Utforme CAD/CAM kirurgisk guider Maxillary gjenoppbygging bruker interne tilnærming
Summary
Metoder for å utforme en dataassistert design/datamaskinassistert produksjon (CAD/CAM) kirurgisk guide vises. Skjæringsplanene atskilt, united og tykkere for å enkelt visualisere nødvendig bein overføringen. Designene kan være tredimensjonale trykt og sjekket for nøyaktighet.
Abstract
Dataassistert design/computer-assistert produksjon (CAD/CAM) nå evalueres som en preparative teknikk for maxillofacial kirurgi. Denne teknikken er dyrt og tilgjengelig i bare begrensede områder av verden, utviklet vi en roman CAD/CAM kirurgisk guide bruke interne tilnærming. Ved hjelp av CAD-programvaren, bestemmes maxillary resection området og skjæringsplan og fibular skjæringsplan og vinkler. Når området reseksjon er bestemt, pakkes de nødvendige ansiktene bruker en boolsk modifikator. Disse overfladiske ansikter er samlet for å passe på overflaten av bein og fortykket å stabilisere faste stoffer. Ikke bare kutte guider for fibula og maxilla men også plassering ordningen av de overførte Ben segmentene defineres av jevning overfladisk ansikter. CAD design registreres som .stl filer og tredimensjonalt (3D) skrives ut som faktisk kirurgisk guider. For å sjekke nøyaktigheten av guider, utføres modell kirurgi med 3-D-trykt ansikts- og fibular modeller. Disse metodene kan brukes å hjelpe kirurger der kommersielle guider er ikke tilgjengelig.
Introduction
Bruk av CAD/CAM teknikker har nylig økt i dental og protese arbeid. Etter denne utviklingen av CAD/CAM, osteocutaneous klaff overføringer ved hjelp av CAD/CAM er nå brukt innen mandibular gjenoppbygging etter en oncologic bredt eksisjon ondsinnethet svulst1,2,3. Flere selskaper i vestlige land har begynt å levere og selge en CAD/CAM kutte guide for regionen mandible. En CAD/CAM rekonstruksjon av mandible anses å ha en fordel i forhold til nøyaktigheten4,5,6,7,8,9,10 ,11. En ulempe er imidlertid at denne teknikken er tilgjengelig i begrensede områder over hele verden og det er svært dyrt12. Dermed har CAD/CAM gjenoppbygging etter maxillary leksjonen ennå ikke blitt populære. Antall tilfeller av maxillary gjenoppbygging er lavere enn for mandible kommersielle guider er ikke vanlig.
Fordi kommersielle maxillary CAD/CAM guider ikke selges i Japan, har vi utviklet CAD/CAM kirurgisk guider med interne tilnærming. Klinisk effektiviteten av CAD/CAM guider allerede er rapportert13,14,15,16,17,18,19, men det er ingen rapport om hvordan du utformer dem. Formålet med rapporten finnes er å vise metoden for CAD/CAM-design med en rimelig in-house tilnærming.
Protocol
Representative Results
Discussion
CAD/CAM rekonstruksjon anses å bidra til oppnåelse av en nøyaktig osteotomi lengde, bredde og vinkel i kutte Ben mens kutte guider4,5,6,7,8 ,9,10,11,12,13,<sup class="xref"…
Disclosures
The authors have nothing to disclose.
Acknowledgements
Dette arbeidet ble delvis støttet av JSP 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/ |
References
- Hirsch, D. L., et al. Use of computer-aided design and computer-aided manufacturing to produce orthognathically ideal surgical outcomes: A paradigm shift in head and neck reconstruction. Journal of Oral and Maxillofacial Surgery. 67 (10), 2115-2122 (2009).
- Hanasono, M. M., Skoracki, R. J. Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction. The Laryngoscope. 123 (3), 597-604 (2013).
- Roser, S. M., et al. The accuracy of virtual surgical planning in free fibula mandibular reconstruction: Comparison of planned and final results. Journal of Oral and Maxillofacial Surgery. 68 (11), 2824-2832 (2010).
- Ayoub, N., et al. Evaluation of computer assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: A randomized prospective clinical trial. Trials. 15, 114 (2014).
- Stirling, C. E., et al. Simulated surgery and cutting guides enhance spatial positioning in free fibular mandibular reconstruction. Microsurgery. 35 (1), 29-33 (2015).
- Schepers, R. H., et al. Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: a new modality for functional reconstruction of mandibular defects. Journal of Cranio-Maxillofacial Surgery. 43 (5), 649-657 (2015).
- Tarsitano, A., et al. Mandibular reconstructions using computer-aided design/computer-aided manufacturing: a systematic review of a defect-based reconstructive algorithm. Journal of Cranio-Maxillofacial Surgery. 43 (9), 1785-1791 (2015).
- Wilde, F., et al. Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction. International Journal of Computer Assisted Radiology and Surgery. 10 (12), 2035-2051 (2015).
- Huang, J. W., et al. Preliminary clinic study on computer assisted mandibular reconstruction: the positive role of surgical navigation technique. Maxillofacial Plastic and Reconstructive Surgery. 37 (1), 20 (2015).
- Numajiri, T., Nakamura, H., Sowa, Y., Nishino, K. Low-cost design and manufacturing of surgical guides for mandibular reconstruction using a fibula. Plastic and Reconstructive Surgery – Global Open. 4 (7), 805 (2016).
- Numajiri, T., Tsujiko, S., Morita, D., Nakamura, H., Sowa, Y. A fixation guide for the accurate insertion of fibular segments in mandibular reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery. Open. 12 (8), 1-8 (2017).
- Toto, J. M., et al. Improved operative efficiency of free fibula flap mandible reconstruction with patient specific, computer-guided preoperative planning. Head & Neck. 37 (11), 1660-1664 (2015).
- Avraham, T., et al. Functional outcomes of virtually planned free fibula flap reconstruction of the mandible. Plastic and Reconstructive Surgery. 134 (628), 634 (2014).
- Sieira, G. R., et al. Surgical planning and microvascular reconstruction of the mandible with a fibular flap using computer-aided design, rapid prototype modeling, and precontoured titanium reconstruction plates: A prospective study. British Journal of Oral and Maxillofacial Surgery. 53 (1), 49-55 (2015).
- Seruya, M., Fisher, M., Rodriguez, E. D. Computer-assisted versus conventional free fibula flap technique for craniofacial reconstruction: An outcomes comparison. Plastic and Reconstructive Surgery. 132 (5), 1219-1225 (2013).
- Metzler, P., et al. Three-dimensional virtual surgery accuracy for free fibula mandibular reconstruction: Planned versus actual results. Journal of Oral and Maxillofacial Surgery. 72 (12), 2601-2604 (2014).
- Numajiri, T., et al. Using an in-house approach to CAD/CAM reconstruction of the maxilla. Journal of Oral and Maxillofacial Surgery. 76 (6), 1361-1369 (2018).
- Bosc, R., et al. Mandibular reconstruction after cancer: An in-house approach to manufacturing cutting guides. International Journal of Oral and Maxillofacial Surgery. 46 (1), 24-29 (2017).
- Ganry, L., et al. Three-dimensional surgical modeling with an open-source software protocol: Study of precision and reproducibility in mandibular reconstruction with the fibula free flap. International Journal of Oral and Maxillofacial Surgery. 46 (8), 946-950 (2017).
- . InVesalius Available from: https://www.cti.gov.br/en/invesalius (2018)
- . Blender Available from: https://www.blender.org/ (2018)
- . Free3D Available from: https://free3d.com/3d-models/human (2018)
- . MakerBot Replicator+ Available from: https://www.makerbot.com/replicator/ (2018)
- . Artec Eva Lite Available from: https://www.artec3d.com/portable-3d-scanners/artec-eva-lite (2018)
- Guerrero-de-Mier, A., Espinosa, M. M., Dominguez, M. Bricking: A new slicing method to reduce warping. Procedia Engineering. 132, 126-131 (2015).
- Petropolis, C., Kozan, D., Sigurdson, L. Accuracy of medical models made by consumer-grade fused deposition modeling printers. Plastic Surgery. 23 (2), 91-94 (2015).
- Alsoufi, M. S., Elsayed, A. E. Warping deformation of desktop 3D printed parts manufactured by open source fused deposition modeling (FDM) system. International Journal of Mechanical and Mechatronics Engineering (IJMME) – International Journal of Engineering and Sciences (IJENS). 17 (4), 7-16 (2017).
- Maschio, F., Pandya, M., Olszewski, R. Experimental validation of plastic mandible models produced by a “low-cost” 3-dimensional fused deposition modeling printer. Medical Science Monitor. 22, 943-957 (2016).
- Rendon-Medina, M. A., Andrade-Delgado, L., Telich-Tarriba, J. E., Fuente-Del-Campo, A., Altamirano-Arcos, C. A. Dimensional error in rapid prototyping with open source software and low-cost 3D-printer. Plastic and Reconstructive Surgery – Global Open. 6 (1), 1646 (2018).
- Nizam, A., Gopal, R. N., Naing, L., et al. Dimensional accuracy of the skull models produced by rapid prototyping technology using stereolithography apparatus. Archives of Orofacial Sciences. 1, 60-66 (2006).
