The application of 3D printed surgical guides in resection and reconstruction of malignant bone tumor

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.

Download Full-text

Quantifying Discrepancies at Positioning Custom 3D-Printed Surgical Guides for Bone Tumor Resection

Advances in Manufacturing, Production Management and Process Control - Advances in Intelligent Systems and Computing ◽

10.1007/978-3-030-51981-0_13 ◽

2020 ◽

pp. 103-109

Author(s):

Carlos G. Helguero ◽

Fausto Maldonado ◽

Emilio A. Ramirez ◽

Paulina Arnés Urgellés ◽

Jorge Hurel ◽

...

Keyword(s):

Bone Tumor ◽

Tumor Resection ◽

Surgical Guides ◽

3D Printed ◽

Bone Tumor Resection

Download Full-text

Accuracy of Guided Implant Surgery in the Edentulous Jaw Using Desktop 3D-Printed Mucosal Supported Guides

Journal of Clinical Medicine ◽

10.3390/jcm10030391 ◽

2021 ◽

Vol 10 (3) ◽

pp. 391

Author(s):

Rani D’haese ◽

Tom Vrombaut ◽

Geert Hommez ◽

Hugo De Bruyn ◽

Stefan Vandeweghe

Keyword(s):

In Vitro Study ◽

Angular Deviation ◽

Implant Surgery ◽

Implant Position ◽

Surgical Guides ◽

Negative Effect ◽

Bone Level ◽

3D Printed ◽

Implant Alignment

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.

Download Full-text

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

European Journal of Medical Research ◽

10.1186/s40001-021-00495-w ◽

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.

Download Full-text