scholarly journals Quantitative fit analysis of acromion fracture plating systems using three-dimensional reconstructed scapula fractures – A multi-observer study

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 36
Author(s):  
Johan Charilaou ◽  
Roopam Dey ◽  
Marilize Burger ◽  
Sudesh Sivarasu ◽  
Ruan van Staden ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Spine Fractures ◽  
Tertiary Teaching ◽  
Acromion Fracture ◽  
Bony Anatomy ◽  
Tertiary Teaching Hospital ◽  
3D Printed ◽  
Picture Archiving And Communication ◽  
Surgical Guidelines

Introduction: Surgical treatment of displaced acromial and scapula spine fractures may be challenging due to the bony anatomy and variable fracture patterns. This difficulty is accentuated by the limitations of the available scapular plates for fracture fixation. This study compares the quantitative fitting of anatomic scapular plates and clavicle plates, using three-dimensional (3D) printed fractured scapulae. Methods: Fourteen scapulae with acromion and spine fractures were used for this study. Computerized tomographic (CT) scans of the fractured scapulae were obtained from the Philips picture archiving and communication system (PACS) database of patients admitted to a tertiary teaching hospital in Cape Town, South Africa between 2012 and 2016. The reconstructed scapulae were 3D printed and the anatomical acromion and clavicle plates were templated about the fracture regions. The fit assessment was performed by five observers who classified the plates as no-fit, intermediate fit, and anatomical fit according to the surgical guidelines. Results: The 6-hole anterior clavicle plate performed better than any of the scapular plates as they were able to fit 45.7% of the fractured acromion, including the spine. Among the pre-contoured anatomical scapula plates, both the short and the long acromion plates could fit only 27.3% of the fractured acromion. The intraclass correlation coefficient was 0.965 suggesting excellent consensus among the five observers. Conclusion: Clavicle plates were found to be better suited to fit around a scapula fracture in its acromion and spine region.

scholarly journals Computer-Aided Surgical Simulation for Correcting Complex Limb Deformities in Children

2020 ◽  
Vol 10 (15) ◽  
pp. 5181 ◽  
Author(s):  
Leonardo Frizziero ◽  
Gian Maria Santi ◽  
Alfredo Liverani ◽  
Francesca Napolitano ◽  
Paola Papaleo ◽  
...  
Keyword(s):  
Surgical Simulation ◽  
Low Cost ◽  
Three Dimensional ◽  
Computer Aided ◽  
Limb Deformities ◽  
Bony Anatomy ◽  
3D Printed ◽  
Post Traumatic ◽  
Paediatric Orthopaedics ◽  
User Friendly

This work aims to present an in-house low-cost computer-aided simulation (CASS) process that was recently implemented in the preoperative planning of complex osteotomies for limb deformities in children. Five patients admitted to the Unit of Paediatric Orthopaedics and Traumatology from April 2018 to December 2019, for correcting congenital or post-traumatic limb deformities were included in the study. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software, and the surgery was planned and simulated starting from the 3D digital model. 3D printed sterilizable models were fabricated using a low-cost 3D printer, and animations of the operation were generated with the aim to accurately explain the operation to parents. All procedures were successfully planned using our CASS method and the 3D printed models were used during the operation, improving the understanding of the severely abnormal bony anatomy. The surgery was precisely reproduced according to CASS and the deformities were successfully corrected in four cases, while in one case, the intraoperative intentional undersizing of the bone osteotomy produced an incomplete correction of a congenital forearm deformity. Our study describes the application of a safe, effective, user-friendly, and low-cost CASS process in paediatric orthopaedics (PO) surgery. We are convinced that our study will stimulate the widespread adoption of this technological innovation in routine clinical practice for the treatment of rare congenital and post-traumatic limb deformities during childhood.

scholarly journals Reproducibility of Digital Indirect Bonding Technique Using Three-dimensional (3d) Models and 3d-printed Transfer Trays

2019 ◽  
Vol 90 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Maria Eduarda Assad Duarte ◽  
Bruno Frazão Gribel ◽  
Alice Spitz ◽  
Flavia Artese ◽  
José Augusto Mendes Miguel
Keyword(s):  
Repeated Measures ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
3D Models ◽  
Digital Models ◽  
Intraclass Correlation Coefficients ◽  
Indirect Bonding ◽  
3D Printed ◽  
Clinically Significant

ABSTRACT Objective To evaluate the reproducibility of digital tray transfer fit on digital indirect bonding by analyzing the differences in bracket positions. Materials and Methods Digital indirect bonding was performed by positioning brackets on digital models superimposed by tomography using Ortho Analyzer (3Shape) software. Thirty-three orthodontists performed indirect bonding on prototyped models of the same malocclusion using prototyped transfer trays for two types of brackets (MiniSprint Roth and BioQuick self-ligating). The models with brackets were scanned using an intraoral scanner (Trios, 3Shape). Superimpositions were made between the digital models obtained after indirect bonding and those from the original virtual setup. To analyze the differences in bracket positions, three planes were examined for each bracket: vertical, horizontal, and angulation. Three orthodontists repeated indirect bonding after 15 days, and Bland-Altman plots and intraclass correlation coefficients were used to evaluate inter- and intraevaluator reproducibility and reliability, respectively. Repeated-measures analysis of variance (ANOVA) was used to analyze the differences between bracket positions, and multivariate ANOVA was used to evaluate the influence of orthodontists' experience on the results. Results Differences between bracket positions were not statistically significant, except mesial-distal discrepancies in the BioQuick group (P = .016). However, differences were not clinically significant (horizontal varied from 0.04 to 0.13 mm; angulation, 0.45° to 2.03°). There was no significant influence of orthodontist experience and years of clinical practice on bracket positions (P = .314 and P = .158). The reproducibility among orthodontists was confirmed. Conclusions The reproducibility of digital indirect bonding was confirmed in terms of bracket positions using three-dimensional printed transfer trays.

scholarly journals A new segmentation algorithm for measuring CBCT images of nasal airway: a pilot study

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6246 ◽  
Author(s):  
Chen Zhang ◽  
Robin Bruggink ◽  
Frank Baan ◽  
Ewald Bronkhorst ◽  
Thomas Maal ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Nasal Airway ◽  
Intraclass Correlation Coefficients ◽  
Shell Models ◽  
3D Printed ◽  
Software Programs ◽  
Equivalent Method

Background Three-dimensional (3D) modeling of the nasal airway space is becoming increasingly important for assessment in breathing disorders. Processing cone beam computed tomography (CBCT) scans of this region is complicated, however, by the intricate anatomy of the sinuses compared to the simpler nasopharynx. A gold standard for these measures also is lacking. Previous work has shown that software programs can vary in accuracy and reproducibility outcomes of these measurements. This study reports the reproducibility and accuracy of an algorithm, airway segmentor (AS), designed for nasal airway space analysis using a 3D printed anthropomorphic nasal airway model. Methods To test reproducibility, two examiners independently used AS to edit and segment 10 nasal airway CBCT scans. The intra- and inter-examiner reproducibility of the nasal airway volume was evaluated using paired t-tests and intraclass correlation coefficients. For accuracy testing, the CBCT data for pairs of nasal cavities were 3D printed to form hollow shell models. The water-equivalent method was used to calculate the inner volume as the gold standard, and the models were then embedded into a dry human skull as a phantom and subjected to CBCT. AS, along with the software programs MIMICS 19.0 and INVIVO 5, was applied to calculate the inner volume of the models from the CBCT scan of the phantom. The accuracy was reported as a percentage of the gold standard. Results The intra-examiner reproducibility was high, and the inter-examiner reproducibility was clinically acceptable. AS and MIMICS presented accurate volume calculations, while INVIVO 5 significantly overestimated the mockup of the nasal airway volume. Conclusion With the aid of a 3D printing technique, the new algorithm AS was found to be a clinically reliable and accurate tool for the segmentation and reconstruction of the nasal airway space.

Use of Three-dimensional Printing in the Development of Optimal Cardiac CT Scanning Protocols

2020 ◽  
Vol 16 (8) ◽  
pp. 967-977
Author(s):  
Zhonghua Sun
Keyword(s):  
Cardiovascular Disease ◽  
Cardiac Computed Tomography ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Aortic Diseases ◽  
Clinical Value ◽  
Three Dimensional Printing ◽  
Doctor Patient Communication ◽  
Medical Education And Training ◽  
3D Printed

Three-dimensional (3D) printing is increasingly used in medical applications with most of the studies focusing on its applications in medical education and training, pre-surgical planning and simulation, and doctor-patient communication. An emerging area of utilising 3D printed models lies in the development of cardiac computed tomography (CT) protocols for visualisation and detection of cardiovascular disease. Specifically, 3D printed heart and cardiovascular models have shown potential value in the evaluation of coronary plaques and coronary stents, aortic diseases and detection of pulmonary embolism. This review article provides an overview of the clinical value of 3D printed models in these areas with regard to the development of optimal CT scanning protocols for both diagnostic evaluation of cardiovascular disease and reduction of radiation dose. The expected outcomes are to encourage further research towards this direction.

Investigation of the Static Behavior and Failure Mechanisms of a 3D Printed Bio-Based Sandwich with Auxetic Core

2020 ◽  
Vol 12 (05) ◽  
pp. 2050051
Author(s):  
Khawla Essassi ◽  
Jean-Luc Rebiere ◽  
Abderrahim El Mahi ◽  
Mohamed Amine Ben Souf ◽  
Anas Bouguecha ◽  
...  
Keyword(s):  
Failure Mechanisms ◽  
Three Dimensional ◽  
Acoustic Emissions ◽  
Shear Stiffness ◽  
Tensile Tests ◽  
Sandwich Composite ◽  
Static Behavior ◽  
Flax Fibers ◽  
Data Points ◽  
3D Printed

In this research contribution, the static behavior and failure mechanisms are developed for a three-dimensional (3D) printed dogbone, auxetic structure and sandwich composite using acoustic emissions (AEs). The skins, core and whole sandwich are manufactured using the same bio-based material which is polylactic acid reinforced with micro-flax fibers. Tensile tests are conducted on the skins and the core while bending tests are conducted on the sandwich composite. Those tests are carried out on four different auxetic densities in order to investigate their effect on the mechanical and damage properties of the materials. To monitor the invisible damage and damage propagation, a highly sensitive AE testing method is used. It is found that the sandwich with high core density displays advanced mechanical properties in terms of bending stiffness, shear stiffness, facing bending stress and core shear stress. In addition, the AE data points during testing present an amplitude range of 40–85[Formula: see text]dB that characterizes visible and invisible damage up to failure.

scholarly journals A New Method to Evaluate Trueness and Precision of Digital and Conventional Impression Techniques for Complete Dental Arch

2021 ◽  
Vol 11 (10) ◽  
pp. 4612
Author(s):  
KweonSoo Seo ◽  
Sunjai Kim
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
New Method ◽  
Digital Impression ◽  
Dental Arch ◽  
Digital Models ◽  
Digital Impressions ◽  
Measuring Machine ◽  
Master Model ◽  
Conventional Impression

Purpose: The aim of this study was to present a new method to analyze the three-dimensional accuracy of complete-arch dental impressions and verify the reliability of the method. Additionally, the accuracies of conventional and intraoral digital impressions were compared using the new method. Methods: A master model was fabricated using 14 milled polyetheretherketone cylinders and a maxillary acrylic model. Each cylinder was positioned and named according to its corresponding tooth position. Twenty-five definitive stone casts were fabricated using conventional impressions of the master model. An intraoral scanner was used to scan the master model 25 times to fabricate 25 digital models. A coordinate measuring machine was used to physically probe each cylinder in the master model and definitive casts. An inspection software was used to probe cylinders of digital models. A three-dimensional part coordinate system was defined and used to compute the centroid coordinate of each cylinder. Intraclass correlation coefficient (ICC) was evaluated to examine the reliability of the new method. Independent two sample t-test was performed to compare the trueness and precision of conventional and intraoral digital impressions (α = 0.05). Results: ICC results showed that, the new method had almost perfect reliability for the measurements of the master model, conventional and digital impression. Conventional impression showed more accurate absolute trueness and precision than intraoral digital impression for most of the tooth positions (p < 0.05). Conclusions: The new method was reliable to analyze the three-dimensional deviation of complete-arch impressions. Conventional impression was still more accurate than digital intraoral impression for complete arches.

Factors Impacting CTCA Quality in a Major Tertiary Teaching Hospital

2021 ◽  
Vol 30 ◽  
pp. S189
Author(s):  
I. Button ◽  
J. Bradley ◽  
R. Roberts-Thomson ◽  
B. Lorraine
Keyword(s):  
Teaching Hospital ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

scholarly journals Midface Reconstruction: Planning and Outcome

2020 ◽  
Vol 53 (03) ◽  
pp. 324-334
Author(s):  
Gautam Biswas
Keyword(s):  
Digital Imaging ◽  
3D Structure ◽  
Three Dimensional ◽  
The Past ◽  
Complex Anatomy ◽  
Osseointegrated Implants ◽  
Low Profile ◽  
3D Printed ◽  
Midface Reconstruction ◽  
Reconstruction Planning

Abstract Reconstruction of the complex anatomy and aesthetics of the midface is often a challenge. A careful understanding of this three-dimensional (3D) structure is necessary. Anticipating the extent of excision and its planning following oncological resections is critical.In the past over two decades, with the advances in microsurgical procedures, contributions toward the reconstruction of this area have generated interest. Planning using digital imaging, 3D printed models, osseointegrated implants, and low-profile plates, has favorably impacted the outcome. However, there are still controversies in the management: to use single composite tissues versus multiple tissues; implants versus autografts; vascularized versus nonvascularized bone; prosthesis versus reconstruction.This article explores the present available options in maxillary reconstruction and outlines the approach in the management garnered from past publications and experiences.

scholarly journals Impact of inter-reader contouring variability on textural radiomics of colorectal liver metastases

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Francesco Rizzetto ◽  
Francesca Calderoni ◽  
Cristina De Mattia ◽  
Arianna Defeudis ◽  
Valentina Giannini ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Hausdorff Distance ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Liver Lesion ◽  
Dice Coefficient ◽  
Rf Values ◽  
Enhanced Computed Tomography ◽  
Relative Change ◽  
The Impact

Abstract Background Radiomics is expected to improve the management of metastatic colorectal cancer (CRC). We aimed at evaluating the impact of liver lesion contouring as a source of variability on radiomic features (RFs). Methods After Ethics Committee approval, 70 liver metastases in 17 CRC patients were segmented on contrast-enhanced computed tomography scans by two residents and checked by experienced radiologists. RFs from grey level co-occurrence and run length matrices were extracted from three-dimensional (3D) regions of interest (ROIs) and the largest two-dimensional (2D) ROIs. Inter-reader variability was evaluated with Dice coefficient and Hausdorff distance, whilst its impact on RFs was assessed using mean relative change (MRC) and intraclass correlation coefficient (ICC). For the main lesion of each patient, one reader also segmented a circular ROI on the same image used for the 2D ROI. Results The best inter-reader contouring agreement was observed for 2D ROIs according to both Dice coefficient (median 0.85, interquartile range 0.78–0.89) and Hausdorff distance (0.21 mm, 0.14–0.31 mm). Comparing RF values, MRC ranged 0–752% for 2D and 0–1567% for 3D. For 24/32 RFs (75%), MRC was lower for 2D than for 3D. An ICC > 0.90 was observed for more RFs for 2D (53%) than for 3D (34%). Only 2/32 RFs (6%) showed a variability between 2D and circular ROIs higher than inter-reader variability. Conclusions A 2D contouring approach may help mitigate overall inter-reader variability, albeit stable RFs can be extracted from both 3D and 2D segmentations of CRC liver metastases.

scholarly journals Recurrent contracted sockets treated with personalized, three-dimensionally printed conformers and buccal grafts

2021 ◽  
pp. 112067212110000
Author(s):  
Annabel LW Groot ◽  
Jelmer S Remmers ◽  
Roel JHM Kloos ◽  
Peerooz Saeed ◽  
Dyonne T Hartong
Keyword(s):  
Three Dimensional ◽  
Case Series ◽  
Secondary Outcome ◽  
Retrospective Case ◽  
Upper Eyelid ◽  
Ocular Prosthesis ◽  
Buccal Mucosal Graft ◽  
Custom Made ◽  
3D Printed

Purpose: Recurrent contracted sockets are complex situations where previous surgeries have failed, disabling the wear of an ocular prosthesis. A combined method of surgery and long-term fixation using custom-made, three-dimensional (3D) printed conformers is evaluated. Methods: Retrospective case series of nine patients with recurrent excessive socket contraction and inability to wear a prosthesis, caused by chemical burns ( n = 3), fireworks ( n = 3), trauma ( n = 2) and enucleation and radiotherapy at childhood due to optic nerve glioma ( n = 1) with three average previous socket surgeries (range 2–6). Treatment consisted of a buccal mucosal graft and personalized 3D-printed conformer designed to be fixated to the periosteum and tarsal plates for minimal 2 months. Primary outcome was the retention of an ocular prosthesis. Secondary outcome was the need for additional surgeries. Results: Outcomes were measured at final follow-up between 7 and 36 months postoperatively (mean 20 months). Eight cases were able to wear an ocular prosthesis after 2 months. Three cases initially treated for only the upper or only the lower fornix needed subsequent surgery for the opposite fornix for functional reasons. Two cases had later surgery for cosmetic improvement of upper eyelid position. Despite pre-existing lid abnormalities (scar, entropion, lash deficiency), cosmetic outcome was judged highly acceptable in six cases because of symmetric contour and volume, and reasonably acceptable in the remaining two. Conclusions: Buccal mucosal transplant fixated with a personalized 3D-designed conformer enables retention of a well-fitted ocular prosthesis in previously failed socket surgeries. Initial treatment of both upper and lower fornices is recommended to avoid subsequent surgeries for functional reasons.

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