Health as a Symbolic Media Interchanging between Body and Social System

Genetics of disease, diagnosis and treatmen

3-D stereophotogrammetry in oral- and maxillofacial surgery

Contains fulltext : 98585.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 19 september 2012Promotores : Bergé, S.J., Kuijpers-Jagtman, A.M. Co-promotor : Borstlap, W.A

Integration of digital dental casts in cone-beam computed tomography scans

Contains fulltext : 108380.pdf (publisher's version ) (Open Access)Cone-beam computed tomography (CBCT) is widely used in maxillofacial surgery. The CBCT image of the dental arches, however, is of insufficient quality to use in digital planning of orthognathic surgery. Several authors have described methods to integrate digital dental casts into CBCT scans, but all reported methods have drawbacks. The aim of this feasibility study is to present a new simplified method to integrate digital dental casts into CBCT scans. In a patient scheduled for orthognathic surgery, titanium markers were glued to the gingiva. Next, a CBCT scan and dental impressions were made. During the impression-taking procedure, the titanium markers were transferred to the impression. The impressions were scanned, and all CBCT datasets were exported in DICOM format. The two datasets were matched, and the dentition derived from the scanned impressions was transferred to the CBCT of the patient. After matching the two datasets, the average distance between the corresponding markers was 0.1 mm. This novel method allows for the integration of digital dental casts into CBCT scans, overcoming problems such as unwanted extra radiation exposure, distortion of soft tissues due to the use of bite jigs, and time-consuming digital data handling

Canalis mandibulae bifidus en trifidus. Een toevalsbevinding.

Contains fulltext : 83453.pdf (publisher's version ) (Open Access)3 p

Fusion of intra-oral scans in cone-beam computed tomography scans

Contains fulltext : 232756.pdf (Publisher’s version ) (Open Access)PURPOSE: The purpose of this study was to evaluate the clinical accuracy of the fusion of intra-oral scans in cone-beam computed tomography (CBCT) scans using two commercially available software packages. MATERIALS AND METHODS: Ten dry human skulls were subjected to structured light scanning, CBCT scanning, and intra-oral scanning. Two commercially available software packages were used to perform fusion of the intra-oral scans in the CBCT scan to create an accurate virtual head model: IPS CaseDesigner® and OrthoAnalyzer™. The structured light scanner was used as a gold standard and was superimposed on the virtual head models, created by IPS CaseDesigner® and OrthoAnalyzer™, using an Iterative Closest Point algorithm. Differences between the positions of the intra-oral scans obtained with the software packages were recorded and expressed in six degrees of freedom as well as the inter- and intra-observer intra-class correlation coefficient. RESULTS: The tested software packages, IPS CaseDesigner® and OrthoAnalyzer™, showed a high level of accuracy compared to the gold standard. The accuracy was calculated for all six degrees of freedom. It was noticeable that the accuracy in the cranial/caudal direction was the lowest for IPS CaseDesigner® and OrthoAnalyzer™ in both the maxilla and mandible. The inter- and intra-observer intra-class correlation coefficient showed a high level of agreement between the observers. CLINICAL RELEVANCE: IPS CaseDesigner® and OrthoAnalyzer™ are reliable software packages providing an accurate fusion of the intra-oral scan in the CBCT. Both software packages can be used as an accurate fusion tool of the intra-oral scan in the CBCT which provides an accurate basis for 3D virtual planning

Oromandibular Reconstruction Using 3D Planned Triple Template Method

Item does not contain fulltextPURPOSE: Reconstruction of an oromandibular defect remains one of the most formidable surgical challenges faced by the reconstructive head and neck surgeon. The purpose of this study was to illustrate the added value of 3D imaging and planning in oromandibular reconstruction. MATERIALS AND METHODS: A 41-year-old dentate male patient with T2N0M0 osteosarcoma of the mandible required segmental resection of the lateral mandible. In a virtual environment, the bony resection and reconstruction were planned preoperatively based on computed tomographic data of the head and neck and lower leg. Three custom-made templates designed in a computer-assisted design and manufacturing software package and materialized by a selective laser sintering process (DuraForm PA, 3D Worknet, Ede, Netherlands) were used to transfer this planning to the operating theater. RESULTS: During the operative procedure, the 3 templates allowed for a rapid and accurate execution of the different surgical steps, ie, establishing the bony surgical margins and resection of the mandible (first template), cutting of the fibula while being pedicled to the leg (second template), and placement of the fibula to the donor site (third template). CONCLUSION: Computer-aided surgery and planning using the 3-template method lead to an accurate and oncologically safe reconstruction of the mandibular geometry by eliminating intraoperative decision making, shortening ischemic time of the fibular graft, and shortening overall operative time

Applications and limitations of using patient-specific 3D printed molds in autologous breast reconstruction

Contains fulltext : 195860.pdf (Publisher’s version ) (Open Access