Designe CAD/CAM kirurgisk guider Maxillary Genopbygningsagentur ved hjælp af en In-house tilgang
Summary
Metoder til at designe en computer-aided design/computer-aided manufacturing (CAD/CAM) kirurgisk vejledning er vist. Beskæringsplaner er adskilt, united og fortykket for at nemt visualisere den nødvendige knogle overførsel. Disse design kan være tre-dimensionelle trykt og kontrolleret for nøjagtighed.
Abstract
Computer-aided design/computer-assisteret fremstilling (CAD/CAM) vurderes nu som en forberedende teknik til maxillofacial kirurgi. Fordi denne teknik er dyre og fås i kun begrænsede områder i verden, udviklet vi en roman CAD/CAM kirurgisk guide ved hjælp af en in-house tilgang. Ved hjælp af CAD-software, bestemmes området maxillary resektion og beskæringsplaner og fibular beskæringsplaner og vinkler. Når området resektion er besluttet, er de nødvendige ansigter udvundet ved hjælp af en boolesk modifikator. Disse overfladiske ansigter er forenet til passer til overfladen af knoglerne og fortykket at stabilisere legemer. Ikke kun opskæring guider for fibula og maxilla men også arrangementet placering af de overførte knogle segmenter er defineret ved fortykkelse de overfladiske ansigter. CAD-design er registreret som .stl filer og tre dimensioner (3-D) udskrives som faktiske kirurgisk guider. For at kontrollere nøjagtigheden af guiderne, er model operation ved hjælp af udskrives 3 3-d facial og fibular modeller udført. Disse metoder kan bruges til at hjælpe kirurger hvor kommercielle hjælpelinjer er ikke tilgængelige.
Introduction
Anvendelsen af CAD/CAM teknik har for nylig øget i dental og protese arbejde. Efter denne udvikling af CAD/CAM, osteocutaneous klap overførsler via CAD/CAM anvendes nu i feltet af mandibular genopbygning efter en oncologic bred resektion af maligne tumorer1,2,3. Flere selskaber i de vestlige lande er begyndt at levere og sælge en CAD/CAM skære guide for regionen underkæben. En CAD/CAM rekonstruktion af mandiblen er anset for at have en fordel i form af nøjagtighed4,5,6,7,8,9,10 ,11. En ulempe er imidlertid, at denne teknik er tilgængelig i begrænsede områder over hele verden og det er meget dyrt12. Således har CAD/CAM genopbygning for maxillary læsioner ikke endnu blevet populær. Antallet af tilfælde af maxillary genopbygning er lavere end for mandiblen, og kommercielle guider er ikke almindelig.
Fordi kommercielle maxillary CAD/CAM guider ikke er solgt i Japan, har vi udviklet CAD/CAM kirurgisk hjælpelinjer ved hjælp af en in-house tilgang. Den kliniske effektivitet af CAD/CAM guider er allerede blevet rapporteret13,14,15,16,17,18,19, men der er ingen rapport om, hvordan at designe dem. Formålet med den foreliggende betænkning er at vise metoden CAD/CAM design ved hjælp af en billig in-house tilgang.
Protocol
Representative Results
Discussion
CAD/CAM genopbygning anses for at bidrage til virkeliggørelsen af en nøjagtig osteotomi længde, bredde og vinkel i skæring knogler mens du bruger skære guider4,5,6,7,8 ,9,10,11,12,13</sup…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Dette arbejde blev delvist støttet af JSP’ER KAKENHI Grant nummer JP17K11914.
Materials
| Information Technology Center, Renato Archer, Campinas, Brazil | InVesalius | Free software https://www.cti.gov.br/en/invesalius | |
| The Blender Foundation, Amsterdam, Netherlands | Blender | Free software https://www.blender.org/ | |
| TurboSquid, Inc. 935 Gravier St., Suite 1600, New Orleans, LA. | Free 3D skeletal data file | Free3D https://free3d.com/3d-models/human | |
| MakerBot Industries, LLC One MetroTech Center, 21st Fl, Brooklyn, NY. | MakerBot Replicator+ | https://www.makerbot.com/replicator/ | |
| YouTube (Google, Inc.), 901 Cherry Ave. San Bruno, CA | video sharing website. | https://www.youtube.com/results?search_query=invesalius+dicom+to+stl | |
| Artec 3D, 2, rue Jean Engling, Luxembourg | Artec Eva Lite | https://www.artec3d.com/portable-3d-scanners/artec-eva-lite | |
| CloudCompare | CloudCompare | http://www.danielgm.net/cc/ |
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