CAD-CAM Prosthesis in Maxillo-Facial Surgery

2010 ◽  
Vol 139-141 ◽  
pp. 1241-1244 ◽  
Author(s):  
Singare Sekou ◽  
Shou Yan Zhong ◽  
Guang Hui Xu ◽  
Wei Ping Wang ◽  
Jian Jun Zhou
Keyword(s):  
Maxillofacial Surgery ◽  
Bony Defect ◽  
Imaging Data ◽  
Surgery Outcome ◽  
Facial Surgery ◽  
Custom Made ◽  
Cad Cam ◽  
Computer Based ◽  
Modern Manufacturing ◽  
Custom Made Prostheses

To improve the maxillofacial surgery outcome, modern manufacturing methods such as rapid prototyping (RP), reverse engineering (RE) and medical imaging data have been utilised to manufacture custom-made prostheses after previous failed reconstructive surgery. After acquisition of data, an individual computer-based 3D model of the bony defect was generated and transferred into RE software to create the prosthesis CAD model. Then the physical model of the prosthesis was fabricated by RP technique. The precise fit of the prosthesis was evaluated using the prosthesis and skull models. The prosthesis was then directly used in investment casting such as “Quick Cast” pattern to produce the titanium model. In the clinical reports presented here, reconstructions of one patient with large mandible bone defects were performed using this method. The custom prostheses perfectly fit the defects during the operations, and surgery time was reduced. These cases showed that the prefabrication of a prosthesis using modern manufacturing technology is an effective method for maxillofacial defect reconstruction.

Fabrication of Maxillofacial Implant Using CAD CAM System

2010 ◽  
Vol 146-147 ◽  
pp. 353-356
Author(s):  
Se Kou Singare ◽  
Li Wang ◽  
Shou Yan Zhong ◽  
Guang Hui Xu ◽  
Wei Ping Wang ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
3D Model ◽  
Maxillofacial Surgery ◽  
Bone Defects ◽  
Bony Defect ◽  
Cad Cam ◽  
Computer Based ◽  
3D Acquisition ◽  
Aided Design ◽  
Individual Implant

We present an approach that combines Computer Tomography (CT), reverse engineering (RE) and rapid prototyping (RP) for individual implant production in maxillofacial surgery. 3D acquisition of the patient’s skull is performed, after acquisition of data; an individual computer-based 3D model of the bony defect is generated. These data are transferred into RE software to create the implant using a computer-aided design (CAD) model, which is directed into the RP machine for the production of the physical model. The implant is then directly used in investment casting such as “Quick Cast” pattern to produce the titanium model. In the clinical reports presented here, reconstructions of one patient with mandible bone defects were performed using this method. The custom prostheses perfectly fit the defects during the operations, and surgery time was reduced.

Managing the Edentulous Mandible using Recent Technological Developments: A Case Study

2013 ◽  
Vol 2 (2) ◽  
pp. 50-54
Author(s):  
Ashok Sethi ◽  
Thomas Kaus ◽  
Naresh Sharma ◽  
Peter Sochor
Keyword(s):  
Computed Tomography ◽  
Spatial Information ◽  
Imaging Techniques ◽  
Accurate Information ◽  
Imaging Data ◽  
Surgical Guide ◽  
Prosthetic Reconstruction ◽  
Anterior Teeth ◽  
Edentulous Mandible ◽  
Cad Cam

Safe clinical practice in implant dentistry requires an accurate investigation of the availability of bone for implant placement and the avoidance of critical anatomical structures. Modern imaging techniques using computed tomography (CT) and cone beam computed tomography (CBCT) provide the clinician with the required information. The imaging thus obtained provides accurate representation of the height, width and length of the available bone.1 In addition, whenever adequate radiation dose is used, accurate information about the bone density in Hounsfield units can be obtained. Important spatial information regarding the orientation of the ridges and the relationship to the proposed prosthetic reconstruction can be obtained with the aid of radiopaque templates during the acquisition of CT scan data. Modern software also provides the facility to decide interactively upon the positioning of the implants and is able to relate this to a stereolithographic model constructed from the imaging data. A surgical guide for the accurate positioning of the implants can be constructed. The construction of screw retained prostheses is fraught with difficulties regarding the accuracy of the construction. Accurate fit of the prosthesis is difficult to obtain due to the inherent errors in impression taking, component discrepancies, investing and casting inaccuracies.2,3 CAD/CAM technology eliminates the inaccuracies involved with the investing and casting of superstructures. Clinical Case This case describes the management of an 84 year old female patient, who had recently lost her remaining mandibular anterior teeth. This resulted in the patient's inability to wear conventional dentures in the mandible.

Limb-salvage reconstruction following resection of pelvic bone sarcomas involving the acetabulum

2021 ◽  
Vol 103-B (4) ◽  
pp. 795-803
Author(s):  
Tomohiro Fujiwara ◽  
Manuel Ricardo Medellin Rincon ◽  
Andrea Sambri ◽  
Yusuke Tsuda ◽  
Rhys Clark ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Major Complication ◽  
Ice Cream ◽  
Pelvic Bone ◽  
Limb Salvage Surgery ◽  
Consecutive Series ◽  
Major Complications ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Limb salvage for pelvic sarcomas involving the acetabulum is a major surgical challenge. There remains no consensus about what is the optimum type of reconstruction after resection of the tumour. The aim of this study was to evaluate the surgical outcomes in these patients according to the methods of periacetabular reconstruction. Methods The study involved a consecutive series of 122 patients with a periacetabular bone sarcoma who underwent limb-salvage surgery involving a custom-made prosthesis in 65 (53%), an ice-cream cone prosthesis in 21 (17%), an extracorporeal irradiated autograft in 18 (15%), and nonskeletal reconstruction in 18 (15%). Results The rates of major complications necessitating further surgery were 62%, 24%, 56%, and 17% for custom-made prostheses, ice-cream cone prostheses, irradiated autografts and nonskeletal reconstructions, respectively (p = 0.001). The ten-year cumulative incidence of failure of the reconstruction was 19%, 9%, 33%, and 0%, respectively. The major cause of failure was deep infection (11%), followed by local recurrence (6%). The mean functional Musculoskeletal Tumour Society (MSTS) scores were 59%, 74%, 64%, and 72%, respectively. The scores were significantly lower in patients with major complications than in those without complications (mean 52% (SD 20%) vs 74% (SD 19%); p < 0.001). For periacetabular resections involving the ilium, the mean score was the highest with custom-made prostheses (82% (SD 10%)) in patients without any major complication; however, nonskeletal reconstruction resulted in the highest mean scores (78% (SD 12%)) in patients who had major complications. For periacetabular resections not involving the ilium, significantly higher mean scores were obtained with ice-cream cone prostheses (79% (SD 17%); p = 0.031). Conclusion Functional outcome following periacetabular reconstruction is closely associated with the occurrence of complications requiring further surgery. For tumours treated with periacetabular and iliac resection, skeletal reconstruction may result in the best outcomes in the absence of complications, whereas nonskeletal reconstruction is a reasonable option if the risk of complications is high. For tumours requiring periacetabular resection without the ilium, reconstruction using an ice-cream cone prosthesis supported by antibiotic-laden cement is a reliable option. Cite this article: Bone Joint J 2021;103-B(4):795–803.

Maxillofacial surgery

2014 ◽  
pp. 463-501 ◽  
Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul
Keyword(s):  
Life Support ◽  
Maxillofacial Surgery ◽  
Soft Tissue Injuries ◽  
Advanced Trauma Life Support ◽  
Mandibular Fractures ◽  
Facial Soft Tissue ◽  
Salivary Gland Tumours ◽  
Preprosthetic Surgery ◽  
Facial Surgery ◽  
Primary Management

Contents. Advanced trauma life support (ATLS). Primary management of maxillofacial trauma. Assessing head injury. Mandibular fractures. Mid-face fractures. Nasal and malar fractures. Treatment of facial fractures. Facial soft-tissue injuries. Surgery and the temporomandibular joint. Major preprosthetic surgery. Clefts and craniofacial anomalies. Orthognathic surgery. Salivary gland tumours. Surgery of the salivary glands. Facial skin cancer. Oral cancer. Neck lumps. Flaps and grafts. Aesthetic facial surgery.

Early to medium-term outcomes of uncemented ceramic-bearing total hip arthroplasty in teenagers for paediatric hip conditions

2020 ◽  
Vol 102-B (11) ◽  
pp. 1491-1496
Author(s):  
Pranai K. Buddhdev ◽  
Ivor S. Vanhegan ◽  
Tahir Khan ◽  
Aresh Hashemi-Nejad
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Adolescent And Young Adult ◽  
Medium Term ◽  
Total Hip ◽  
Custom Made ◽  
The Mean ◽  
Custom Made Prostheses

Aims Despite advances in the treatment of paediatric hip disease, adolescent and young adult patients can develop early onset end-stage osteoarthritis. The aims of this study were to address the indications and medium-term outcomes for total hip arthroplasty (THA) with ceramic bearings for teenage patients. Methods Surgery was performed by a single surgeon working in the paediatric orthopaedic unit of a tertiary referral hospital. Databases were interrogated from 2003 to 2017 for all teenage patients undergoing THA with a minimum 2.3 year follow-up. Data capture included patient demographics, the underlying hip pathology, number of previous surgeries, and THA prostheses used. Institutional ethical approval was granted to contact patients for prospective clinical outcomes and obtain up-to-date radiographs. In total, 60 primary hips were implanted in 51 patients (35 female, 16 male) with nine bilateral cases. The mean age was 16.7 years (12 to 19) and mean follow-up was 9.3 years (2.3 to 16.8). Results The most common indication for teenage hip arthroplasty was avascular necrosis secondary to slipped upper femoral epiphysis (31%; n = 16). Overall, 64% of patients (n = 33) had undergone multiple previous operations. The survival at follow-up was 97%; two patients required revision for aseptic loosening (one femoral stem, one acetabular component). Both patients had fused hips noted at the time of arthroplasty. A further two patients had radiolucent lines but were asymptomatic. At latest follow-up the mean Oxford Hip Score was 44 (31 to 48) and a Visual Analogue Scale measurement of 1.5, indicating satisfactory function. Conclusion Operating on this cohort can be complicated by multiple previous surgeries and distorted anatomy, which in some cases require custom-made prostheses. We have demonstrated a good outcome with low revision rate in this complex group of patients. Cite this article: Bone Joint J 2020;102-B(11):1491–1496.

scholarly journals Integrated Interface Development Environment using STEP Universal Data Structure

2018 ◽  
Vol 7 (2.15) ◽  
pp. 27 ◽  
Author(s):  
T M.S. Tg Sulaiman ◽  
S B. Mohamed ◽  
M Minhat ◽  
A S. Mohamed ◽  
A R. Mohamed
Keyword(s):  
Data Structure ◽  
Relevant Information ◽  
Design Development ◽  
Product Model ◽  
Input Language ◽  
Development Environment ◽  
3D Cad ◽  
Cad Cam ◽  
G Code ◽  
Modern Manufacturing

Nowadays modern manufacturing demands advanced computer controller, having higher input language and less proprietary vendor dependencies. STEP stands for Standard for the Exchange of Product model data is the next generation of data model between CAD/CAM and CNC system. STEP is still under research and development all around the world. This paper describes the design, development and testing of an integrated Interface development environment for STEP file using Universal Data Structure, which aims to provide support for machining operation.  The system also aims to provide function of reading and extracting the relevant information associated with the machining data and to write the G-Code file. The sample of machined block is designed from 3D CAD modeler which consisted of features need to be machined from a blank workpiece and saved in the STEP file format. The validation process will be done using the simulation in the Mach3 software.  

scholarly journals Xeno-Hybrid Composite Scaffold Manufactured with CAD/CAM Technology for Horizontal Bone-Augmentation in Edentulous Atrophic Maxilla: A Short Communication

2020 ◽  
Vol 10 (8) ◽  
pp. 2659 ◽  
Author(s):  
Maria Paola Cristalli ◽  
Gerardo La Monaca ◽  
Nicola Pranno ◽  
Susanna Annibali ◽  
Giovanna Iezzi ◽  
...  
Keyword(s):  
Short Communication ◽  
Bone Structure ◽  
Bovine Bone ◽  
Ridge Augmentation ◽  
Additional Surgery ◽  
Custom Made ◽  
Atrophic Maxilla ◽  
Computer Aided ◽  
Cad Cam ◽  
Deproteinized Bovine Bone

The present short communication described a new procedure for the reconstruction of the horizontal severely resorbed edentulous maxilla with custom-made deproteinized bovine bone block, fabricated using three-dimensional imaging of the patient and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The protocol consisted of three phases. In the diagnosis and treatment planning, cone-beam computed tomographic scans of the patient were saved in DICOM (digital imaging and communication in medicine) format, anatomic and prosthetic data were imported into a dedicated diagnostic and medical imaging software, the prosthetic-driven position of the implants, and the graft blocks perfectly adapted to the residual bone structure were virtually planned. In the manufacturing of customized graft blocks, the CAD-CAM technology and the bovine-derived xenohybrid composite bone (SmartBone® on Demand - IBI SA - Industrie Biomediche Insubri SA Switzerland) were used to fabricate the grafts in the exact shape of the 3D planning virtual model. In the surgical and prosthetic procedure, the maxillary ridge augmentation with custom-made blocks and implant-supported full-arch screw-retained rehabilitation were performed. The described protocol offered some advantages when compared to conventional augmentation techniques. The use of deproteinized bovine bone did not require additional surgery for bone harvesting, avoided the risk of donor site morbidity, and provided unlimited biomaterial availability. The customization of the graft blocks reduced the surgical invasiveness, shorting operating times because the manual shaping of the blocks and its adaptation at recipient sites are not necessary and less dependent on the clinician’s skill and experience.

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