A selective laser sintering guide for transferring a virtual plan to real time surgery in composite mandibular reconstruction with free fibula osseous flaps

Introductory Chapter: Multi-Aspect Bibliographic Analysis of the Synergy of Technical, Biological and Medical Sciences Concerning Materials and Technologies Used for Medical and Dental Implantable Devices

“…Such technologies can be applied for various engineering materials, not only metals and alloys which are prepared, respectively, as powder or liquid, rolled material or thin fibres. Additive technologies have been widely used for fabricating diverse, customised elements applied in medicine, in particular, scaffolds with required porosity and strength with living cells implanted into an organism [225][226][227], models of implants and dental bridges [228][229][230], implants of individualised implants of the upper jaw bone, hip joint and skull fragments [231][232][233][234][235][236][237][238]. Considering the additive technologies applied most widely, the following have found their application for scaffold manufacturing, in implantology and prosthetics, i.e., electron beam melting (EBM) [222,[239][240][241][242][243], and also 3D printing for production of indirect models, although selective laser sintering/selective laser melting (SLS/SLM) and its technological variants offers broadest opportunities [220,222,[244][245][246][247][248][249][250][251][252][253], which was noted in discussing each group of materials.…”

Rapid Prototyping for Biomedical Engineering: Current Capabilities and Challenges

“…Groundbreaking research has been done in the production of prototypes for biological models that are used to plan surgical operations in fields as diverse as neurology (10), traumatology (11), and maxillofacial surgery (12,13).…”

Clinical Applications of Rapid Prototyping Models in Cranio-Maxillofacial Surgery

“…An SLS model could also be used during surgery as a guide for the surgeon to mark the bone graft taken from the fibula and transfer the position of osteotomies from the SLS preoperative model to the operating theatre (Sannomiya et al, 2008). A custom-made SLS model has also been developed that can be fitted at any site of a microvascular fibula flap, taking into account the vascular anatomy (Leiggener et al, 2009). This procedure enhanced the visualisation of points to be remodelled in an autogenous fibular graft to reproduce a new mandible (Sannomiya et al, 2008).…”

“…The accuracy of SLS model is relatively high with standard errors of a maximum of 0.1 to 0.6 mm. This accuracy depends on the thickness of the CT scans used, which should be as thin as possible (1 to 2 mm is a good compromise for a skull study); the field of view should have a resolution of 512 x 512 and not generate tilting during image acquisition (Leiggener et al, 2009). Relying on the accuracy of the guide, osteotomies and plating can be safely and swiftly performed with the osseous flap in place, which reduces the ischaemic time.…”

“…Such virtual plans allow for the movement of bony segments to find the best positions with regard to function, aesthetics and blood supply (the vascular anatomy can be visualised), which means that the optimal donor location on the fibula can be determined. Using RP model to manufacture a guide directly from a dataset obtained from the virtual plan eliminates the intermediate steps of model construction, from which different types of guides are produced (Leiggener et al, 2009). A 3D SLS skull model has been found to be able to accurately reproduce and reconstruct a fracture model (Aung et al, 1999) and fully reveal the anatomical structure of the craniomaxillary bone and its relationship to surrounding tissues.…”