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 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.

The role of three-dimensional imaging in patients with cleft lip and palate

2013 ◽  
Vol 4 (3) ◽  
pp. 118-123
Author(s):  
Lauren Gardner ◽  
Toby Gillgrass ◽  
Mark Devlin
Keyword(s):  
Computer Aided Design ◽  
3D Imaging ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Optical Scanning ◽  
Fixed Prosthodontics ◽  
Computer Aided ◽  
Dental Hospital ◽  
Aided Design

Three-dimensional (3D) imaging is revolutionising patient assessment, diagnosis, management and treatment planning. Restorative dentistry is using optical scanning such as the computer aided design/computer aided manufacture systems to help with tooth preparation design and construction of fixed prosthodontics. Other specialties in dentistry are frequently employing cone beam computed tomography (CBCT) to facilitate 3D imaging. This article outlines how CBCT and 3D sterophotogrammetry have been used in the management of cleft lip and palate with reference to the cleft team based at Glasgow Dental Hospital.

scholarly journals Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques

2014 ◽  
Vol 7 (2) ◽  
pp. 158-166 ◽  
Author(s):  
Frank Wilde ◽  
Carl-Peter Cornelius ◽  
Alexander Schramm
Keyword(s):  
Computer Aided Design ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Reconstruction Plate ◽  
Fibula Flap ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Five Axis

We investigated the workflow of computer-assisted mandibular reconstruction that was performed with a patient-specific mandibular reconstruction plate fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) techniques and a fibula flap. We assessed the feasibility of this technique from virtual planning to the completion of surgery. Computed tomography (CT) scans of a cadaveric skull and fibula were obtained for the virtual simulation of mandibular resection and reconstruction using ProPlan CMF software (Materialise®/DePuy Synthes®). The virtual model of the reconstructed mandible provided the basis for the computer-aided design of a patient-specific reconstruction plate that was milled from titanium using a five-axis milling machine and CAM techniques. CAD/CAM techniques were used for producing resection guides for mandibular resection and cutting guides for harvesting a fibula flap. Mandibular reconstruction was simulated in a cadaveric wet laboratory. No problems were encountered during the procedure. The plate was fixed accurately to the residual bone without difficulty. The fibula segments were attached to the plate rapidly and reliably. The fusion of preoperative and postoperative CT datasets demonstrated high reconstruction precision. Computer-assisted mandibular reconstruction with CAD/CAM-fabricated patient-specific reconstruction plates appears to be a promising approach for mandibular reconstruction. Clinical trials are required to determine whether these promising results can be translated into successful practice and what further developments are needed.

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.

Precise Implant Placement with a Computer-Assisted Surgical Guide in Cleft Lip and Palate Patients

2015 ◽  
Vol 52 (3) ◽  
pp. 65-71 ◽  
Author(s):  
Re-Mee Doh ◽  
Chugeum Dam ◽  
Kyu-Young Kyung ◽  
Wonse Park
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Computer Assisted ◽  
Surgical Guide ◽  
Implant Placement

scholarly journals Reconstruction of Post-Traumatic Orbital Defects and Deformities with Custom-Made Patient-Specific Implants: Evaluation of the Efficacy and Clinical Outcome

2019 ◽  
Vol 3 (1) ◽  
pp. s-0039-1685505 ◽  
Author(s):  
Yurii Chepurnyi ◽  
Denis Chernogorskyi ◽  
Oksana Petrenko ◽  
Andrii Kopchak
Keyword(s):  
Computer Aided Design ◽  
Visual Fields ◽  
Infectious Complications ◽  
Patient Specific ◽  
Reconstructive Procedures ◽  
Patient Specific Implants ◽  
Custom Made ◽  
Computer Aided ◽  
Post Traumatic ◽  
Orbital Defects

The main purpose of this article is to evaluate the efficacy of patient-specific implants (PSI) in treatment of patients with post-traumatic orbital defects and deformities. Twenty-three patients with post-traumatic orbital defects and deformities, who underwent subsequent reconstructive procedures using PSI, were included in the study. All the patients were examined according to the standard algorithm involving the local status examination, vision assessment, and computed tomography before and after surgery. The study findings show neither postoperative infectious complications nor decreased visual acuity or loss of visual fields. Functional disorders resolved in 65.2% of cases 1 month after the surgical intervention and in 86.96% of patients within a 3-month term. Positive aesthetic outcomes were seen in 95.7% of cases. Reconstruction with computer-aided design/computer-aided manufactured PSI is an effective procedure that allows accurate restoring of the complex orbital anatomy.

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