A Procedure for Designing Custom-Made Implants for Forehead Augmentation in People Suffering from Apert Syndrome

Abstract

This paper presents a methodological procedure, based on the anatomical reconstruction and constrained deformation, to design custom-made implants for forehead augmentation in people affected by Apert syndrome, experiencing a frontal bone deficiency. According to the anthropometric theory, a cranial landmarks identification procedure was applied to retrieve, from a repository, a healthy skull, used as reference geometry for implant modelling. Then, using constrained deformation and free-form modelling techniques, it was possible to design a patient-specific implant. At last, the implant was realised using a custom mould, specially designed according to the patient's needs to provide an accurate fit of the defect site. The design procedure was tested on a patient suffering from Apert syndrome. Three implants were virtually modelled and 3D-printed for pre-surgical evaluation. Their shapes were 3D compared with a reference one (handcrafted by a surgeon) to test the accuracy. Deviations are negligible, and the customised implant fulfilled the surgeon's requirements.

Biomechanical Study on the Comparison of Synthetic Materials for Cranio-Orbital Fracture Repair

“…5 Therefore, when repairing and reconstructing a certain area of cranio-orbital defects, it is necessary to replace them with suitable implants to restore their anatomy and function. 17 Park et al 18 stated that cranial implants should fit the size of the cranial defect and need to fill the gap between the implant and the bone. In addition, individualized implants can substantially reduce operative time and enhance surgical precision.…”

“…Although autologous reconstruction has been the gold standard for repairing skull defects, 16 it is difficult to completely repair the larger defects and to recover the natural contours and curves of the craniomaxillofacial surface, which may result in poor cosmetic repair 5 . Therefore, when repairing and reconstructing a certain area of cranio-orbital defects, it is necessary to replace them with suitable implants to restore their anatomy and function 17 . Park et al 18 stated that cranial implants should fit the size of the cranial defect and need to fill the gap between the implant and the bone.…”

A novel approach to craniofacial analysis using automated 3D landmarking of the skull

“…More recently, the dental and plastic surgery fields have also capitalized on skull shape analyses to aid in reconstructive surgical procedures and preoperative surgical planning. This can be accomplished by visualizing not only the shape differences between syndromic and non-syndromic skulls useful for diagnoses, but also representations of the potential outcome in surgical procedures 19 – 21 . However, many of these previous approaches were constrained by their reliance on manual cranial landmarks (usually less than 50) and the use of physical skulls or radiographs as data sources 22 , 23 .…”

A Comprehensive Methodological Framework for Anthropometric Head Shape Modeling Using Small Dataset

“…Anthropometric head shape modeling is essential for ensuring functional fit, safety, and the efficacy of head-mounted products (e.g., helmets, virtual/augmented reality, headgear, glasses, headphones, etc.) 1,2 , in addition to designing population-specific head-neck finite-element models 3 , head implant design 4,5 , and head and brain surgical planning 6,7 . Traditionally, one-dimensional (1D) head anthropometry measures (e.g., head breadth, length, circumference, etc.…”