Facial Deformity Correction with Bespoke PEEK, Patient Specific Implants (PSI): Journey from In-house Manufacturing to Virtual Planning and Navigational Technology

2016 ◽  
Vol 54 (10) ◽  
pp. e111
Author(s):  
Mathew Thomas ◽  
Ibraz Siddique ◽  
Nicholas Lee ◽  
Sachin Salvi
Keyword(s):  
Deformity Correction ◽  
Patient Specific ◽  
Facial Deformity ◽  
Virtual Planning ◽  
Patient Specific Implants

scholarly journals CAD/CAM Engineered Patient-Specific Impants as a Reposition Device in Le Fort I and Modified Subcondylar Osteotomies: Case Report of Facial Deformity Correction in Acromegaly

2020 ◽  
Vol 13 (3) ◽  
pp. 226-236
Author(s):  
Juho Suojanen ◽  
Zlatan Hodzic ◽  
Tuula Palotie ◽  
Patricia Stoor
Keyword(s):  
Computer Aided Design ◽  
Medical Condition ◽  
Deformity Correction ◽  
Open Bite ◽  
Patient Specific ◽  
Facial Deformity ◽  
Le Fort ◽  
Patient Specific Implants ◽  
Drill Holes ◽  
Le Fort I

Acromegaly is a medical condition where elevated growth hormone or insulin-like growth factor I levels cause several changes in the craniofacial soft and hard features. We report the correction of facial deformity and posterior open bite with Le Fort I and modified subcondylar osteotomies in a patient affected by acromegaly. Computer-aided design and manufacturing generated saw and drill guides were used to perform osteotomies and segment removal. The placement of the patient-specific implants (PSIs) was guided by predesigned drill holes ensuring the required and planned movement of the jaws and position of the PSIs. After segment removal, the PSIs fitted the predesigned drill holes with high precision and were secured without problems. The planned amount of mandibular and maxillary movement was achieved. The occlusion and osteotomies remained stable for the follow-up of 22 months. The use of PSIs combined with guided surgery can be beneficial for selected cases with asymmetry or posterior open bite enabling new approaches and yielding good functional and aesthetic outcome. The modification of conventional ramus osteotomy combined with utilization of ramus segment removal and the use of PSI for reposition is an interesting and promising technique for rare conditions with ramus height asymmetry.

scholarly journals Preoperative Planning of Virtual Osteotomies Followed by Fabrication of Patient Specific Reconstruction Plate for Secondary Correction and Fixation of Displaced Bilateral Mandibular Body Fracture

2016 ◽  
Vol 9 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Andreas Thor
Keyword(s):  
Trauma Surgery ◽  
Computer Software ◽  
Open Bite ◽  
Patient Specific ◽  
Facial Skeleton ◽  
Reconstruction Plate ◽  
Virtual Planning ◽  
Patient Specific Implants ◽  
Body Fracture ◽  
Mandibular Body

This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible. After segmentation, the mandible was virtually rotated back into position and the open bite was closed. A patient specific mandibular reconstruction plate was outlined and fabricated from the new virtual situation and the plate was thereafter installed utilizing the preoperative plan. Osteotomy- and drill-guides was used and thus simplified the surgery resulting in uneventful healing. Virtual planning and patient specific implants and guides were valuable in this case of secondary reconstructive trauma surgery.

The use of cranial resection templates with 3D virtual planning and PEEK patient-specific implants: A 3 year follow-up

2019 ◽  
Vol 47 (4) ◽  
pp. 542-547 ◽  
Author(s):  
S.E.C.M. van de Vijfeijken ◽  
R. Schreurs ◽  
L. Dubois ◽  
A.G. Becking ◽  
A.G. Becking ◽  
...  
Keyword(s):  
Patient Specific ◽  
Virtual Planning ◽  
Patient Specific Implants

Computer-Assisted Virtual Planning for Surgical Guide Manufacturing and Internal Distractor Adaptation in the Management of Midface Hypoplasia in Cleft Patients

2017 ◽  
Vol 54 (4) ◽  
pp. 457-464 ◽  
Author(s):  
Paolo Scolozzi ◽  
Georges Herzog
Keyword(s):  
Computer Aided Design ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Patient Specific ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Patient Specific Implants ◽  
Surgical Guides ◽  
Computer Aided

We are reporting the treatment of severe maxillary hypoplasia in two patients with unilateral cleft lip and palate by using a specific approach combining the Le Fort I distraction osteogenesis technique coupled with computer-aided design/computer-aided manufacturing customized surgical guides and internal distractors based on virtual computational planning. This technology allows for the transfer of the virtual planned reconstruction to the operating room by using custom patient-specific implants, surgical splints, surgical cutting guides, and surgical guides to plate or distractor adaptation.

Computed Tomography-Based Patient-Specific Instrumentation Loses Accuracy with Significant Varus Preoperative Misalignment

2020 ◽  
Author(s):  
Vicente Jesús León-Muñoz ◽  
Mirian López-López ◽  
Alonso José Lisón-Almagro ◽  
Francisco Martínez-Martínez ◽  
Fernando Santonja-Medina
Keyword(s):  
Computed Tomography ◽  
Deformity Correction ◽  
Patient Specific ◽  
Control Group ◽  
X Rays ◽  
Varus Alignment ◽  
Patient Specific Instrumentation ◽  
Conventional Instrumentation ◽  
The Mean ◽  
Valgus Alignment

AbstractPatient-specific instrumentation (PSI) has been introduced to simplify and make total knee arthroplasty (TKA) surgery more precise, effective, and efficient. We performed this study to determine whether the postoperative coronal alignment is related to preoperative deformity when computed tomography (CT)-based PSI is used for TKA surgery, and how the PSI approach compares with deformity correction obtained with conventional instrumentation. We analyzed pre-and post-operative full length standing hip-knee-ankle (HKA) X-rays of the lower limb in both groups using a convention > 180 degrees for valgus alignment and < 180 degrees for varus alignment. For the PSI group, the mean (± SD) pre-operative HKA angle was 172.09 degrees varus (± 6.69 degrees) with a maximum varus alignment of 21.5 degrees (HKA 158.5) and a maximum valgus alignment of 14.0 degrees. The mean post-operative HKA was 179.43 degrees varus (± 2.32 degrees) with a maximum varus alignment of seven degrees and a maximum valgus alignment of six degrees. There has been a weak correlation among the values of the pre- and postoperative HKA angle. The adjusted odds ratio (aOR) of postoperative alignment outside the range of 180 ± 3 degrees was significantly higher with a preoperative varus misalignment of 15 degrees or more (aOR: 4.18; 95% confidence interval: 1.35–12.96; p = 0.013). In the control group (conventional instrumentation), this loss of accuracy occurs with preoperative misalignment of 10 degrees. Preoperative misalignment below 15 degrees appears to present minimal influence on postoperative alignment when a CT-based PSI system is used. The CT-based PSI tends to lose accuracy with preoperative varus misalignment over 15 degrees.

Development of JIT patient-specific implants

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Leanne SOBEL ◽  
Katrina SKELLERN ◽  
Kat PEREIRA
Keyword(s):  
Design Thinking ◽  
Technology Development ◽  
Complex Problem ◽  
Project Team ◽  
Healthcare Sector ◽  
Strategy Development ◽  
Patient Specific ◽  
Critical System ◽  
Patient Specific Implants ◽  
Human Centred Design

Design thinking and human-centred design is often discussed and utilised by teams and organisations seeking to develop more optimal, effective or innovative solutions for better customer outcomes. In the healthcare sector the opportunity presented by the practice of human-centred design and design thinking in the pursuit of better patient outcomes is a natural alignment. However, healthcare challenges often involve complex problem sets, many stakeholders, large systems and actors that resist change. High-levels of investment and risk aversion results in the status quo of traditional technology-led processes and analytical decision-making dominating product and strategy development. In this case study we present the opportunities, challenges and benefits that including a design-led approach in developing complex healthcare technology can bring. Drawing on interviews with participants and reflections from the project team, we explore and articulate the key learning from using a design-led approach. In particular we discuss how design-led practices that place patients at the heart of technology development facilitated the project team in aligning key stakeholders, unearthing critical system considerations, and identifying product and sector-wide opportunities.

Fused filament printing of specialized biomedical devices: a state-of-the art review of technological feasibilities with PEEK

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Erfan Rezvani Ghomi ◽  
Saeideh Kholghi Eshkalak ◽  
Sunpreet Singh ◽  
Amutha Chinnappan ◽  
Seeram Ramakrishna ◽  
...  
Keyword(s):  
High Performance ◽  
State Of The Art ◽  
Three Dimensional ◽  
Patient Specific ◽  
Biomedical Devices ◽  
Fused Filament Fabrication ◽  
Content Type ◽  
Patient Specific Implants ◽  
Complex Design ◽  
Wide Range

Purpose The potential implications of the three-dimensional printing (3DP) technology are growing enormously in the various health-care sectors, including surgical planning, manufacturing of patient-specific implants and developing anatomical models. Although a wide range of thermoplastic polymers are available as 3DP feedstock, yet obtaining biocompatible and structurally integrated biomedical devices is still challenging owing to various technical issues. Design/methodology/approach Polyether ether ketone (PEEK) is an organic and biocompatible compound material that is recently being used to fabricate complex design geometries and patient-specific implants through 3DP. However, the thermal and rheological features of PEEK make it difficult to process through the 3DP technologies, for instance, fused filament fabrication. The present review paper presents a state-of-the-art literature review of the 3DP of PEEK for potential biomedical applications. In particular, a special emphasis has been given on the existing technical hurdles and possible technological and processing solutions for improving the printability of PEEK. Findings The reviewed literature highlighted that there exist numerous scientific and technical means which can be adopted for improving the quality features of the 3D-printed PEEK-based biomedical structures. The discussed technological innovations will help the 3DP system to enhance the layer adhesion strength, structural stability, as well as enable the printing of high-performance thermoplastics. Originality/value The content of the present manuscript will motivate young scholars and senior scientists to work in exploring high-performance thermoplastics for 3DP applications.

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