scholarly journals Effects of Steam Sterilization on 3D Printed Biocompatible Resin Materials for Surgical Guides—An Accuracy Assessment Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1506 ◽  
Author(s):  
Neha Sharma ◽  
Shuaishuai Cao ◽  
Bilal Msallem ◽  
Christoph Kunz ◽  
Philipp Brantner ◽  
...  
Keyword(s):  
Accuracy Assessment ◽  
Three Dimensional ◽  
Dimensional Accuracy ◽  
Hand Surgery ◽  
Computer Assisted Surgery ◽  
Third Party ◽  
Computer Assisted ◽  
Steam Sterilization ◽  
Surgical Guides ◽  
3D Printed

Computer-assisted surgery with three-dimensional (3D) printed surgical guides provides more accurate results than free-hand surgery. Steam sterilization could be one of the factors that affect the dimensions of surgical guide resin materials, leading to inaccuracies during surgeries. The purpose of this study was to evaluate the effects of steam sterilization on the dimensional accuracy of indication-specific hollow cube test bodies, manufactured in-house using Class IIa biocompatible resin materials (proprietary and third-party). To evaluate the pre- and post-sterilization dimensional accuracy, root mean square (RMS) values were calculated. The results indicate that, in all the groups, steam sterilization resulted in an overall linear expansion of the photopolymeric resin material, with an increase in outer dimensions and a decrease in inner dimensions. The effects on the dimensional accuracy of test bodies were not statistically significant in all the groups, except PolyJet Glossy (p > 0.05). The overall pre- and post-sterilization RMS values were below 100 and 200 µm, respectively. The highest accuracies were seen in proprietary resin materials, i.e., PolyJet Glossy and SLA-LT, in pre- and post-sterilization measurements, respectively. The dimensional accuracy of third-party resin materials, i.e., SLA-Luxa and SLA-NextDent, were within a comparable range as proprietary materials and can serve as an economical alternative.

scholarly journals Dimensional Accuracy of Dental Models for Three-Unit Prostheses Fabricated by Various 3D Printing Technologies

Materials ◽  
2021 ◽  
Vol 14 (6) ◽  
pp. 1550
Author(s):  
Soo-Yeon Yoo ◽  
Seong-Kyun Kim ◽  
Seong-Joo Heo ◽  
Jai-Young Koak ◽  
Joung-Gyu Kim
Keyword(s):  
Surface Roughness ◽  
Three Dimensional ◽  
Dimensional Accuracy ◽  
3D Analysis ◽  
Digital Light Processing ◽  
Test Models ◽  
Reference File ◽  
Significant Difference ◽  
Jet Printing ◽  
3D Printed

Previous studies on accuracy of three-dimensional (3D) printed model focused on full arch measurements at few points. The aim of this study was to examine the dimensional accuracy of 3D-printed models which were teeth-prepped for three-unit fixed prostheses, especially at margin and proximal contact areas. The prepped dental model was scanned with a desktop scanner. Using this reference file, test models were fabricated by digital light processing (DLP), Multi-Jet printing (MJP), and stereo-lithography apparatus (SLA) techniques. We calculated the accuracy (trueness and precision) of 3D-printed models on 3D planes, and deviations of each measured points at buccolingual and mesiodistal planes. We also analyzed the surface roughness of resin printed models. For overall 3D analysis, MJP showed significantly higher accuracy (trueness) than DLP and SLA techniques; however, there was not any statistically significant difference on precision. For deviations on margins of molar tooth and distance to proximal contact, MJP showed significantly accurate results; however, for a premolar tooth, there was no significant difference between the groups. 3D color maps of printed models showed contraction buccolingually, and surface roughness of the models fabricated by MJP technique was observed as the lowest. The accuracy of the 3D-printed resin models by DLP, MJP, and SLA techniques showed a clinically acceptable range to use as a working model for manufacturing dental prostheses

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

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Lukas Postl ◽  
Thomas Mücke ◽  
Stefan Hunger ◽  
Oliver Bissinger ◽  
Michael Malek ◽  
...  
Keyword(s):  
Control Group ◽  
Head Model ◽  
Computer Assisted ◽  
3D Printer ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Lower Jaw ◽  
Bony Lesion ◽  
3D Printed ◽  
Phantom Head

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.

scholarly journals Inter-rater variability of three-dimensional fracture reduction planning according to the educational background

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christoph Zindel ◽  
Philipp Fürnstahl ◽  
Armando Hoch ◽  
Tobias Götschi ◽  
Andreas Schweizer ◽  
...  
Keyword(s):  
Distal Radius ◽  
Clinical Experience ◽  
Three Dimensional ◽  
Computer Assisted Surgery ◽  
Educational Background ◽  
Fracture Reduction ◽  
Computer Assisted ◽  
Operation Planning ◽  
Level Of Evidence ◽  
Fragment Displacement

Abstract Background Computer-assisted three-dimensional (3D) planning is increasingly delegated to biomedical engineers. So far, the described fracture reduction approaches rely strongly on the performance of the users. The goal of our study was to analyze the influence of the two different professional backgrounds (technical and medical) and skill levels regarding the reliability of the proposed planning method. Finally, a new fragment displacement measurement method was introduced due to the lack of consistent methods in the literature. Methods 3D bone models of 20 distal radius fractures were presented to nine raters with different educational backgrounds (medical and technical) and various levels of experience in 3D operation planning (0 to 10 years) and clinical experience (1.5 to 24 years). Each rater was asked to perform the fracture reduction on 3D planning software. Results No difference was demonstrated in reduction accuracy regarding rotational (p = 1.000) and translational (p = 0.263) misalignment of the fragments between biomedical engineers and senior orthopedic residents. However, a significantly more accurate planning was performed in these two groups compared with junior orthopedic residents with less clinical experience and no 3D planning experience (p < 0.05). Conclusion Experience in 3D operation planning and clinical experience are relevant factors to plan an intra-articular fragment reduction of the distal radius. However, no difference was observed regarding the educational background (medical vs. technical) between biomedical engineers and senior orthopedic residents. Therefore, our results support the further development of computer-assisted surgery planning by biomedical engineers. Additionally, the introduced fragment displacement measure proves to be a feasible and reliable method. Level of Evidence Diagnostic Level II

scholarly journals Advances in the Resection and Reconstruction of Midfacial Tumors Through Computer Assisted Surgery

2021 ◽  
Vol 11 ◽  
Author(s):  
Max Wilkat ◽  
Norbert Kübler ◽  
Majeed Rana
Keyword(s):  
Tumor Resection ◽  
Three Dimensional ◽  
Computer Assisted Surgery ◽  
Close Relation ◽  
Tissue Loss ◽  
R0 Resection ◽  
Computer Assisted ◽  
Oncologic Surgery ◽  
Complex Anatomy ◽  
Interdisciplinary Exchange

Curatively intended oncologic surgery is based on a residual-free tumor excision. Since decades, the surgeon’s goal of R0-resection has led to radical resections in the anatomical region of the midface because of the three-dimensionally complex anatomy where aesthetically and functionally crucial structures are in close relation. In some cases, this implied aggressive overtreatment with loss of the eye globe. In contrast, undertreatment followed by repeated re-resections can also not be an option. Therefore, the evaluation of the true three-dimensional tumor extent and the intraoperative availability of this information seem critical for a precise, yet substance-sparing tumor removal. Computer assisted surgery (CAS) can provide the framework in this context. The present study evaluated the beneficial use of CAS in the treatment of midfacial tumors with special regard to tumor resection and reconstruction. Therefore, 60 patients diagnosed with a malignancy of the upper jaw has been treated, 31 with the use of CAS and 29 conventionally. Comparison of the two groups showed a higher rate of residual-free resections in cases of CAS application. Furthermore, we demonstrate the use of navigated specimen taking called tumor mapping. This procedure enables the transparent, yet precise documentation of three-dimensional tumor borders which paves the way to a more feasible interdisciplinary exchange leading e.g. to a much more focused radiation therapy. Moreover, we evaluated the possibilities of primary midface reconstructions seizing CAS, especially in cases of infiltrated orbital floors. These cases needed reduction of intra-orbital volume due to the tissue loss after resection which could be precisely achieved by CAS. These benefits of CAS in midface reconstruction found expression in positive changes in quality of life. The present work was able to demonstrate that the area of oncological surgery of the midface is a prime example of interface optimization based on the sensible use of computer assistance. The fact that the system makes the patient transparent for the surgeon and the procedure controllable facilitates a more precise and safer treatment oriented to a better outcome.

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.

Computer-Assisted Surgery Using 3D Printed Saw Guides for Acute Correction of Antebrachial Angular Limb Deformities in Dogs

2019 ◽  
Vol 32 (03) ◽  
pp. 241-249 ◽  
Author(s):  
Andrew Worth ◽  
Katherine Crosse ◽  
Andrew Kersley
Keyword(s):  
Computer Aided Design ◽  
Sagittal Plane ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Computer Assisted Surgery ◽  
Computer Assisted ◽  
Computed Tomographic ◽  
Limb Deformities ◽  
Ct Data ◽  
Saw Blade

Objective The aim of this study was to report the use of custom saw guides produced using computed tomographic imaging (CT), computer simulation and three-dimensional (3D) printing to aid surgical correction of antebrachial deformities in six dogs. Materials and Methods Antebrachial limb deformities in four small, and two large, breed dogs (seven limbs) were surgically corrected by a radial closing wedge ostectomy and ulnar osteotomy. The location and orientation of the wedge ostectomy were determined using CT data, computer-assisted planning and production of a saw guide in plastic using a 3D printer. At surgery, the guide was clamped to the surface of the radius and used to direct the oscillating saw blade. The resultant ostectomy was closed and stabilized with a bone plate. Results Five limbs healed without complications. One limb was re-operated due to a poorly resolved rotational component of the deformity. One limb required additional stabilisation with external fixation due to screw loosening. The owners of five dogs completed a Canine Orthopedic Index survey at a follow-up period of 37 to 81 months. The median preoperative score was 3.5 and the median postoperative score was 1, representing an overall positive effect of surgery. Radiographically, 5/7 limbs were corrected in the frontal plane (2/7 were under-corrected). Similarly, 5/7 limbs were corrected in the sagittal plane, and 2/7 were over-corrected in the sagittal place. Conclusions Computer-aided design and rapid prototyping technologies can be used to create saw guides to simplify one-stage corrective osteotomies of the antebrachium using internal fixation in dogs. Despite the encouraging results, accurate correction of rotational deformity was problematic and this aspect requires further development.

Accuracy Assessment of Immediate and Delayed Implant Placements Using CAD/CAM Surgical Guides

2016 ◽  
Vol 42 (5) ◽  
pp. 391-398 ◽  
Author(s):  
Fawaz Alzoubi ◽  
Nima Massoomi ◽  
Anders Nattestad
Keyword(s):  
Accuracy Assessment ◽  
Computer Assisted ◽  
Apical Position ◽  
Surgical Guides ◽  
Computer Assisted Design ◽  
Significant Difference ◽  
Cad Cam ◽  
Delayed Group ◽  
Immediate Implant ◽  
Delayed Implant Placement

The aim of this study is to assess the accuracy of immediately placed implants using Anatomage Invivo5 computer-assisted design/computer-assisted manufacturing (CAD/CAM) surgical guides and compare the accuracy to delayed implant placement protocol. Patients who had implants placed using Anatomage Invivo5 CAD/CAM surgical guides during the period of 2012–2015 were evaluated retrospectively. Patients who received immediate implant placements and/or delayed implant placements replacing 1–2 teeth were included in this study. Pre- and postsurgical images were superimposed to evaluate deviations at the crest, apex, and angle. A total of 40 implants placed in 29 patients were included in this study. The overall mean deviations measured at the crest, apex, and angle were 0.86 mm, 1.25 mm, and 3.79°, respectively. The means for the immediate group deviations were: crest = 0.85 mm, apex = 1.10, and angle = 3.49°. The means for the delayed group deviations were: crest = 0.88 mm, apex = 1.59, and angle = 4.29°. No statistically significant difference was found at the crest and angle; however, there was a statistically significant difference between the immediate and delayed group at the apex, with the immediate group presenting more accurate placements at the apical point than the delayed group. CAD/CAM surgical guides can be reliable tools to accurately place implants immediately and/or in a delayed fashion. No statistically significant differences were found between the delayed and the immediate group at the crest and angle, however apical position was more accurate in the immediate group.

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

Improving Cutting Path on Custom 3D-Printed Surgical Guides for Bone-Tumor Resection

2019 ◽  
Author(s):  
Carlos G. Helguero ◽  
Juan Castro ◽  
César Ochoa ◽  
Fausto Maldonado ◽  
Emilio A. Ramírez ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Element Analysis ◽  
Surgical Guides ◽  
Orthopedic Oncology ◽  
3D Printed ◽  
Bone Tumor Resection ◽  
High Level ◽  
Cutting Path

Abstract Custom three-dimensional (3D) printed guides are being used in the operative room as an aid to surgeons for increasing the accuracy of their cutting and resection techniques. In terms of bone-tumor resection, the cutting path printed in the custom jig is significantly important for two main purposes: first, the required fit for the implant that will replace the resected bone section and, second, the interaction between the remaining, healthy bone and the new implant in terms of forces, stresses and deformation. Bone tumor resection has posed a challenge in orthopedic oncology, specifically due to a high level of difficulty in performing a limb-sparing surgery with negative margins on the remaining bone. A straight cutting path is usually used in clinical procedures due to the type of tooling available inside the operative room. 3D printed cutting path guides offer the possibility to evolve from a straight to a different path, e.g. a tapered path, and overcome fitting problems during surgery. This work investigates the current straight cutting path used for typical bone tumor resection and compares it to a proposed tapered cutting path in terms of both implant fitting and stress analysis. Finite element analysis software is used to simulate a compression force exerted over the femur bone. Different taper cut angles are studied and results are reported to obtain an ideal angle for resection. Results are presented to evidence the need to evolve from the current resection technique in order to minimize the number of revision surgeries and for a better quality of life of patients under this type of surgical procedure.

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