Cold-Injection Molded Gentamicin-Impregnated Polymethyl Methacrylate Implants for Cranioplasty

2021 ◽  
Author(s):  
Mena Mekhael Fahem ◽  
Nabeel Hameed Ali ◽  
Joseph Ravindra Duddu ◽  
Harleen Luther
Keyword(s):  
Polymethyl Methacrylate ◽  
Low Cost ◽  
Geographical Location ◽  
Patient Specific ◽  
Injection Technique ◽  
Computer Assisted ◽  
3 Dimensional ◽  
3D Cad ◽  
Patient Specific Implants ◽  
Fresh Frozen

Abstract BACKGROUND Cranioplasty can be carried out using either fresh, frozen autologous bone or synthetic substitutes. Ordering artificial 3 dimensional (3D) implants is challenging and time consuming depending on geographical location. In this article, we share our experience using a streamlined process of producing 3D computer-assisted design (CAD) implants using commercially available 3D printers and silicone molds that can be easily replicated with consistent results and are associated with good outcomes. OBJECTIVE To develop patient-specific implants for patients with cranial defects that are accurate, consistent, low cost, and easy to replicate while reducing operator-dependent factors. METHODS We present data from 15 patients who underwent cranioplasty with 3D CAD-designed gentamicin-impregnated bone cement implants that were molded using the cold injection technique. RESULTS The technique was consistent in result production, required little postdemolding manipulation, and showed no dimensional variation in design. Postoperative computed tomography scans showed excellent implant fit, and patients had a low complication rate. CONCLUSION We have demonstrated a technique of mold preparation that is efficient and that produces a reliable result. Polymethyl methacrylate implants molded using this technique showed better reproducibility, higher accuracy, and precision than other types of implants and required minimal postdemolding clean-up.

scholarly journals Comparison of the Accuracy and Clinical Parameters of Patient-Specific and Conventionally Bended Plates for Mandibular Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Henriette L. Möllmann ◽  
Laura Apeltrath ◽  
Nadia Karnatz ◽  
Max Wilkat ◽  
Erik Riedel ◽  
...  
Keyword(s):  
Computer Assisted Surgery ◽  
Reference Points ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Advantages And Disadvantages ◽  
Patient Specific Implants ◽  
Operative Complications ◽  
The Difference ◽  
And Training

ObjectivesThis retrospective study compared two mandibular reconstruction procedures—conventional reconstruction plates (CR) and patient-specific implants (PSI)—and evaluated their accuracy of reconstruction and clinical outcome.MethodsOverall, 94 patients had undergone mandibular reconstruction with CR (n = 48) and PSI (n = 46). Six detectable and replicable anatomical reference points, identified via computer tomography, were used for defining the mandibular dimensions. The accuracy of reconstruction was assessed using pre- and postoperative differences.ResultsIn the CR group, the largest difference was at the lateral point of the condyle mandibulae (D2) -1.56 mm (SD = 3.8). In the PSI group, the largest difference between preoperative and postoperative measurement was shown at the processus coronoid (D5) with +1.86 mm (SD = 6.0). Significant differences within the groups in pre- and postoperative measurements were identified at the gonion (D6) [t(56) = -2.217; p = .031 <.05]. In the CR group, the difference was 1.5 (SD = 3.9) and in the PSI group -1.04 (SD = 4.9). CR did not demonstrate a higher risk of plate fractures and post-operative complications compared to PSI.ConclusionFor reconstructing mandibular defects, CR and PSI are eligible. In each case, the advantages and disadvantages of these approaches must be assessed. The functional and esthetic outcome of mandibular reconstruction significantly improves with the experience of the surgeon in conducting microvascular grafts and familiarity with computer-assisted surgery. Interoperator variability can be reduced, and training of younger surgeons involved in planning can be reaching better outcomes in the future.

Craniofacial Reconstruction Using Patient-Specific Implants Polyether Ether Ketone With Computer-Assisted Planning

2015 ◽  
Vol 26 (3) ◽  
pp. 663-666 ◽  
Author(s):  
Oscar J. Manrique ◽  
Frank Lalezarzadeh ◽  
Erez Dayan ◽  
Joseph Shin ◽  
Daniel Buchbinder ◽  
...  
Keyword(s):  
Patient Specific ◽  
Computer Assisted ◽  
Craniofacial Reconstruction ◽  
Patient Specific Implants ◽  
Polyether Ether Ketone ◽  
Ether Ketone

Accuracy of computer-assisted mandibular reconstructions using patient-specific implants in combination with CAD/CAM fabricated transfer keys

2017 ◽  
Vol 45 (11) ◽  
pp. 1884-1897 ◽  
Author(s):  
Frank Mascha ◽  
Karsten Winter ◽  
Sebastian Pietzka ◽  
Marcus Heufelder ◽  
Alexander Schramm ◽  
...  
Keyword(s):  
Patient Specific ◽  
Computer Assisted ◽  
Patient Specific Implants ◽  
Cad Cam

scholarly journals Post Operative Analysis of a Novel Application of Surgical Navigation

10.29007/qmm6 ◽  
2020 ◽  
Author(s):  
Benjamin Roberts ◽  
Willy Theodore
Keyword(s):  
Surgical Navigation ◽  
Sagittal Alignment ◽  
Low Cost ◽  
Femoral Condyle ◽  
Computer Assisted Surgery ◽  
Patient Specific ◽  
Computer Assisted ◽  
Tibial Resection ◽  
Patient Specific Instrumentation ◽  
The Mean

A cohort of 84 patients underwent Total Knee Replacement surgery using Patient Specific Instrumentation fitted with an optical tracker that was monitored by a Computer Assisted Surgery system. The CAS system was low cost with small footprint in the operating theatre. The hip centre was collected and four other landmarks were recorded as rotational measures. The CAS system then reported the deviation in PSI placement against the targeted PSI placement, the surgeon then made a judgement whether to replace the guide. Post-operative analysis was done to determine the achieved alignment of the component and compared to the targeted alignment. From 45 results available for analysis the study found that the mean of rotational measures over the femur and tibia were found to be within ±30 of the targeted alignment, except for femur sagittal alignment. When a single outlier was removed from the femur sagittal alignment measures, the mean fell below ±30 of the targeted alignment. Distal femoral condyle resection measures fell below a mean of 1mm and posterior femoral condyle measures fell below a mean of 2mm. Lateral proximal tibial resection fell below a mean of 2.5mm as did medial proximal tibial resection when two outliers were removed. This shows that a CAS system incorporating the low cost, quicker time, and smaller footprint benefits of PSI with the accuracy of traditional navigation may be a feasible device.

scholarly journals Low-cost three-dimensional printed orbital template-assisted patient-specific implants for the correction of spherical orbital implant migration

2018 ◽  
Vol 66 (11) ◽  
pp. 1600 ◽  
Author(s):  
TarjaniVivek Dave ◽  
Sweety Tiple ◽  
Sandeep Vempati ◽  
Mansha Palo ◽  
MohammadJaved Ali ◽  
...  
Keyword(s):  
Low Cost ◽  
Three Dimensional ◽  
Patient Specific ◽  
Orbital Implant ◽  
Implant Migration ◽  
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.

scholarly journals Computer-Assisted Secondary Orbital Reconstruction

2020 ◽  
pp. 194338752093500
Author(s):  
Daman D. Singh ◽  
Lara Schorn ◽  
E. Bradley Strong ◽  
Michael Grant ◽  
Alexander Schramm ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Computer Assisted Surgery ◽  
Patient Specific ◽  
Computer Assisted ◽  
Data Sets ◽  
Orbital Reconstruction ◽  
Secondary Reconstruction ◽  
Patient Specific Implants ◽  
Before And After ◽  
Secondary Orbital Reconstruction

Study Design: This study presents a case-control study of 33 patients who underwent secondary orbital reconstruction, evaluating techniques and outcome. Objective: Adequate functional and aesthetical appearance are main goals for secondary orbital reconstruction. Insufficient premorbid orbital reconstruction can result in hypoglobus, enophthalmos, and diplopia. Computer-assisted surgery and the use of patient-specific implants (PSIs) is widely described in the literature. The authors evaluate the use of selective laser-melted PSIs and hypothesize that PSIs are an excellent option for secondary orbital reconstruction. Methods: The sample was composed of 33 patients, previously treated with primary orbital reconstruction, presenting themselves with indications for secondary reconstruction (i.e. enophthalmos, diplopia, or limited eye motility). Computed tomography and/or cone beam data sets were assessed before and after secondary reconstruction comparing intraorbital volumes, infraorbital angles, and clinical symptoms. Clinical outcomes were assessed using a standardized protocol. Results: Results show a significant change in intraorbital volumes and a reduction of clinical symptoms after secondary reconstruction. Conclusions: Outcomes of this study suggest that secondary orbital reconstruction can be performed routinely using selective laser-melted PSIs and titanium spacers.

scholarly journals Evaluation of a Patient-Specific, Low-Cost, 3-Dimensional–Printed Transesophageal Echocardiography Human Heart Phantom

2021 ◽  
Vol 35 (1) ◽  
pp. 208-215
Author(s):  
Massimiliano Meineri ◽  
Joshua Qua-Hiansen ◽  
Jacobo Moreno Garijo ◽  
Bilal Ansari ◽  
Giulia Maria Ruggeri ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Human Heart ◽  
Low Cost ◽  
Patient Specific ◽  
3 Dimensional

scholarly journals In-Hospital 3D Printed Scaphoid Prosthesis Using Medical-Grade Polyetheretherketone (PEEK) Biomaterial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Philipp Honigmann ◽  
Neha Sharma ◽  
Ralf Schumacher ◽  
Jasmine Rueegg ◽  
Mathias Haefeli ◽  
...  
Keyword(s):  
3D Printing ◽  
Point Of Care ◽  
Low Cost ◽  
Three Dimensional ◽  
Patient Specific ◽  
Fused Filament Fabrication ◽  
Patient Specific Implants ◽  
Surgical Guides ◽  
3D Printed ◽  
Medical Grade

Recently, three-dimensional (3D) printing has become increasingly popular in the medical sector for the production of anatomical biomodels, surgical guides, and prosthetics. With the availability of low-cost desktop 3D printers and affordable materials, the in-house or point-of-care manufacturing of biomodels and Class II medical devices has gained considerable attention in personalized medicine. Another projected development in medical 3D printing for personalized treatment is the in-house production of patient-specific implants (PSIs) for partial and total bone replacements made of medical-grade material such as polyetheretherketone (PEEK). We present the first in-hospital 3D printed scaphoid prosthesis using medical-grade PEEK with fused filament fabrication (FFF) 3D printing technology.

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