A Procedure for Designing Custom-Made Implants for Forehead Augmentation in People Suffering from Apert Syndrome

none5noThis paper presents a methodological procedure, based on the anatomical reconstruction and constrained deformation, to design custom-made implants for forehead augmentation in people affected by Apert syndrome, experiencing a frontal bone deficiency. According to the anthropometric theory, a cranial landmarks identification procedure was applied to retrieve, from a repository, a healthy skull, used as reference geometry for implant modelling. Then, using constrained deformation and free-form modelling techniques, it was possible to design a patient-specific implant. At last, the implant was realised using a custom mould, specially designed according to the patient’s needs to provide an accurate fit of the defect site. The design procedure was tested on a patient suffering from Apert syndrome. Three implants were virtually modelled and 3D-printed for pre-surgical evaluation. Their shapes were 3D compared with a reference one (handcrafted by a surgeon) to test the accuracy. Deviations are negligible, and the customised implant fulfilled the surgeon’s requirements.openMandolini M.; Caragiuli M.; Brunzini A.; Mazzoli A.; Pagnoni M.Mandolini, M.; Caragiuli, M.; Brunzini, A.; Mazzoli, A.; Pagnoni, M

Improvement In Cranioplasty: Advanced Prosthesis Biomanufacturing

Additive manufacturing (AM) is a technology that enables the production of models and prosthesis directly from the 3D CAD model facilitating surgical procedures, implant quality and reducing risks. Furthermore, the additive manufacturing has been used to produce implants especially designed for a particular patient, with sizes, shapes and mechanical properties optimized, in many areas of medicine such as cranioplasty surgery. This work presents AM technologies applied to design and manufacture of a biomodel, in fact, an implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used for creation of anatomic biomodel of the bone defect for the surgical planning as well as to design and manufacture of the patient-specific implant, reducing duration of surgery besides improving the surgical accuracy due to preoperative planning of the anatomical details. (C) 2015 The Authors. Published by Elsevier B.V.492032082nd CIRP Conference on Biomanufacturing (CIRP-BioM)JUL 29-31, 2015Manchester, ENGLAN

Synthetic skull bone defects for automatic patient-specific craniofacial implant design

Patient-specific craniofacial implants are used to repair skull bone defects after trauma or surgery. Currently, cranial implants are designed and produced by third-party suppliers, which is usually time-consuming and expensive. Recent advances in additive manufacturing made the in-hospital or in-operation-room fabrication of personalized implants feasible. However, the implants are still manufactured by external companies. To facilitate an optimized workflow, fast and automatic implant manufacturing is highly desirable. Data-driven approaches, such as deep learning, show currently great potential towards automatic implant design. However, a considerable amount of data is needed to train such algorithms, which is, especially in the medical domain, often a bottleneck. Therefore, we present CT-imaging data of the craniofacial complex from 24 patients, in which we injected various artificial cranial defects, resulting in 240 data pairs and 240 corresponding implants. Based on this work, automatic implant design and manufacturing processes can be trained. Additionally, the data of this work build a solid base for researchers to work on automatic cranial implant designs. Image Acquisition Matrix Size center dot Image Slice Thickness center dot craniofacial regionimaging technique center dot computed tomography Sample Characteristic - Organism Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13265225This investigation was approved by the internal review board (IRB) of the Medical University of Graz, Austria (IRB: EK-30-340 ex 17/18). This work was supported by CAMed (COMET K-Project 871132), which is funded by the Austrian Federal Ministry of Transport, Innovation and Technology (BMVIT) and the Austrian Federal Ministry for Digital and Economic Affairs (BMDW) and the Styrian Business Promotion Agency (SFG). Furthermore, the Austrian Science Fund (FWF) KLI 678-B31: "enFaced: Virtual and Augmented Reality Training and Navigation Module for 3D-Printed Facial Defect Reconstructions" and the TU Graz LEAD Project "Mechanics, Modeling and Simulation of Aortic Dissection". Privatdozent Dr. Dr. Jan Egger was supported as Visiting Professor by the Overseas Visiting Scholars Program from the Shanghai Jiao Tong University (SJTU) in China. Finally, we thank Professor Hannes Deutschmann, MD, from the Department of Radiology - Division of Neuroradiology, Vascular and Interventional Neuroradiology of the Medical University of Graz, for having kindly provided us with the source CT datasets used in this work

Additively manufactured versus conventionally pressed cranioplasty implants: An accuracy comparison

This article compared the accuracy of producing patient-specific cranioplasty implants using four different approaches. Benchmark geometry was designed to represent a cranium and a defect added simulating a craniectomy. An ‘ideal’ contour reconstruction was calculated and compared against reconstructions resulting from the four approaches –‘conventional’, ‘semi-digital’, ‘digital – non-automated’ and ‘digital – semi-automated’. The ‘conventional’ approach relied on hand carving a reconstruction, turning this into a press tool, and pressing titanium sheet. This approach is common in the UK National Health Service. The ‘semi-digital’ approach removed the hand-carving element. Both of the ‘digital’ approaches utilised additive manufacturing to produce the end-use implant. The geometries were designed using a non-specialised computer-aided design software and a semi-automated cranioplasty implant-specific computer-aided design software. It was found that all plates were clinically acceptable and that the digitally designed and additive manufacturing plates were as accurate as the conventional implants. There were no significant differences between the additive manufacturing plates designed using non-specialised computer-aided design software and those designed using the semi-automated tool. The semi-automated software and additive manufacturing production process were capable of producing cranioplasty implants of similar accuracy to multi-purpose software and additive manufacturing, and both were more accurate than handmade implants. The difference was not of clinical significance, demonstrating that the accuracy of additive manufacturing cranioplasty implants meets current best practice

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Integrated Methodologies and Technologies for the Design of Advanced Biomedical Devices

Biomedical devices with tailored properties were designed using advanced methodologies and technologies. In particular, design for additive manufacturing, reverse engineering, material selection, experimental and theoretical analyses were properly integrated. The focus was on the design of: i) 3D additively manufactured hybrid structures for cranioplasty; ii) technical solutions and customized prosthetic devices with tailored properties for skull base reconstruction after endoscopic endonasal surgery; iii) solid-lattice hybrid structures with optimized properties for biomedical applications. The feasibility of the proposed technical solutions was also assessed through virtual and physical models

Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants

Previously published evidence has established major clinical benefits from using Computer Aided Design (CAD), Computer Aided Manufacturing (CAM), and Additive Manufacturing (AM) to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use – particularly by the UK National Health Service (NHS). Oft-cited reasons for this slow uptake include: a higher up-front cost than conventionally-fabricated devices, material-choice uncertainty, and a lack of long-term follow-up due to their relatively recent introduction. This paper identifies a further gap in current knowledge – that of design rules, or key specification considerations for complex CAD/CAM/AM devices. This research begins to address the gap by combining a detailed review of the literature with first-hand experience of interdisciplinary collaboration on five craniofacial patient case-studies. In each patient case, bony lesions in the orbito-temporal region were segmented, excised, and reconstructed in the virtual environment. Three cases translated these digital plans into theatre via polymer surgical guides. Four cases utilised AM to fabricate titanium implants. One implant was machined from PolyEther Ether Ketone (PEEK). From the literature, articles with relevant abstracts were analysed to extract design considerations. 19 frequently-recurring design considerations were extracted from previous publications. 9 new design considerations were extracted from the case studies – on the basis of subjective clinical evaluation. These were synthesised to produce a design considerations framework to assist clinicians with prescribing and design engineers with modelling. Promising avenues for further research are proposed

DESIGN STRATEGIES AND ADDITIVE MANUFACTURING OF 3D CUSTOMIZED SCAFFOLDS WITH OPTIMIZED PROPERTIES FOR CRANIOFACIAL TISSUE ENGINEERING

3D customized scaffolds for craniofacial tissue engineering were designed using advanced strategies and technologies. Specifically, reverse engineering, additive manufacturing, material selection, experimental and theoretical analyses were properly integrated. The focus was on: i) design strategies of 3D customized nanocomposite scaffolds for hard tissue regeneration; ii) an engineered design of 3D additive manufactured nanocomposite scaffolds with optimized properties; iii) an approach toward the design of 3D customized scaffolds for large cranial defects

Applications of AM

In this chapter, three strategic domains of Additive Manufacturing application are presented: tool making, medicine and transportation, with main benefits and results obtained by application of AM. Chapter presents some of on-going or already finished project from mentioned AM application fields