Maxillofacial prostheses challenges in resource constrained regions

Background: This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. Method: A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results: Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. Conclusion: In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities

New Trends in 3D Printing

A quarter century period of the 3D printing technology development affords ground for speaking about new realities or the formation of a new technological system of digital manufacture and partnership. The up-to-date 3D printing is at the top of its own overrated expectations. So the development of scalable, high-speed methods of the material 3D printing aimed to increase the productivity and operating volume of the 3D printing machines requires new original decisions. It is necessary to study the 3D printing applicability for manufacturing of the materials with multilevel hierarchical functionality on nano-, micro- and meso-scales that can find applications for medical, aerospace and/or automotive industries. Some of the above-mentioned problems and new trends are considered in this book

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

Manufacturing of custom-made medical implants for cranio / maxillofacial and orthopaedic surgery - an overview of the current state of the industry

Published ArticleExtensive work has been done in the area of manufacturing implants for medical purposes, and more recently the development of customised implants. Areas of application include cranio/maxillo-facial implants, dental drill guides, hip, knee and shoulder replacements, as well as different implants for the spine. Due to their high prevalence and complex anatomical geometry the purpose of this study is to investigate the current state of the industry regarding customised medical implants for cranio/maxillofacial and orthopaedic surgery. Implant customisation has far-reaching benefits, and a collective approach to solving current difficulties will require an in-depth study of successes already achieved. Several issues in this regard are examined, including what defines customisation, regulatory issues that govern customisation and design constraints, trends in different areas of application, suitable materials, and finally which manufacturing techniques are being employed, with a focus on the use of Layer Manufacturing technologies and their role in custom-made medical implants

Characterisation of Implant Supported Soft Tissue Prostheses Produced with 3D Colour Printing Technology

The numbers of patients needing facial prostheses has increased in the last few decades due to improving cancer survival rates. The many limitations of the handmade prostheses together with rapid expansion of prototyping in all directions, particularly in producing human anatomically accurate parts, have raised the question of how to employ this technology for rapid manufacturing of facial soft tissue prostheses. The idea started to grow and the project was implemented based on CAD/CAM principles – additive manufacturing technology, by employing layered fabrication of facial prostheses from starch powder and a water based binder and infiltrated with a silicone polymer (SPIS). The project aimed to produce a facial prosthesis by using 3D colour printing, which would match the patient’s skin shade and have the desirable mechanical properties, through a relatively low cost process that would be accessible to the global patient community. This was achieved by providing a simple system for data capture, design and reproducible method of manufacture with a clinically acceptable material. The prosthesis produced has several advantages and few limitations when compared to existing products/prostheses made from silicone polymer (SP). The mechanical properties and durability were not as good as those of the SP made prosthesis but they were acceptable, although the ideal properties have yet to be identified. Colour reproduction and colour matching were more than acceptable, although the colour of the SPIS parts was less stable than the SP colour under natural and accelerated weathering conditions. However, it is acknowledged that neither of the two methods used represent the natural life use on patients and the deficiencies demonstrated in terms of mechanical properties and colour instability were partially inherent in the methodology used, as the project was still at the developmental stage and it was not possible to apply real life tests on patients. Moreover, deficiencies in mechanical and optical properties were probably caused by the starch present, which was used as a scaffold for the SP. Furthermore, a suitable retention system utilising existing components was designed and added to the prosthesis. This enabled the prosthesis to be retained by implants with no need for the addition of adhesive. This would also help to prolong the durability and life span of the prosthesis. The capability of the printer to produce skin shades was determined and it was found that all the skin colours measured fall within the range of the 3D colour printer and thereby the printer was able to produce all the colours required. Biocompatibility was also acceptable, with a very low rate of toxicity. However, no material is 100% safe and each material has a certain range of toxicity at certain concentrations. At this stage of the project, it can be confirmed that facial prostheses were successfully manufactured by using 3D colour printing to match the patient’s skin shade, using biocompatible materials and having the desirable mechanical properties. Furthermore, the technology used enabled prostheses to be produced in a shorter time frame and at a lower cost than conventional SP prostheses. They are also very lightweight, easier to use and possibly more comfortable for the patients. Moreover, this technology has the capability of producing multiple prostheses at the time of manufacture at reduced extra cost, whilst the data can be saved and can be utilised/modified for producing further copies in the future without having to going through all the steps involved with handmade prostheses. Based on the mechanical properties and colour measurements the prostheses will have a finite service life and the recommendation is that these prostheses will need replacing every 6 to 12 months, depending on how the patient handles and maintains the prostheses and whether the prosthesis is being used as an interim or definitive prosthesis. This was largely comparable to existing prostheses but without the time and cost implications for replacement. However, it is acknowledged that further investigations and clinical case studies are required to investigate the “real life” effect on the prostheses and to get feedback from the patients in order to make appropriate improvements to the mechanical properties and the durability of the prosthesis

Role of Computer Technology in Changing Smile

In the ever changing complex society, where success has become a mantra for both young and old, facial appearance that includes smile, plays a pivotal role. Among many attractive components in a person’s face, smile reflects the persona of an individual. In the present day next gen age, science in unison with technology and techniques which are rapidly getting ingrained into day to day dental practice, has changed the perception of healthy smile by more effective and less invasive approach. In this scenario, the onus lies on the dentist to give that perfectionist touch to a customised smile using computer aided software and hardware apparatus, and to avail the best state of the art material, equipment and techniques. Hence, it is imperative for us to understand and inculcate the role of modern cutting edge computer-aided technologies used in designing and changing the smile of an individual

3D-printing techniques in a medical setting : a systematic literature review

Background: Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Methods: Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. Results: 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. Conclusion: 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D- printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis