In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study

Abstract Background The accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies. Methods Patients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group. Results The deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies. Conclusions Surgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.

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Computer-assisted extra-articular distal radius osteotomies using patient-specific surgical guides

10.29007/svbd ◽

2018 ◽

Author(s):

Vasilii Shishkin ◽

Valeriy Golubev

Keyword(s):

Distal Radius ◽

Patient Specific ◽

Control Group ◽

Computer Assisted ◽

X Ray ◽

Surgical Guides ◽

Planning Approach ◽

3D Printed ◽

Planning Group

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.

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Digital Workflow for Periodontal Crown Lengthening in Treatment of Altered Passive Eruption: Case Report

Dental Research and Management ◽

10.33805/2572-6978.140 ◽

2020 ◽

pp. 27-30

Author(s):

Vilma A Umanzor ◽

Hugo H Romero ◽

Zamir Kafati ◽

Ana Rodriguez ◽

Juan Guifarro ◽

...

Keyword(s):

Soft Tissues ◽

Cone Beam ◽

Computer Assisted ◽

Surgical Guide ◽

Computed Tomography Images ◽

Surgical Guides ◽

Planning Software ◽

Cone Beam Computerized Tomography ◽

Precise Representation ◽

Crown Lengthening

This paper describes the treatment of a patient diagnosed clinically and based on cone beam computed tomography images with excessive gingival display caused by altered passive eruption Type 1B. A digitally computer designed and 3-D printed surgical guide was fabricated for crown lengthening to provide periodontal esthetics. The combination of intraoral scanners and cone-beam computerized tomography images, and use of planning software, provides a very precise representation of the real conditions of the hard and soft tissues. The design and fabrication of computer surgical guides can improve precision and predictability for surgical procedures and can be superior to conventional free-handed surgery in terms of efficiency and treatment outcomes. Surgical experience and general understanding of computer assisted systems and thorough knowledge of conventional protocols is mandatory to make routine use of these systems. To select a treatment modality, the etiology must be clearly identified and the patient has to be informed of his options for treatment which for this condition are a gingivectomy or an apically positioned flap with or without osseous reduction determined by the type of altered passive eruption.

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A New Twist on Surgical Guides

Journal of Oral Implantology ◽

10.1563/1548-1336-34.6.325 ◽

2008 ◽

Vol 34 (6) ◽

pp. 325-329 ◽

Cited By ~ 1

Author(s):

Trevor Bavar

Keyword(s):

Computer Assisted ◽

Implant Surgery ◽

Surgical Guide ◽

Time Of Surgery ◽

Surgical Guides ◽

Rotational Position ◽

Computer Assisted Tomography ◽

Ct Technology

Abstract Surgical guides have evolved to the point that they can be created with the aid of computer-assisted tomography (CT) technology. Surgical guides also are used in construction of the prosthesis prior to implant surgery. With existing guide techniques, the prosthesis is screw retained, or cone-shaped temporary abutments may be used to overcome the lack of parallelism of the implants. With the New Twist technique, we are able to create the surgical guide in such a way that optimum bone may be used and the rotational position of the implant may be established for the surgeon and for the laboratory. Custom abutments are inserted at the time of surgery, as is an esthetic, functionally provisional cemented prosthesis. Castings for the finished ceramo-metal bridge are fabricated before surgery is performed. The final prosthesis then is easily constructed by the restorative dentist during just 3 simple patient visits.

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The use of 3D-printed surgical guides and models for sinus lift surgery planning and education

Journal of 3D Printing in Medicine ◽

10.2217/3dp-2019-0014 ◽

2019 ◽

Vol 3 (3) ◽

pp. 145-155

Author(s):

Robert-Angelo Tuce ◽

Stelian Arjoca ◽

Monica Neagu ◽

Adrian Neagu

Keyword(s):

Maxillofacial Surgery ◽

Skills Training ◽

Physical Models ◽

Sinus Lift ◽

Dental Resin ◽

Sinus Augmentation ◽

Surgical Guide ◽

Surgical Guides ◽

Training Materials ◽

3D Printed

Aim: To develop 3D printing and dentistry methods for building physical models that enable one to simulate a sinus lift surgery. Materials & methods: The Blue Sky Plan software was used to create a digital model from the cone beam computed tomography scan of the subject’s maxilla and to design a surgical guide for sinus augmentation and implant placement. The anatomical model and surgical guide were 3D printed from dental resin. Results: Sinus augmentation and dental implant insertion were carried out on the model as examples of practical skills training for residents in maxillofacial surgery. Conclusion: The 3D-printed models and surgical guides are useful training materials. They could be helpful also in a dental practice for surgical planning and for illustrating the procedure to the patient.

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Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

Applied Sciences ◽

10.3390/app10041325 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1325

Author(s):

Bo-Yeon Hwang ◽

Jae-Yeol Lee ◽

Junho Jung ◽

Joo-Young Ohe ◽

Young-Gyu Eun ◽

...

Keyword(s):

Computer Assisted ◽

Defect Classification ◽

Anatomical Structures ◽

Less Invasive ◽

Surgical Guides ◽

Invasive Method ◽

3D Printed ◽

Inferior Border ◽

Bone Margin ◽

Disease Free

This study aimed to present and evaluate alternative lesion-specific mandibulectomy methods for preserving the mandibular anatomical structures as compared with the conventional virtual surgical plan. Fifteen patients who received segmental mandibulectomy were included in this study, and the following parameters were evaluated: (1) the disease-free bone margin, (2) the volume and surface between the tailor-made resection simulation and conventional resection simulation, and (3) the preserved mandibular anatomical structures. In all 15 patients, disease-free bone margins were confirmed by histopathology. Volumes of conventional resection simulation and tail-made resection simulation were 49,468.66 ± 14,007.96 mm3 and 52,610.01 ± 13,755.33 mm3 and the surfaces were 20,927.38 ± 4471.70 mm2 and 22,356.49 ± 4185.73 mm2, respectively; these were statistically significant (both, p < 0.001). Mandibular dentition was partially preserved in six patients. Twelve of the 15 patients had changes in defect classification with preservation of the mandibular inferior border. In conclusion, alternative lesion-specific mandibulectomy was a less invasive method for effectively removing mandibular lesions while preserving the important anatomical structures of the mandible.

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Torque Mechanical Evaluation for 3D Printed Orthodontic Springs with Different Parameters: Invitro Study

10.21203/rs.3.rs-19614/v1 ◽

2020 ◽

Author(s):

Ahmed Othman ◽

Steven Hartman ◽

Dragan Ströbele ◽

Jassin Arnold ◽

Constantin von See

Keyword(s):

Testing Machine ◽

Control Group ◽

3D Printer ◽

Coil Design ◽

Flexible Material ◽

Universal Testing ◽

Length Group ◽

Cad Cam ◽

3D Printed ◽

Sydney Australia

Abstract Background: The purpose of the presented investigation is to evaluate the resulting torque on loaded 3D printed springs using different coil thickness and length. Methods: Specimens were designed and printed using the 3D printer MAX (Asiga, Sydney, Australia) with 3D printable, experimental, flexible material (Code:BM2008, GC, Tokyo, Japan). The specimens were divided into three groups according to spring coil design. Control group (n=18), length group (n=19) and thickness group (n=22). Groups were tested using a Sauter Machine for torque calculation (DB, Grindelwald, Switzerland) in conjunction with a universal testing machine (Zwick Z010, Ulm, Germany) for clock-wise and anti-clockwise testing. Statistical analysis was performed using the Steel-Dwass test to compare median values of the three groups in both testing directions (p<0.001). Results: The highest torque value was determined in the thickness group for both clockwise and anti-clockwise testing directions, achieving 44.00N/mm and 39.62N/mm respectively. For the thickness group values ranged from 21.28N/mm anti-clockwise to 44.00N/mm clockwise. The length group ranged from 21.65N/mm to 11.04N/mm in clockwise direction and from 18.04N/mm to 11.38N/mm in counter-clockwise testing. The control group ranged from 22.72N/mm to 17.18N/mm in the clock-wise direction while in the anti-clock wise testing it ranged from 21.34N/mm to 16.02N/mm. Conclusions: 3D printed springs are being affected by diameter than length as a design parameter compared to the control group. The thickness group values are statistically significant than the length group (P<0.001). Key words: CAD/CAM, 3D printing, Digital Orthodontics, Torque, Springs.

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Mandibular Reconstruction Using ProPlan CMF: A Review

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0037-1606835 ◽

2017 ◽

Vol 1 (1) ◽

pp. s-0037-1606835 ◽

Cited By ~ 2

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.

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Using a 3D Printed “Phantom of the Opera” Soft Tissue Surgical Guide for Complex Facial Reconstruction

FACE ◽

10.1177/2732501620949198 ◽

2020 ◽

Vol 1 (1) ◽

pp. 23-28

Author(s):

Gina Sacks ◽

Raquel M. Ulma ◽

Samuel D. Dolphin ◽

Stephanie Kline ◽

Steven R. Buchman

Keyword(s):

Soft Tissue ◽

Surgical Planning ◽

Aesthetic Judgment ◽

Soft Tissue Reconstruction ◽

Unique Challenge ◽

Surgical Guide ◽

Virtual Surgical Planning ◽

Surgical Guides ◽

Tissue Reconstruction ◽

3D Printed

Computer aided technology in the form of virtual surgical planning (VSP) and 3D printed surgical guides can allow for a more accurate reconstruction of complex maxillofacial deformities. While this technology is now routinely used for bony reconstruction, it is rarely utilized for soft tissue. In ballistic injuries there is often disfiguring damage to the soft tissue, with destruction of anatomic landmarks making satisfactory soft tissue reconstruction a unique challenge. In this study, the authors present the application of virtual surgical planning and 3D printed guides, in conjunction with anaplastology, for complex soft tissue reconstruction resulting from a gunshot injury. By combining tangible surgical models and aesthetic judgment in a team setting, it is possible to optimize the efficiency and accuracy of soft tissue reconstruction in the setting of complex facial deformities.

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Computer-Assisted Virtual Planning for Surgical Guide Manufacturing and Internal Distractor Adaptation in the Management of Midface Hypoplasia in Cleft Patients

The Cleft Palate-Craniofacial Journal ◽

10.1597/15-208 ◽

2017 ◽

Vol 54 (4) ◽

pp. 457-464 ◽

Cited By ~ 3

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.

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In Vitro Comparison between Metal Sleeve-Free and Metal Sleeve-Incorporated 3D-Printed Computer-Assisted Implant Surgical Guides

Materials ◽

10.3390/ma14030615 ◽

2021 ◽

Vol 14 (3) ◽

pp. 615

Author(s):

Kyung Chul Oh ◽

June-Sung Shim ◽

Ji-Man Park

Keyword(s):

Computer Assisted ◽

Cross Sectional ◽

Implant Placement ◽

Surgical Guides ◽

Measured Weight ◽

Before And After ◽

3D Printed ◽

Student’S T ◽

The Right

The present study aims to compare the accuracy of metal sleeve-free 3D-printed computer-assisted implant surgical guides (MSF group) (n = 10) with metal sleeve-incorporated 3D-printed computer-assisted implant surgical guides (MSI group) (n = 10). Implants of diameter 4.0 mm and 5.0 mm were placed in the left second premolars and bilateral first molars, respectively, using a fully guided system. Closed-form sleeves were used in teeth on the left and open-form sleeves on the right. The weight differences of the surgical guides before and after implant placement, and angular deviations before and after implant placement were measured. Weight differences were compared with Student’s t-tests and angular deviations with Mann–Whitney tests. Cross-sectional views of the insert parts were observed with a scanning electron microscope. Preoperative and postoperative weight differences between the two groups were not statistically significant (p = 0.821). In terms of angular deviations, those along the mesiodistal direction for the left second premolars were significantly lower in the MSF group (p = 0.006). However, those along the mesiodistal direction for the bilateral molars and those along the buccolingual direction for all teeth were not significantly different (p > 0.05). 3D-printed implant surgical guides without metal sleeve inserts enable accurate implant placement without exhausting the guide holes, rendering them feasible for fully guided implant placement.

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