Surgical Guides and Prebent Titanium Improve the Planning for the Treatment of Dentofacial Deformities Secondary to Condylar Osteochondroma

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zhaokun Zhu ◽  
Ze He ◽  
Yue Tai ◽  
Yao Liu ◽  
Hanghang Liu ◽  
...  
Author(s):  
Michelle Carvalho de Sales ◽  
Rafael Maluza Flores ◽  
Julianny da Silva Guimaraes ◽  
Gustavo Vargas da Silva Salomao ◽  
Tamara Kerber Tedesco ◽  
...  

Dental surgeons need in-depth knowledge of the bone tissue status and gingival morphology of atrophic maxillae. The aim of this study is to describe preoperative virtual planning of placement of five implants and to compare the plan with the actual surgical results. Three-dimensional planning of rehabilitation using software programs enables surgical guides to be specially designed for the implant site and manufactured using 3D printing. A patient with five teeth missing was selected for this study. The patient’s maxillary region was scanned with CBCT and a cast model was produced. After virtual planning using ImplantViewer, five implants were placed using a printed surgical guide. Two weeks after the surgical procedure, the patient underwent another CBCT scan of the maxilla. Statistically significant differences were detected between the virtually planned positions and the actual positions of the implants, with a mean deviation of 0.36 mm in the cervical region and 0.7 mm in the apical region. The surgical technique used enables more accurate procedures when compared to the conventional technique. Implants can be better positioned, with a high level of predictability, reducing both operating time and patient discomfort.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Han Shin Lee ◽  
Hee Jeong Kim ◽  
Il Yong Chung ◽  
Jisun Kim ◽  
Sae Byul Lee ◽  
...  

AbstractWe used 3D printed-breast surgical guides (3DP-BSG) to designate the original tumor area from the pre-treatment magnetic resonance imaging (MRI) during breast-conserving surgery (BCS) in breast cancer patients who received neoadjuvant systemic therapy (NST). Targeting the original tumor area in such patients using conventional localization techniques is difficult. For precise BCS, a method that marks the tumor area found on MRI directly to the breast is needed. In this prospective study, patients were enrolled for BCS after receiving NST. Partial resection was performed using a prone/supine MRI-based 3DP-BSG. Frozen biopsies were analyzed to confirm clear tumor margins. The tumor characteristics, pathologic results, resection margins, and the distance between the tumor and margin were analyzed. Thirty-nine patients were enrolled with 3DP-BSG for BCS. The median nearest distance between the tumor and the resection margin was 3.9 cm (range 1.2–7.8 cm). Frozen sections showed positive margins in 4/39 (10.3%) patients. Three had invasive cancers, and one had carcinoma in situ; all underwent additional resection. Final pathology revealed clear margins. After 3-year surveillance, 3/39 patients had recurrent breast cancer. With 3DP-BSG for BCS in breast cancer patients receiving NST, the original tumor area can be identified and marked directly on the breast, which is useful for surgery. Trial Registration: Clinical Research Information Service (CRIS) Identifier Number: KCT0002272. First registration number and date: No. 1 (27/04/2016).


2021 ◽  
Vol 10 (3) ◽  
pp. 391
Author(s):  
Rani D’haese ◽  
Tom Vrombaut ◽  
Geert Hommez ◽  
Hugo De Bruyn ◽  
Stefan Vandeweghe

Purpose: The aim of this in vitro study is to evaluate the accuracy of implant position using mucosal supported surgical guides, produced by a desktop 3D printer. Methods: Ninety implants (Bone Level Roxolid, 4.1 mm × 10 mm, Straumann, Villerat, Switzerland) were placed in fifteen mandibular casts (Bonemodels, Castellón de la Plana, Spain). A mucosa-supported guide was designed and printed for each of the fifteen casts. After placement of the implants, the location was assessed by scanning the cast and scan bodies with an intra-oral scanner (Primescan®, Dentsply Sirona, York, PA, USA). Two comparisons were performed: one with the mucosa as a reference, and one where only the implants were aligned. Angular, coronal and apical deviations were measured. Results: The mean implant angular deviation for tissue and implant alignment were 3.25° (SD 1.69°) and 2.39° (SD 1.42°) respectively, the coronal deviation 0.82 mm (SD 0.43 mm) and 0.45 mm (SD 0.31 mm) and the apical deviation 0.99 mm (SD 0.45 mm) and 0.71 mm (SD 0.43 mm). All three variables were significantly different between the tissue and implant alignment (p < 0.001). Conclusion: Based on the results of this study, we conclude that guided implant surgery using desktop 3D printed mucosa-supported guides has a clinically acceptable level of accuracy. The resilience of the mucosa has a negative effect on the guide stability and increases the deviation in implant position.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Fernández Álvarez ◽  
C Garcés Zarzalejo ◽  
M Adeba García ◽  
P Pernia Gomez ◽  
J A. Martínez Agüeros ◽  
...  

Abstract INTRODUCTION 3D printing technology is penetrating the healthcare field at an astonishing rate. The reduction of its costs, makes it more accessible to everyone. MATERIAL AND METHODS 35-year-old woman who had functional limitation in her right hip due to pelvic ring fracture in her childhood. She had dysmetria of lower limbs and femoral anteversion of 40 degrees. Imaging tests showed vicious consolidation of the right hemipelvis associated with antero-medial displacement. RESULTS Preoperative, we performed her 3D printing pelvic ring model. Osteotomies were digital planned (iliac crest, superior pubic ramus, incomplete of inferior pubic ramus, and semicircular of posterior column) and also how many degrees we would need for rotation the osteotomized fragment. Posterior column osteotomy was the most difficult, so we designed 3D surgical printing cutting guide able to being inserted into the iliac fossa. We used it to introduced four Kirschnner wires that leads us as a guide to avoid the greater sciatic notch. O-arm navigation system helped us make sure to achieve more precision. 3D printing pelvic ring model was sterilized to pre-contouring osteosynthesis plates. After two years of follow-up, good functional results were observed, without gait claudication either limb dysmetria. Her range of motion is 105 degrees of hip flexion, 20 degrees of internal hip rotation and 40 degrees of external hip rotation. Complete radiological consolidation was observed. CONCLUSION Digital planning and 3D printing technology allows to improve three-dimensional compression of bone pathology leading to a higher likelihood of a predictable ideal outcome compared to conventional techniques.


2021 ◽  
Vol 11 (14) ◽  
pp. 6444
Author(s):  
Jörg Lüchtenborg ◽  
Felix Burkhardt ◽  
Julian Nold ◽  
Severin Rothlauf ◽  
Christian Wesemann ◽  
...  

Additive manufacturing is becoming an increasingly important technique for the production of dental restorations and assistive devices. The most commonly used systems are based on vat polymerization, e.g., stereolithography (SLA) and digital light processing (DLP). In contrast, fused filament fabrication (FFF), also known under the brand name fused deposition modeling (FDM), is rarely applied in the dental field. This might be due to the reduced accuracy and resolution of FFF compared to vat polymerization. However, the use of FFF in the dental sector seems very promising for in-house production since it presents a cost-effective and straight forward method. The manufacturing of nearly ready-to-use parts with only minimal post-processing can be considered highly advantageous. Therefore, the objective was to implement FFF in a digital dental workflow. The present report demonstrates the production of surgical guides for implant insertion by FFF. Furthermore, a novel approach using a temperature-sensitive filament for bite registration plates holds great promise for a simplified workflow. In combination with a medical-grade filament, a multi-material impression tray was printed for optimized impression taking of edentulous patients. Compared to the conventional way, the printed thermoplastic material is pleasant to model and can allow clean and fast work on the patient.


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