Computer-Assisted Virtual Planning and Surgical Template Fabrication for Fronto-orbital Advancement

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
J. Soleman ◽  
F. Thieringer ◽  
J. Beinemann ◽  
V. Oesch ◽  
C. Kunz ◽  
...  
Keyword(s):  
Computer Assisted ◽  
Virtual Planning ◽  
Surgical Template

scholarly journals Accuracy of Computer-Assisted Template-Based Implant Placement Using Two Different Surgical Templates Designed with or without Metallic Sleeves: A Randomized Controlled Trial

2019 ◽  
Vol 7 (2) ◽  
pp. 41 ◽  
Author(s):  
Marco Tallarico ◽  
Matteo Martinolli ◽  
Yong-Jin Kim ◽  
Fabio Cocchi ◽  
Silvio Mario Meloni ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Test Group ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Implant Placement ◽  
Surgical Template ◽  
Significant Difference ◽  
Cad Cam ◽  
Open Versus ◽  
Surgical Templates

Purpose: To compare virtual planning accuracy of novel computer-assisted, template-based implant placement techniques, which make use of CAD/CAM stereolithographic surgical templates with or without metallic sleeves. Furthermore, to compare open versus closed sleeves for templates without metallic sleeves. Materials and methods: Any partially edentulous patients requiring at least one implant to be placed according to a computer-assisted template-based protocol were enrolled. Patients were randomized according to a parallel group design into two arms: Surgical template with or without metallic sleeves. Three deviation parameters (angular, horizontal, vertical) were defined to evaluate the discrepancy between the planned and placed implant positions. Results: No implants failed, and no complications were experienced. Forty-one implants were placed using surgical templates with metallic sleeves while 49 implants were placed with a surgical template without metallic sleeves. Of these, 16 implants were placed through open sleeves and 33 through closed sleeves. There was a statistically significant difference in angle (p = 0.0212) and in the vertical plan (p = 0.0073) with lower values for implants placed with a surgical template without metallic sleeves. In the test group, close sleeves were more accurate compared with open sleeves in angle (p = 0.0268) and in horizontal plan (p = 0.0477). Conclusion: With the limitations of the present study, surgical templates without metallic sleeves were more accurate in the vertical plan and angle compared to the conventional template with metallic sleeves. Open sleeves should be used with caution in the molar region only in case of reduced interarch space. Further research is needed to confirm these preliminary results.

scholarly journals Computer-assisted virtual planning and surgical template fabrication for frontoorbital advancement

2015 ◽  
Vol 38 (5) ◽  
pp. E5 ◽  
Author(s):  
Jehuda Soleman ◽  
Florian Thieringer ◽  
Joerg Beinemann ◽  
Christoph Kunz ◽  
Raphael Guzman
Keyword(s):  
Computer Assisted ◽  
Virtual Planning ◽  
Novel Technique ◽  
Skull Model ◽  
Computer Assisted Design ◽  
Long Term Follow Up ◽  
Frontoorbital Advancement ◽  
3D Printed ◽  
Surgical Templates

OBJECT The authors describe a novel technique using computer-assisted design (CAD) and computed-assisted manufacturing (CAM) for the fabrication of individualized 3D printed surgical templates for frontoorbital advancement surgery. METHODS Two patients underwent frontoorbital advancement surgery for unilateral coronal synostosis. Virtual surgical planning (SurgiCase-CMF, version 5.0, Materialise) was done by virtual mirroring techniques and superposition of an age-matched normative 3D pediatric skull model. Based on these measurements, surgical templates were fabricated using a 3D printer. Bifrontal craniotomy and the osteotomies for the orbital bandeau were performed based on the sterilized 3D templates. The remodeling was then done placing the bone plates within the negative 3D templates and fixing them using absorbable poly-dl-lactic acid plates and screws. RESULTS Both patients exhibited a satisfying head shape postoperatively and at follow-up. No surgery-related complications occurred. The cutting and positioning of the 3D surgical templates proved to be very accurate and easy to use as well as reproducible and efficient. CONCLUSIONS Computer-assisted virtual planning and 3D template fabrication for frontoorbital advancement surgery leads to reconstructions based on standardizedmeasurements, precludes subjective remodeling, and seems to be overall safe and feasible. A larger series of patients with long-term follow-up is needed for further evaluation of this novel technique.

scholarly journals 3D virtual planning in orthognathic surgery and CAD/CAM surgical splints generation in one patient with craniofacial microsomia: a case report

2016 ◽  
Vol 21 (1) ◽  
pp. 89-100 ◽  
Author(s):  
Francisco Vale ◽  
Jessica Scherzberg ◽  
João Cavaleiro ◽  
David Sanz ◽  
Francisco Caramelo ◽  
...  
Keyword(s):  
Case Report ◽  
Computer Aided Design ◽  
Computer Assisted ◽  
Linear Measurements ◽  
Postoperative Results ◽  
Virtual Planning ◽  
Postoperative Changes ◽  
Craniofacial Microsomia ◽  
Computer Aided ◽  
Cad Cam

Objective: In this case report, the feasibility and precision of tridimensional (3D) virtual planning in one patient with craniofacial microsomia is tested using Nemoceph 3D-OS software (Software Nemotec SL, Madrid, Spain) to predict postoperative outcomes on hard tissue and produce CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) surgical splints. Methods: The clinical protocol consists of 3D data acquisition of the craniofacial complex by cone-beam computed tomography (CBCT) and surface scanning of the plaster dental casts. The ''virtual patient'' created underwent virtual surgery and a simulation of postoperative results on hard tissues. Surgical splints were manufactured using CAD/CAM technology in order to transfer the virtual surgical plan to the operating room. Intraoperatively, both CAD/CAM and conventional surgical splints are comparable. A second set of 3D images was obtained after surgery to acquire linear measurements and compare them with measurements obtained when predicting postoperative results virtually. Results: It was found a high similarity between both types of surgical splints with equal fitting on the dental arches. The linear measurements presented some discrepancies between the actual surgical outcomes and the predicted results from the 3D virtual simulation, but caution must be taken in the analysis of these results due to several variables. Conclusions: The reported case confirms the clinical feasibility of the described computer-assisted orthognathic surgical protocol. Further progress in the development of technologies for 3D image acquisition and improvements on software programs to simulate postoperative changes on soft tissue are required.

scholarly journals Deviation Analyses of Computer-Assisted, Template-Guided Mandibular Reconstruction With Combined Osteotomy and Reconstruction Pre-Shaped Plate Position Technology: A Comparative Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jie Chen ◽  
Ruipu Zhang ◽  
Ye Liang ◽  
Yujie Ma ◽  
Saiwen Song ◽  
...  
Keyword(s):  
Coracoid Process ◽  
Mandibular Reconstruction ◽  
Computer Assisted ◽  
Anatomical Landmarks ◽  
Virtual Planning ◽  
Actual Length ◽  
Deviation Analysis ◽  
Resection Line ◽  
Condylar Head ◽  
Fibular Flap

BackgroundComputer-assisted and template-guided mandibular reconstruction provides higher accuracy and less variation than conventional freehand surgeries. The combined osteotomy and reconstruction pre-shaped plate position (CORPPP) technique is a reliable choice for mandibular reconstruction. This study aimed to evaluate the accuracy of CORPPP-guided fibular flap mandibular reconstruction and analyze the possible causes of the deviations.Patients and MethodsFrom June 2015 to December 2016, 28 patients underwent fibular flap mandibular reconstruction. Virtual planning and personalized CORPPP-guided templates were applied in 15 patients while 13 patients received conventional freehand surgeries. Deviations during mandibulectomy and fibular osteotomy, and overall and triaxial deviation of the corresponding mandibular anatomical landmarks were measured by superimposing the pre- and postoperative virtual models.ResultsThe deviation of the resection line and resection angle was 1.23 ± 0.98 mm and 4.11° ± 2.60°. The actual length of fibula segments was longer than the designed length in 7 cases (mean: 0.35 ± 0.32 mm) and shorter in 22 cases (mean: 1.53 ± 1.19 mm). In patients without ramus reconstruction, deviations of the ipsilateral condylar head point (Co.), gonion point (Go.), and coracoid process point (Cor.) were 6.71 ± 3.42 mm, 5.38 ± 1.71 mm, and 11.05 ± 3.24 mm in the freehand group and 1.73 ± 1.13 mm, 1.86 ± 0.96 mm, and 2.54 ± 0.50 mm in the CORPPP group, respectively, with significant statistical differences (p < 0.05). In patients with ramus reconstruction, deviations of ipsilateral Co. and Go. were 9.79 ± 4.74 mm vs. 3.57 ± 1.62 mm (p < 0.05), and 15.17 ± 6.53 mm vs. 4.36 ± 1.68 mm (p < 0.05) in the freehand group and CORPPP group, respectively.ConclusionMandibular reconstructions employing virtual planning and personalized CORPPP-guided templates show significantly higher predictability, convenience, and accuracy of mandibular reconstruction compared with conventional freehand surgeries. However, more clinical cases were required for further dimensional deviation analysis. The application and exploration of clinical practice would also continuously improve the design of templates.

Virtual Surgery in Implantology: A Systematic Review and State of the Art

2021 ◽  
pp. 10-16
Author(s):  
Kamilla Carneiro Agreli ◽  
Idiberto José Zotarelli Filho ◽  
Elias Naim Kassis
Keyword(s):  
Systematic Review ◽  
Dental Implants ◽  
Virtual Surgery ◽  
Computer Assisted ◽  
Success Rates ◽  
Oral Rehabilitation ◽  
Virtual Planning ◽  
Computer Assisted Design ◽  
Dental Rehabilitation

Introduction: Dental implant procedures have increased worldwide, reaching approximately one million dental implants per year. The optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life stimulated the development of numerous software and hardware for performing computer-guided surgeries, so-called virtual surgeries (VS). Objective: to present, through a systematic review, the main considerations of virtual surgery in dentistry and their respective advantages, disadvantages, and limitations. Methods: The model used for the review was PRISMA. We used databases such as Scielo, Lilacs, Google Scholar, PubMed. Major findings: In the scenario of VS in dentistry, advances in technology have contributed to the improvement of the models, since there was only the direct molding technique to obtain patient models, with the positioning of implants not very favorable in terms aesthetics. The information that is acquired in the 3D reconstructions allows us to determine the quantity and quality of the available bone and also allows the simulation of the installation of the implants in a virtual environment. This provides predictability of techniques and difficulties that can be encountered during surgical intervention, reducing the time and the possibility of errors, allowing the overall reduction of oral rehabilitation costs. Conclusion: Preoperative virtual planning and reconstruction of the mandible guided by dental implants through preoperative designs provide high success rates for the implant and dental rehabilitation, benefiting also prosthetic restorations supported by fixed implants. Still, the concept of using personalized implants with the help of 3D virtual treatment planning, stereolithographic models, and computer-assisted design greatly improves the mandibular restoration and helps to obtain a good facial profile, aesthetic and dental rehabilitation, avoiding complications with the grafts autologous.

scholarly journals Mandibular Reconstruction Using ProPlan CMF: A Review

2017 ◽  
Vol 1 (1) ◽  
pp. s-0037-1606835 ◽  
Author(s):  
Ryo Sasaki ◽  
Michael Rasse
Keyword(s):  
Computer Assisted Surgery ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Planning Service ◽  
Virtual Planning ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Computer Aided

ProPlan CMF (Depuy Synthes, Solothurn, Switzerland, and Materialise, Leuven, Belgium) is a computer-aided surgical virtual planning service using an online meeting with professional medical engineers and transfers patient-specific surgical guide to the virtual plan. Moreover, prebent reconstruction plates or patient-specific computer-aided manufacturing-fabricated reconstruction can also be used. This service started in 2011. Currently, it is widely used in Europe. Current status of mandibular reconstruction with ProPlan CMF vertical planning service with the surgical guide was reviewed. The accuracy was excellent in terms of contact of the osteotomized parts and the contact to the remaining skeleton. The authors found that currently, a small number of reports regarding the mandibular reconstruction with virtual planning service and surgical guides are available. These reports also have a small number of cases and short-term follow-up results. In this situation, this review revealed that (1) mainly the resection guides, cutting guides, and patient-specific mandible reconstruction plates were adequately well fitted to the surgical site intraoperatively, (2) the ischemic time might be more reduced than that of the conventional surgery (3) the accuracy of computer-assisted surgery in the mandibular reconstruction was clinically acceptable, and (4) condyle positions after the computer-assisted surgery was mainly normal. The higher additional cost than that of the conventional technique is presently an issue. Large-scale clinical studies and long-term follow-up studies are demanded.

CT-MRI Image Fusion-Based Computer-Assisted Navigation Management of Communicative Tumors Involved the Infratemporal-Middle Cranial Fossa

2020 ◽  
Author(s):  
Rong Yang ◽  
Han Lu ◽  
Yang Wang ◽  
Xin Peng ◽  
Chi Mao ◽  
...  
Keyword(s):  
Image Fusion ◽  
Preoperative Assessment ◽  
Middle Cranial Fossa ◽  
Computer Assisted ◽  
3D Image ◽  
Virtual Planning ◽  
Assisted Navigation ◽  
3D Image Reconstruction ◽  
Cranial Fossa ◽  
Mri Image

Abstract Purpose Computed tomography (CT) and magnetic resonance imaging (MRI) are crucial for preoperative assessment of the three-dimensional (3D) spatial position relationships of tumor, vital vessels, brain tissue, and craniomaxillofacial bones precisely. The value of CT-MRI-based image fusion was explored for the preoperative assessment, virtual planning, and navigation surgery application during the treatment of communicative tumors involved the infratemporal fossa (ITF) and middle cranial fossa. Methods Eight patients with infratemporal-middle cranial fossa communicative tumors (ICFCTs) were enrolled in this retrospective study. Plain CT, contrast CT, and MRI image data were imported into a workstation for image fusion, which were used for 3D image reconstruction, virtual surgical planning, and intraoperative navigation sequentially. Therapeutic effect was evaluated through the clinical data analysis of ICFCT patients after CT-MRI image fusion-based navigation-guided biopsy or surgery. Results High-quality CT-MRI image fusion and 3D reconstruction were obtained in all eight cases. Image fusion combined with 3D image reconstruction enhanced the preoperative assessment of ICFCT, and improved the surgical performance via virtual planning. Definite pathological diagnosis was obtained in all four navigation-guided core needle biopsies. Complete removal of the tumor was achieved with one exception among the seven navigation-guided operations. Postoperative cerebrospinal fluid leakage occurred in one patient with recurrent meningioma. Conclusions CT-MRI image fusion combined with computer-assisted navigation management, optimized the accuracy, safety, and surgical results for core needle biopsy and surgery of ICFCTs.

scholarly journals Computer-Assisted Three-Dimensional Planning for Orbital Decompression

2015 ◽  
Vol 8 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Nicholas Mahoney ◽  
Michael P. Grant ◽  
SrinivasMurthy Susarla ◽  
Shannath Merbs
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Orbital Decompression ◽  
Virtual Planning ◽  
Common Cause ◽  
Tissue Volume ◽  
The Past ◽  
Soft Tissue Volume

Thyroid-associated orbitopathy is the most common cause of unilateral or bilateral proptosis in adults. A mainstay of surgical treatment is orbital decompression utilizing osteotomies to increase the size of the affected bony orbit to accommodate the larger soft tissue volume. Over the past several decades, numerous approaches have been described for orbital decompression. However, given the intricate osseous and soft tissue anatomy within the orbit, orbital decompression is a potentially hazardous intervention. With advances in three-dimensional imaging and virtual planning, extensive orbital decompressions can be performed safely and efficiently. In this report, we describe two cases of three-wall orbital decompressions using three-dimensional planning.

scholarly journals Computer-assisted resection of mandibular cancer and repair with fibula free flap. Case report

2021 ◽  
pp. 109-117
Author(s):  
Ioannis CHATZISTEFANOU ◽  
◽  
Ioannis Tilaveridis ◽  
Vasileios Banikas ◽  
Dimitris Deligiannidis ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Cancer ◽  
Free Flap ◽  
Gold Standard ◽  
Digital Design ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Fibula Free Flap ◽  
Cutting Guides ◽  
Fibular Flap

Oral cancer is a disease, in the treatment of which the surgical resection of the lesion plays a lead- ing role. Oncological resections in the maxillofacial area create large deficits that affect the functionality and aesthetics of the patient to a large extent, while many times make oncological resection impossible due to their inability to restore. The mandibular deficits are particularly difficult, with the free osteocutaneous fibular flap being the gold standard in repairing large mandibular deficits. In recent years, technology has offered significant as- sistance in the successful restoration of functional and aesthetic disorders through the virtual planning of the operation. In this paper we present a case of oral cancer whose resection and reconstruction with fibula free flap were done after digital design and under the guidance of special cutting guides. To our knowledge, this case of computer-guided reconstruction with FFF represents the first description of such a technique for mandibular reconstruction in the available greek medico-dental literature.

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