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

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

Computer-aided position planning of miniplates to treat facial bone defects

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon's desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.Comment: 19 pages, 13 Figures, 2 Table

The application of virtual reality and augmented reality in oral & maxillofacial surgery

Background: Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery. Methods: We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included. Results: We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training. Conclusion: Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education

THREE-DIMENSIONAL MODEL PRINTING IN ORAL AND MAXILLOFACIAL RECONSTRUCTIVE SURGERY: COMPARISON OF THREE-DIMENSIONAL MODELS AND MULTISLICE COMPUTED TOMOGRAPHY SCANS

Objective: The objective of this study is to compare fabrication of commonly used three-dimensional (3D) models with original multislice computed tomography (MSCT) scan data for accuracy and precision in reconstruction surgery.Methods: MSCT data from 10 samples are processed and manufactured to be 3D models. Both groups are then measured and analyzed for the purpose of comparison.Results: The average mandibular measurement difference between 3D models and MSCT scans is 0.26 mm more <2%. The final results of the comparison reveal high accuracy in 3D models compared to MSCT scan data.Conclusion: The 3D model could be considered as surgical guidance for maxillofacial reconstruction surgery since it yields highly accurate results

Calculation of bone graft volume using 3D reconstruction system

Objectives: To obtain bone ?bioreplicas? for determining precisely the amount of biomaterial required for bone regeneration procedure. Study design: A case-control comparison with a total sample size of 20 cases, 10 control and 10 test samples. ?Bioreplicas? were generated from helical CAT scans with 0.5 mm slices, without 3D reconstruction or image filters. Bone defects in premolar and molar areas were treated with titanium mesh and xenograft (MP3) combined with resorbable carriers. Time taken to carry out procedures with and without the use of ?bioreplicas? (in minutes), discrepancies between the grafts performed with and without ?bioreplicas? and bone defects (mm), and postoperative complications were registered. Results: No significant differences were recorded for measurements of width and length of bone defect between patient bone and the biological models. Conclusions: The use of ?bioreplicas? obtained by rapid prototyping is effective in treatment planning

Colour Image Reproduction for 3D Printing Facial Prostheses

In this chapter, using colour 3D printing technology, a 3D colour image reproduction system is detailed for the semi-automated and accurate additive manufacturing of facial soft tissue prostheses. A protocol for 3D colour image reproduction was designed based on the six steps of processing. For this specific application, protocols for each sub‐process required development and details of each technique applied are discussed. The quality of facial prostheses was evaluated through objective measurement and subjective assessment. The results demonstrated that the proposed colour reproduction system can be effectively used to produce accurate skin colour with fine textures over a 3D shape, with significant savings in both time and cost when compared to traditional techniques

Evaluation of the accuracy of surgical reconstruction of mandibular defects when using navigation templates and patient-specific titanium implants

The management of patients with post-traumatic and post-operative mandibular defects is a major challenge even for experienced surgeons. Performing traditional reconstructive interventions with the use of bone autografts is always confronted with the problem of inconsistency between the shape, architecture, a biological. An alternative to conventional bone grafting is the use of digital protocol and CAD /CAMtechnology, which allows fabricating different types of customised medical devices. All patients underwent reconstructive and restoring interventions with the use of patient-specific titanium implants guided by a full digital protocol.Patients were examined in compliance with the standard scheme. To repair the defects, PSIs were fabricated with the use of selective laser sintering of titanium.The introduction of digital technologies and computer technique of diagnosing, planning and implementation of surgical interventions has been the main direction aimed at the improving the accuracy and predictability of reconstructive restorative surgery. Among the main achievements in this direction are the improvement of software and methods of computer modeling, as well as the introduction of CAD /CAMtechnology.The use of CAD /CAMtechnologies, in particular, navigational surgical templates and patient-specific implants for the repair of mandibular defects ensures a high level of accuracy and predictability