surg 2023; 47:2367-2377. [PMID: 37204439 DOI: 10.1007/s00268-023-07064-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Surgery is often a complex process that requires detailed 3-dimensional anatomical knowledge and rigorous interplay between team members to attain ideal operational efficiency or "flow." Virtual Reality (VR) represents a technology by which to rehearse complex plans and communicate precise steps to a surgical team prior to entering the operating room. The objective of this study was to evaluate the use of VR for preoperative surgical team planning and interdisciplinary communication across all surgical specialties. METHODS A systematic review of the literature was performed examining existing research on VR use for preoperative surgical team planning and interdisciplinary communication across all surgical fields in order to optimize surgical efficiency. MEDLINE, SCOPUS, CINAHL databases were searched from inception to July 31, 2022 using standardized search clauses. A qualitative data synthesis was performed with particular attention to preoperative planning, surgical efficiency optimization, and interdisciplinary collaboration/communication techniques determined a priori. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. All included studies were appraised for their quality using the Medical Education Research Study Quality Instrument (MERSQI) tool. RESULTS One thousand and ninety-three non-duplicated articles with abstract and full text availability were identified. Thirteen articles that examined preoperative VR-based planning techniques for optimization of surgical efficiency and/or interdisciplinary communication fulfilled inclusion and exclusion criteria. These studies had a low-to-medium methodological quality with a MERSQI mean score of 10.04 out of 18 (standard deviation 3.61). CONCLUSIONS This review demonstrates that time spent rehearsing and visualizing patient-specific anatomical relationships in VR may improve operative efficiency and communication across multiple surgical specialties.
Collapse
Affiliation(s)
- Nicholas M B Laskay
- Department of Neurosurgery, University of Alabama at Birmingham, 1060 Faculty Office Tower, 1720 2nd Avenue South, Birmingham, AL, 35294-3410, USA.
| | - Jordan A George
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Laquanda Knowlin
- Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Todd P Chang
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - James M Johnston
- Department of Neurosurgery, University of Alabama at Birmingham, 1060 Faculty Office Tower, 1720 2nd Avenue South, Birmingham, AL, 35294-3410, USA
| | - Jakub Godzik
- Department of Neurosurgery, University of Alabama at Birmingham, 1060 Faculty Office Tower, 1720 2nd Avenue South, Birmingham, AL, 35294-3410, USA
| |
Collapse
|
49
|
Ivanovski S, Breik O, Carluccio D, Alayan J, Staples R, Vaquette C. 3D printing for bone regeneration: challenges and opportunities for achieving predictability. Periodontol 2000 2023; 93:358-384. [PMID: 37823472 DOI: 10.1111/prd.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/18/2023] [Accepted: 08/26/2023] [Indexed: 10/13/2023]
Abstract
3D printing offers attractive opportunities for large-volume bone regeneration in the oro-dental and craniofacial regions. This is enabled by the development of CAD-CAM technologies that support the design and manufacturing of anatomically accurate meshes and scaffolds. This review describes the main 3D-printing technologies utilized for the fabrication of these patient-matched devices, and reports on their pre-clinical and clinical performance including the occurrence of complications for vertical bone augmentation and craniofacial applications. Furthermore, the regulatory pathway for approval of these devices is discussed, highlighting the main hurdles and obstacles. Finally, the review elaborates on a variety of strategies for increasing bone regeneration capacity and explores the future of 4D bioprinting and biodegradable metal 3D printing.
Collapse
Affiliation(s)
- Saso Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Omar Breik
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Danilo Carluccio
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jamil Alayan
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Ruben Staples
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
| | - Cedryck Vaquette
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Queensland, Herston, Australia
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
| |
Collapse
|
50
|
Singh HN, Agrawal S, Kuthe AM. Design of customized implants and 3D printing of symmetric and asymmetric cranial cavities. J Mech Behav Biomed Mater 2023; 146:106061. [PMID: 37544200 DOI: 10.1016/j.jmbbm.2023.106061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
A methodology has been developed in this work to design customized cranial implants from computed tomography (CT) scan images for symmetric as well as asymmetric defects. The two-dimensional CT scan images were converted into three-dimensional geometric models using software packages. Two cases of cranial cavities at different locations were considered for implant design using two different approaches. Case 1 is having a symmetric cranial cavity while Case 2 has an asymmetric frontal cranial cavity. The craniums with defects were 3D reconstructed. Customized cranial implants were made for the two cases. In Case 1, symmetry was used to design the cranial implant. Symmetry cannot be used in Case 2. In Case 2, the implant was designed by blending from the surface available adjacent to the missing portion of the cranium. 3D reconstructed bone models and customized implants were 3D printed in poly-lactic acid (PLA) using a fused deposition modeling process for form and fit evaluation. Finite element analysis was performed to compare the mechanical behavior of bone, and the two biomaterials - polyether ether ketone (PEEK), and Ti6Al4V. Static structural finite element analysis was performed to simulate the impact of falling off a bicycle with an impact on the cranial implants in the two cases. The load was modeled as a normal force acting on the surface of the implant. It was found that the stresses in the titanium alloy are comparable to those of PEEK for both the cases. However, the strains and deformation were found to be much smaller compared to those in PEEK. Therefore, the titanium alloy is the material of choice for both the cases among the materials under consideration. The designed implants are solid hence may face the challenge in bone ingrowth. In future studies, the implant can be made porous by incorporating a lattice structure to enhance osseointegration and promote bone ingrowth. Implants for both symmetric and asymmetric defect cases in cranium were successfully designed.
Collapse
Affiliation(s)
- Hari Narayan Singh
- Department of Mechanical Engineering, National Institute of Technology, Uttarakhand, India.
| | - Sanat Agrawal
- Department of Mechanical Engineering, National Institute of Technology, Uttarakhand, India
| | - Abhaykumar M Kuthe
- Department of Mechanical Engineering, Visvesvaraya National Institute of Technology, Nagpur, Maharashtra, India
| |
Collapse
|