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Vázquez-Silva E, Bohorquez-Vivas D, Peña-Tapia P, Moncayo-Matute F, Torres-Jara P, Moya-Loaiza D. Oculopalpebral prosthesis prototype design using the additive manufacturing technique: A case study. JPRAS Open 2024; 39:228-236. [PMID: 38323101 PMCID: PMC10843991 DOI: 10.1016/j.jpra.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/29/2023] [Indexed: 02/08/2024] Open
Abstract
Three-dimensional (3D) printing technology has advanced for applications in the field of reconstructive surgery. This study reports the application of a comprehensive methodology to obtain an anatomical model, using computed tomography and 3D printing, to treat a patient with cancer who designed a prototype oculopalpebral prosthesis for the reconstruction of the affected area of the face (left eye). A personalized prototype was obtained, which adapted to the face of the person, and improved the aesthetics and quality of life. The applied techniques helped to make definitive prostheses using materials that could be permanent. The training and tests carried out in this study favored the understanding and assimilation of the technology and the possibility of applying it to patients in need of facial prosthetic rehabilitation.
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Affiliation(s)
- E. Vázquez-Silva
- Department of Mechanical Engineering/Research Group on New Materials and Transformation Processes (GIMAT), Salesian Polytechnic University (UPS), Cuenca, Azuay, Ecuador
| | - D.D. Bohorquez-Vivas
- Department of Mechanical Engineering/Research Group on New Materials and Transformation Processes (GIMAT), Salesian Polytechnic University (UPS), Cuenca, Azuay, Ecuador
| | - P.G. Peña-Tapia
- Department of Neurosurgery/Society for the Fight Against Cancer, SOLCA Cancer Institute, Cuenca, Azuay, Ecuador
| | - F.P. Moncayo-Matute
- Department of Mechanical Engineering/Research Group on New Materials and Transformation Processes (GIMAT), Salesian Polytechnic University (UPS), Cuenca, Azuay, Ecuador
| | - P.B. Torres-Jara
- Department of Mechanical Engineering/Research Group on New Materials and Transformation Processes (GIMAT), Salesian Polytechnic University (UPS), Cuenca, Azuay, Ecuador
| | - D.P. Moya-Loaiza
- Department of Mechanical Engineering/Research Group on New Materials and Transformation Processes (GIMAT), Salesian Polytechnic University (UPS), Cuenca, Azuay, Ecuador
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Unkovskiy A, Spintzyk S, Beuer F, Huettig F, Röhler A, Kraemer-Fernandez P. Accuracy of capturing nasal, orbital, and auricular defects with extra- and intraoral optical scanners and smartphone: An in vitro study. J Dent 2021; 117:103916. [PMID: 34875273 DOI: 10.1016/j.jdent.2021.103916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This in vitro study compares the scanning accuracy of various stationary and portable as well as extra- and intraoral devices for capturing oncological defects. METHODS A 3D-printed model of a nasal, orbital, and auricular defect, as well as one of an intact auricle, were digitalized (n = 7 per device) with a stationary optical scanner (Pritiface), a portable extraoral optical scanner (Artec Space Spider), two intraoral scanners (Trios 4 and Primescan), and a smartphone (iPhone 11 Pro). For the reference data, the defect models were digitalized using a laboratory scanner (D2000). For quantitative analysis, the root mean square error value for trueness and precision and mean deviations in millimeters were obtained for each defect type. The data were statistically analyzed using two-way ANOVA and Tukey multiple comparison test. For qualitative analysis, a colorimetric map was generated to display the deviation within the defect area and adjacent tissue. RESULTS Statistically significant interactions were found in the trueness and precision for defect and scanner type. CONCLUSION The Primescan and Artec Space Spider scanners showed the highest accuracy for most defect types. Primescan and Trios 4 failed to capture the orbital defect. The iPhone 11 Pro showed clinically acceptable trueness but inferior precision. CLINICAL SIGNIFICANCE The scanning devices may demonstrate varying accuracy, depending on the defect type. A portable extraoral optical scanner is an universal tool for the digitization of oncological defects. Alternatively, an intraoral scanner may be employed in maxillofacial prosthetics with some restrictions. Utilizing a smartphone in maxillofacial rehabilitation should be considered with caution, because it provides inconsistent accuracy.
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Affiliation(s)
- Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146 Moscow, Russian Federation.
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; ADMiRE Lab-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
| | - Ariadne Röhler
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
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Toso S, Nahles S, Herzog M, Motzkus Y, Heiland M, Raguse JD. Frontal sinus augmentation: Preliminary results of a new approach in prosthetic orbital reconstruction. J Craniomaxillofac Surg 2019; 47:984-90. [PMID: 30975561 DOI: 10.1016/j.jcms.2019.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 01/07/2019] [Accepted: 03/18/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Reliable application of endosseous implants for prosthetic facial reconstruction depends on the bone volume available at the defect site. Regarding the orbit, sufficient bone presentation in the medial superior orbital rim is limited due to the frontal sinus. The aim of this article is to report for the first time on the augmentation of the frontal sinus for gaining bone volume for supraorbital implant placement. MATERIALS AND METHODS Between 2007 and 2014, five patients with orbital exenteration were treated by frontal sinus augmentation using autogenous cancellous bone graft from the ilium. Extraoral implants for prosthetic orbit reconstruction were placed 4-7 months later. In advance, cadaver surgery was performed to prove the feasibility of the method. Surgical technique is described, and intraoperative images are provided. RESULTS The frontal sinus was successfully augmented in all five patients. No major complications related to the procedure were observed. A total of nine orbital implants were inserted in the augmented bone, thereof one sleeping implant. Six implants were restored prosthetically, two implants were lost at exposure. The observation period ranged from 6 to 97 months (mean: 52.8 months). Mean time for patient rehabilitation was 13 months. High patient satisfaction was achieved with the implant-retained orbital prosthesis. CONCLUSION The augmentation of the frontal sinus allows implant placement by providing sufficient bone volume in the medial supraorbital rim. Considering the surgical success of this method and patient satisfaction, this new approach is concluded to be a viable option in a unique subset of patients.
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Unkovskiy A, Roehler A, Huettig F, Geis-Gerstorfer J, Brom J, Keutel C, Spintzyk S. Simplifying the digital workflow of facial prostheses manufacturing using a three-dimensional (3D) database: setup, development, and aspects of virtual data validation for reproduction. J Prosthodont Res 2019; 63:313-320. [PMID: 30792148 DOI: 10.1016/j.jpor.2019.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To set up the digital database (DDB) of various anatomical parts, skin details and retention elements in order to simplify the digital workflow of facial prostheses manufacturing; and to quantify the reproduction of skin wrinkles on the prostheses prototypes with stereolithography (SLA) and direct light processing (DLP) methods. METHODS Two structured light scanners were used to obtain the nasal and auricle forms of 50 probands. Furthermore, the ala nasi and scapha areas were captured with the digital single lens reflex camera and saved in jpeg format. The four magnetic retention elements were remodeled in computer aided design (CAD) software. The 14 test blocks with embossed wrinkles of 0.05-0.8mm were printed with SLA and DLP methods and afterwards analyzed by means of profilometry and confocal microscopy. RESULTS The introduced DDB allows for production of customized facial prosthesis and makes it possible to consider the integration of concrete retention elements on the CAD stage, which makes the prosthesis modelling more predictable and efficient. The obtained skin structures can be applied onto the prosthesis surface for customization. The reproduction of wrinkles from 0.1 to 0.8mm in depth may be associated with the loss of 4.5%-11% of its profile with SLA or DLP respectively. Besides, the reproduction of 0.05mm wrinkles may be met with up to 40% profile increasement. CONCLUSIONS The utilization of DDB may simplify the digital workflow of facial prostheses manufacturing. The transfer of digitally applied skin wrinkles till the prostheses' prototypes may be associated with deviations from 11 to 40%.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Ariadne Roehler
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | | | | | - Constanze Keutel
- Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
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Toso SM, Menzel K, Motzkus Y, Klein M, Menneking H, Raguse JD, Nahles S, Hoffmeister B, Adolphs N. Anaplastology in times of facial transplantation: Still a reasonable treatment option? J Craniomaxillofac Surg 2015; 43:1049-53. [PMID: 26105813 DOI: 10.1016/j.jcms.2015.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/25/2015] [Accepted: 05/20/2015] [Indexed: 11/24/2022] Open
Abstract
Optimum functional and aesthetic facial reconstruction is still a challenge in patients who suffer from inborn or acquired facial deformity. It is known that functional and aesthetic impairment can result in significant psychosocial strain, leading to the social isolation of patients who are affected by major facial deformities. Microvascular techniques and increasing experience in facial transplantation certainly contribute to better restorative outcomes. However, these technologies also have some drawbacks, limitations and unsolved problems. Extensive facial defects which include several aesthetic units and dentition can be restored by combining dental prostheses and anaplastology, thus providing an adequate functional and aesthetic outcome in selected patients without the drawbacks of major surgical procedures. Referring to some representative patient cases, it is shown how extreme facial disfigurement after oncological surgery can be palliated by combining intraoral dentures with extraoral facial prostheses using individualized treatment and without the need for major reconstructive surgery.
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Affiliation(s)
- Sabine Maria Toso
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - Kerstin Menzel
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Yvonne Motzkus
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Martin Klein
- Fachklinik Hornheide, Department of Oral and Maxillofacial Surgery, Dorbaumstrasse 300, 48157 Münster, Germany
| | - Horst Menneking
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jan-Dirk Raguse
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Susanne Nahles
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Bodo Hoffmeister
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Nicolai Adolphs
- Department of Craniomaxillofacial Surgery (Head: Prof. Dr. med. Dr. med. dent. Bodo Hoffmeister), Surgical Navigation, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
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