Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery

PURPOSE

This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of 2D or 3D point clouds with unknown dependencies of the transition from scan s_(k) to scan s_(k+1).

METHODS

The study population was composed of ten patients who presented to the Maxillofacial Surgery Department of the University "Sapienza" of Rome for the evaluation and management of skeletal malocclusions. The patients were divided into two groups, depending on the technique used: group 1: splintless group (custom-made cutting guide and plates); group 2: splint group (using a 3D-printed splint). STL files were imported into Geomagic^® Control X™ software, which allows for comparison and analysis using an ICP algorithm. The RMSE parameter (3D error) was used to calculate the accuracy. In addition, data were compared in two different patient subgroups. The first subgroup only underwent a monobloc Le Fort I osteotomy (p-value = 0.02), and the second subgroup underwent a Le Fort I osteotomy associated with a segmental osteotomy of the maxilla (p-value = 0.23).

RESULTS

Group 1 showed a 3D error of 1.22 mm ± SD 0.456, while group 2 showed a 3D error of 1.63 mm ± SD 0.303. These results have allowed us to compare the accuracy of the two CAD/CAM systems (p-value = 0.09).

CONCLUSIONS

The ICP algorithm provided a reproducible method of comparison. The splintless method would seem more accurate (p-value = 0.02) in transferring the surgical programming into the operating room when only a Le Fort I osteotomy is to be performed.

Reconstruction of the mandibular symphysis: pilot study compares three different flaps

BACKGROUND

Restoration of mandibular continuity, functionality and attempting to return patients to their premorbid state is the ultimate goal of reconstruction. Some studies compare different flaps but the reconstructed portions vary and there is little consensus on the best option for a particular defect.

METHODS

This pilot study compares three different reconstructive options with free flap. We will analyze the accuracy of the reconstruction, the post-operative complications related to the reconstruction, the morbidity of the donor site. This pilot study compares three different reconstructive options with free flap in the reconstruction of the mandibular symphysis: iliac crest, scapula and fibula.

RESULTS

In our sample the morbidity of the donor site was overlapping, as for all three choices free from complications. In post resection edentulous patients, the fibula seems to guarantee better positioning, while in patients with residual occlusion the iliac crest (figure n.4 and n.5) seems to allow a more congruous repositioning. The fibula seems to have a superiority over the other flaps in terms of accuracy in all types of patient.

CONCLUSIONS

Contrary to the most recent work on the accuracy of CAD / CAM, we have analyzed the error in the reconstruction of a specific segment and in the repositioning of the residual mandibular component without the use of guided computer programming.

Determination of fat in leather by the use of supercritical fluid extraction combined with on-line piezoelectric detection

Leather samples were prepared and characterized as 'in house' matrix standards for the determination of fat. The Soxhlet standard method was used to establish the reference fat content in every standard sample. Sample homogeneity and stability were examined under specific storing conditions. The materials were subsequently used as matrix standards for the determination of fat in leather samples, using supercritical fluid extraction (SFE) with on-line piezoelectric detection. Real samples were weighed in the extraction SFE thimble, previously loaded with 1 g of diatomaceous earth. A temperature of 45 degrees C and a CO2 fluid density of 0.85 g ml-1 were used for extraction. The linear calibration range thus achieved was 0.001-0.040% m/m total fat (related to the weight of the leather) and the relative standard deviation +/- 3% (n = 11; P = 0.05). The results were compared with those obtained with the Soxhlet method and no significant differences were found.

Automatic microgravimetric determination of fats in milk products by use of supercritical fluid extraction with on-line piezoelectric detection

An on-line supercritical fluid extraction-piezoelectric detection system was developed and applied to the quantitative gravimetric determination of total fat in food samples (skimmed milk and cocoa). The proposed assembly provides all the advantages of an on-line system as regards automation, in addition to acceptable sensitivity and precision. Its strength lies in the design of the interface between the supercritical fluid extractor and the piezoelectric detector. Samples of skimmed milk and cocoa are weighed in the extraction thimble, previously loaded with I g of diatomaceous earth. A temperature of 100 degrees C and a CO2 fluid density of 0.60 mg/ml are used for extraction. The linear calibration range thus achieved is 0.005-0.07% w/w total fat, and the relative standard deviation is +/-2.3% (n=11; P=0.05). The throughput is six samples h(-1) (for the overall process). The proposed method was used to determine the total fat in food samples (milk, cocoa), the results being competitive with those of the Soxhlet methods for the same purpose.