3D printed ascending aortic simulators with physiological fidelity for surgical simulation

2021 ◽  
pp. bmjstel-2021-000868
Author(s):  
Ali Alakhtar ◽  
Alexander Emmott ◽  
Cornelius Hart ◽  
Rosaire Mongrain ◽  
Richard L Leask ◽  
...  
Keyword(s):  
Energy Loss ◽  
Human Tissue ◽  
Tensile Testing ◽  
Computer Aided Design ◽  
Surgical Simulation ◽  
Three Dimensional ◽  
Stiffness Index ◽  
Aortic Tissue ◽  
Straight Tube ◽  
3D Printed

IntroductionThree-dimensional (3D) printed multimaterial ascending aortic simulators were created to evaluate the ability of polyjet technology to replicate the distensibility of human aortic tissue when perfused at physiological pressures.MethodsSimulators were developed by computer-aided design and 3D printed with a Connex3 Objet500 printer. Two geometries were compared (straight tube and idealised aortic aneurysm) with two different material variants (TangoPlus pure elastic and TangoPlus with VeroWhite embedded fibres). Under physiological pressure, β Stiffness Index was calculated comparing stiffness between our simulators and human ascending aortas. The simulators’ material properties were verified by tensile testing to measure the stiffness and energy loss of the printed geometries and composition.ResultsThe simulators’ geometry had no effect on measured β Stiffness Index (p>0.05); however, β Stiffness Index increased significantly in both geometries with the addition of embedded fibres (p<0.001). The simulators with rigid embedded fibres were significantly stiffer than average patient values (41.8±17.0, p<0.001); however, exhibited values that overlapped with the top quartile range of human tissue data suggesting embedding fibres can help replicate pathological human aortic tissue. Biaxial tensile testing showed that fiber-embedded models had significantly higher stiffness and energy loss as compared with models with only elastic material for both tubular and aneurysmal geometries (stiffness: p<0.001; energy loss: p<0.001). The geometry of the aortic simulator did not statistically affect the tensile tested stiffness or energy loss (stiffness: p=0.221; energy loss: p=0.713).ConclusionWe developed dynamic ultrasound-compatible aortic simulators capable of reproducing distensibility of real aortas under physiological pressures. Using 3D printed composites, we are able to tune the stiffness of our simulators which allows us to better represent the stiffness variation seen in human tissue. These models are a step towards achieving better simulator fidelity and have the potential to be effective tools for surgical training.

scholarly journals Accuracy Assessment of Molded, Patient-Specific Polymethylmethacrylate Craniofacial Implants Compared to Their 3D Printed Originals

2020 ◽  
Vol 9 (3) ◽  
pp. 832 ◽  
Author(s):  
Dave Chamo ◽  
Bilal Msallem ◽  
Neha Sharma ◽  
Soheila Aghlmandi ◽  
Christoph Kunz ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Accuracy Assessment ◽  
Three Dimensional ◽  
Production Costs ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
3D Printed ◽  
Cost Efficient ◽  
Craniofacial Implants ◽  
Aided Design

The use of patient-specific implants (PSIs) in craniofacial surgery is often limited due to a lack of expertise and/or production costs. Therefore, a simple and cost-efficient template-based fabrication workflow has been developed to overcome these disadvantages. The aim of this study is to assess the accuracy of PSIs made from their original templates. For a representative cranial defect (CRD) and a temporo-orbital defect (TOD), ten PSIs were made from polymethylmethacrylate (PMMA) using computer-aided design (CAD) and three-dimensional (3D) printing technology. These customized implants were measured and compared with their original 3D printed templates. The implants for the CRD revealed a root mean square (RMS) value ranging from 1.128 to 0.469 mm with a median RMS (Q1 to Q3) of 0.574 (0.528 to 0.701) mm. Those for the TOD revealed an RMS value ranging from 1.079 to 0.630 mm with a median RMS (Q1 to Q3) of 0.843 (0.635 to 0.943) mm. This study demonstrates that a highly precise duplication of PSIs can be achieved using this template-molding workflow. Thus, virtually planned implants can be accurately transferred into haptic PSIs. This workflow appears to offer a sophisticated solution for craniofacial reconstruction and continues to prove itself in daily clinical practice.

Performance of 3D computers and 3D printed models as a fundamental means for spatial engineering information visualization

2014 ◽  
Vol 41 (10) ◽  
pp. 869-877 ◽  
Author(s):  
Gabriel B. Dadi ◽  
Timothy R.B. Taylor ◽  
Paul M. Goodrum ◽  
William F. Maloney
Keyword(s):  
Computer Aided Design ◽  
Three Dimensional ◽  
3D Models ◽  
The Body ◽  
Information Modeling ◽  
Simple Task ◽  
Great Opportunity ◽  
Cad Models ◽  
Engineering Information ◽  
3D Printed

Engineering information delivery can be a source of inefficient communication of design, leading to construction rework and lower worker morale. Due to errors, omissions, and misinterpretations, there remains a great opportunity to improve the traditional documentation of engineering information that craft professionals use to complete their work. Historically, physical three dimensional (3D) models built by hand provided 3D physical representations of the project to assist in sequencing, visualization, and planning of critical construction activities. This practice has greatly diminished since the adoption of 3D computer-aided design (CAD) and building information modeling technologies. Recently, additive manufacturing (a.k.a. 3D printing) technologies have allowed for three dimensional printing of 3D CAD models. A cognitive experiment was established to measure the effectiveness of 2D drawings, a 3D computer model, and a 3D printed model in delivering engineering information to an end-user are scientifically measured. The 3D printed model outperformed the 2D drawings and 3D computer interface in productivity measures. This paper’s primary contribution to the body of knowledge is identification of how different mediums of engineering information influence the performance of a simple task execution.

scholarly journals Effect of Printing Direction on the Accuracy of 3D-Printed Dentures Using Stereolithography Technology

Materials ◽  
2020 ◽  
Vol 13 (15) ◽  
pp. 3405 ◽  
Author(s):  
Tamaki Hada ◽  
Manabu Kanazawa ◽  
Maiko Iwaki ◽  
Toshio Arakida ◽  
Yumika Soeda ◽  
...  
Keyword(s):  
Experimental Data ◽  
Computer Aided Design ◽  
Three Dimensional ◽  
Data Sets ◽  
Stl File ◽  
Deviation Analysis ◽  
Master Data ◽  
3D Printed ◽  
Map Data ◽  
Printing Direction

This study evaluated the effects of the differences in the printing directions of stereolithography (SLA) three-dimensional (3D)-printed dentures on accuracy (trueness and precision). The maxillary denture was designed using computer-aided design (CAD) software with an STL file (master data) as the output. Three different printing directions (0°, 45°, and 90°) were used. Photopolymer resin was 3D-printed (n = 6/group). After scanning all dentures, the scanning data were saved/output as STL files (experimental data). For trueness, the experimental data were superimposed on the master data sets. For precision, the experimental data were selected from six dentures with three different printing directions and superimposed. The root mean square error (RMSE) and color map data were obtained using a deviation analysis. The averages of the RMSE values of trueness and precision at 0°, 45°, and 90° were statistically compared. The RMSE of trueness and precision were lowest at 45°, followed by 90°; the highest occurred at 0°. The RMSE of trueness and precision were significantly different among all printing directions (p < 0.05). The highest trueness and precision and the most favorable surface adaptation occurred when the printing direction was 45°; therefore, this may be the most effective direction for manufacturing SLA 3D-printed dentures.

Use of three-dimensional printing for simulation in ultrasound education: a scoping review

2020 ◽  
pp. bmjstel-2020-000663
Author(s):  
Patrick Gallagher ◽  
Ryan Smith ◽  
Gillian Sheppard
Keyword(s):  
Scoping Review ◽  
Computer Aided Design ◽  
Low Cost ◽  
Three Dimensional ◽  
Low Frequency ◽  
Imaging Data ◽  
Ultrasound Education ◽  
Three Dimensional Printing ◽  
3D Printed ◽  
Dimensional Printing

BackgroundThere is a significant learning curve when teaching ultrasonography to medical trainees; task trainers can help learners to bridge this gap and develop their skills. Three-dimensional printing technology has the potential to be a great tool in the development of such simulators. ObjectiveThis scoping review aimed to identify what 3D-printed models have been used in ultrasound education to date, how they were created and the pros and limitations involved.DesignResearchers searched three online databases to identify 3D-printed ultrasound models used in medical education.ResultsTwelve suitable publications were identified for inclusion in this review. The models from included articles simulated largely low frequency and/or high stakes events, with many models simulating needle guidance procedures. Most models were created by using patient imaging data and a computer-aided design software to print structures directly or print casting molds. The benefits of 3D-printed educational trainers are their low cost, reproducibility, patient specificity and accuracy. The current limitations of this technology are upfront investments and a lack of optimisation of materials.ConclusionsThe use of 3D-printed ultrasound task trainers is in its infancy, and more research is needed to determine whether or not this technology will benefit medical learners in the future.

scholarly journals Comparison of the Accuracy of Three-Dimensional Printed Casts, Digital, and Conventional Casts: An In Vitro Study

2020 ◽  
Vol 14 (02) ◽  
pp. 189-193 ◽  
Author(s):  
Passent Aly ◽  
Cherif Mohsen
Keyword(s):  
Treatment Planning ◽  
Computer Aided Design ◽  
Three Dimensional ◽  
In Vitro Study ◽  
Vitro Study ◽  
The Other ◽  
Intraoral Scanner ◽  
Linear Measurements ◽  
3D Printed

Abstract Objectives The integration of computer-aided design and manufacturing technologies in diagnosis, treatment planning, and fabrication of prosthetic restoration is changing the way in which prosthodontic treatment is provided to patients. The aim of this study was to compare the accuracy of three-dimensional (3D) printed casts produced from the intraoral scanner using stereolithographic (SLA) 3D printing technique, their digital replicas, and conventional stone casts. Materials and Methods In this in vitro study, a typodont of maxillary and mandibular arches with full dentate ivory teeth was used as a reference cast. The typodont was digitized using Trios 3Shape intraoral scanner to create digital casts. The digital files were converted into 3D printed physical casts using a prototyping machine that utilizes the stereolithography printing technology and photocurable polymer as printing material. Linear measurements (mesiodistal and occlusocervical) and interarch measurements (intercanine and intermolar) were made for digital and prototyped models and were compared with the original stone casts. The reference teeth were canines, first premolars and second premolars in the maxillary and mandibular arches on the right and left sides. The measurements on printed and conventional casts were done by digital caliper while on digital casts; Geomagic Qualify software was used. Statistical Analysis One-way analysis of variance (ANOVA) was used to compare measurements among groups. Results Digital casts showed significantly higher error than the other two groups in all linear and interarch measurements. The mean errors of the digital cast in occlusocervical (OC) and mesiodistal (MD) measurements (0.016 and 0.006, respectively) were higher compared with those in the other two groups (OC, 0.004 and 0.007 and MD, 0.003 and 0.005 [p < 0.0001 and p = 0.02, respectively]). Also, digital mean error in intermolar width (IMW) and intercanine width (ICW) (0.142 and 0.113, respectively) were greater than the other two groups (IMW, 0.019 and 0.008 and ICW, 0.021 and 0.011 [p < 0.0001]). However, the errors were within the acceptable clinical range. Conclusion The 3D printed casts may be considered as a substitute for stone casts with clinically acceptable accuracy that can be used in diagnosis, treatment planning, and fabrication of prosthetic restorations.

scholarly journals Orthopedics and 3D technology in Turkey: A preliminary report

2021 ◽  
Vol 32 (2) ◽  
pp. 279-289
Author(s):  
Cemil Ertürk ◽  
Simel Ayyıldız ◽  
Cevdet Erdöl
Keyword(s):  
Surgical Simulation ◽  
Three Dimensional ◽  
Radiographic Examination ◽  
Acetabular Bone Defect ◽  
Custom Made ◽  
Revision Tha ◽  
3D Printers ◽  
3D Printed ◽  
Acetabular Defects ◽  
Pilon Fractures

Objectives: In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.

scholarly journals Novel open-source 3D-printed eye mount (TEMPO) for the ophthalmology wet lab

2021 ◽  
Vol 6 (1) ◽  
pp. e000685
Author(s):  
Michael Mak ◽  
Yejun Hong ◽  
William Murray Trask ◽  
Randy Thompson ◽  
Helen Chung ◽  
...  
Keyword(s):  
3D Printing ◽  
Open Source ◽  
Surgical Training ◽  
Computer Aided Design ◽  
Anatomical Variation ◽  
Three Dimensional ◽  
Computer Assisted ◽  
3D Printed ◽  
Wet Lab ◽  
Facial Contours

ObjectiveProcuring an affordable eye mount that can stabilise a cadaveric eye and simulate a patient’s normal facial contours represents an ongoing challenge in the ophthalmology simulation wet lab, with notable limitations to all currently available commercial options. This project uses computer-assisted design and three-dimensional (3D)-printing techniques to tackle these challenges for ophthalmologic surgical training.Methods and AnalysisProof-of-concept study. Using Autodesk Fusion 360, we designed and 3D-printed a modular device that consists of 11 pieces forming a head structure. Standard OR tubing and syringes were adapted to create an adjustable-suction system to affix cadaveric eyes. Further modular inserts were customised to house non-cadaveric simulation eyes.ResultsThree-dimensional eye mount for procedures in ophthalmology (TEMPO) reliably fixed a cadaveric eye in stable position throughout surgical manipulation. Trainees were able to drape and practice appropriate hand positioning while corneal suturing. Overall, this model was affordable, at a cost of approximately $C200 to print. The modular nature renders individual pieces convenient for replacement and customisable to simulate regional anatomical variation and accommodate non-cadaveric eyes.ConclusionsTEMPO represents an affordable, high-fidelity alternative to existing commercially available eye mounts. It reliably fixates cadaveric and simulation eyes and provides an enhanced surgical training experience by way of its realistic facial contours. It is released as an open-source computer-aided design file, customisable to interested trainees with appropriate software and 3D-printing capacity.

scholarly journals Conceptualization of a Sensory Feedback System in an Anthropomorphic Replacement Hand

Prosthesis ◽  
2021 ◽  
Vol 3 (4) ◽  
pp. 415-427
Author(s):  
Simon Hazubski ◽  
Derya Bamerni ◽  
Andreas Otte
Keyword(s):  
Computer Aided Design ◽  
Sensory Feedback ◽  
Three Dimensional ◽  
Feedback System ◽  
3D Scanner ◽  
Trade Off ◽  
Computer Aided ◽  
3D Printed ◽  
Aided Design ◽  
Printing Techniques

(1) Background: This paper presents a conceptual design for an anthropomorphic replacement hand made of silicone that integrates a sensory feedback system. In combination with a motorized orthosis, it allows performing movements and registering information on the flexion and the pressure of the fingers. (2) Methods: To create the replacement hand, a three-dimensional (3D) scanner was used to scan the hand of the test person. With computer-aided design (CAD), a mold was created from the hand, then 3D-printed. Bending and force sensors were attached to the mold before silicone casting to implement the sensory feedback system. To achieve a functional and anthropomorphic appearance of the replacement hand, a material analysis was carried out. In two different test series, the properties of the used silicones were analyzed regarding their mechanical properties and the manufacturing process. (3) Results: Individual fingers and an entire hand with integrated sensors were realized, which demonstrated in several tests that sensory feedback in such an anthropomorphic replacement hand can be realized. Nevertheless, the choice of silicone material remains an open challenge, as there is a trade-off between the hardness of the material and the maximum mechanical force of the orthosis. (4) Conclusion: Apart from manufacturing-related issues, it is possible to cost-effectively create a personalized, anthropomorphic replacement hand, including sensory feedback, by using 3D scanning and 3D printing techniques.

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.

Maxillary Cutting Guide for Executing a Simulated Osteotomy and Removing the Bony Interference During Orthognathic Surgery

2015 ◽  
Vol 9 (4) ◽  
Author(s):  
Sang-Hoon Kang ◽  
Hak-Jin Kim ◽  
Ha-Won Park ◽  
Sang-Hwy Lee
Keyword(s):  
Orthognathic Surgery ◽  
3D Model ◽  
Surgical Simulation ◽  
Three Dimensional ◽  
Maxillary Osteotomy ◽  
Cutting Guide ◽  
Surgical Devices ◽  
Simulation Based ◽  
3D Printed ◽  
Osteotomy Line

The results of surgical simulation need to be transferred to the operation table with precision and confidence. We want to introduce a three-dimensional (3D)-printed maxillary cutting guide to perform the simulation-based maxillary osteotomy, interference removal, and the device guide for maxillary orthognathic surgery. The orthognathic simulation is performed with a horizontal osteotomy line and the maxillary segmental movement on a computed tomography (CT)-based 3D model. The maxillary cutting guide is designed as a band-shaped template encompassing the osteotomy line, bone interference area, and guiding holes. The design is exported to a 3D printer and the cutting guide is printed with biocompatible resin materials. The cutting guide was applied to 45 orthognathic surgeries. It could assist the easy and accurate osteotomy as planned and eliminate the repeated empirical checks of the premature interference site while preventing excessive bone reduction. This device guides the surgeon to place the osteotomy line, predict and remove the bony interferences, and place holes for additional surgical devices for maxillary orthognathic surgery.

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