Clinical and radiographic evaluation of a computer-generated guiding device in bilateral sagittal split osteotomies

Barakat, Ahmed Samir; Abou-ElFetouh, Adel; Hakam, Maha Mohammed; El-Hawary, Hesham; Abdelghany, Khaled

doi:10.1016/j.jcms.2013.08.007

Cited by 21 publications

(9 citation statements)

References 45 publications

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“…Surgical guides are the most popular medical application of 3D printing, with mentions in 137 of the 270 papers (50.74 %) [ 10 , 15 , 30 , 31 , 39 , 48 , 59 , 60 , 62 , 70 , 71 , 73 , 74 , 76 , 77 , 79 – 81 , 83 , 84 , 86 , 88 , 89 , 92 , 93 , 96 – 98 , 106 , 108 , 111 – 113 , 118 , 124 – 226 ]. Apart from orthopedics (guides for knee arthroplasties), 3D-printed surgical guides were also used in neurosurgery, dental surgery, spinal surgery, and maxillofacial surgery.…”

Section: Resultsmentioning

confidence: 99%

3D-printing techniques in a medical setting: a systematic literature review

et al. 2016

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BackgroundThree-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes.MethodsThree major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans.Results227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure.Conclusion3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost–effectiveness analysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12938-016-0236-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

3D-printing techniques in a medical setting: a systematic literature review

et al. 2016

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“…The non‐computer‐assisted methods were classified into manual positioning, 8‐10 CPDs, 11‐13 titanium plate positioning 14‐16 and imaging positioning systems 17‐19 . The computer‐assisted ones were classified into CAD/CAM CPDs, 20‐24 CAD/CAM titanium plate positioning 25‐27 and computer‐assisted navigation systems 28‐30 …”

Section: Resultsmentioning

confidence: 99%

“…There were excellent results in CAD/CAM CPDs 21,23,24 and CAD/CAM titanium plate positioning methods 26,27 in preventing post‐TMJ symptoms or surgical relapse. All patients had better occlusion and TMJ function after surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Along with the increasing popularity of digital technology applications in orthognathic surgery, teeth‐supported 20,21,24 and bone‐supported 22,23 CAD/CAM CPDs were highly adopted into clinical surgery, transferring virtual pre‐operative planning to the actual operation (Figure 3). The CAD/CAM CPDs had more effectiveness on stabilizing the proximal segment on the coronal plane than the manual positioning 24 but not on the sagittal plane 22 .…”

Section: Computer‐assisted Condylar Positioningmentioning

confidence: 99%

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Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Chow

Liu

et al. 2022

Orthod Craniofacial Res

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Purpose The surgical condylar displacement often resulted in relapse and serious symptoms of temporomandibular joint disorders (TMD) after orthognathic surgery. To minimize the displacement, numerous techniques have been proposed. To verify their accuracy in positioning and effectiveness in preventing post‐operative TMD and relapse, we reviewed the literature related to intraoperative condylar positioning techniques on the mandible in this study. Methods The literature on condylar positioning techniques was reviewed with two charts, including the non‐computer‐assisted and the computer‐assisted positioning methods. The pre‐ and post‐operative alterations of condyles, the post‐operative temporomandibular joint (TMJ) function and surgical relapse were analysed regarding the techniques. The clinical usage and characteristics were reviewed as well. Results A total of 22 articles, including 907 patients, have been reported since 2001. Nearly all methods reach a considerable positioning accuracy within the range of 1‐2 mm and 1‐2° from the pre‐operative position. We ranked the accuracy of the methods from high to low: CAD/CAM CPDs > CAD/CAM titanium plate positioning > manual positioning > computer‐assisted navigation systems > imaging positioning systems. Most skeletal class II and class III patients achieved great occlusion and had no TMJ dysfunction or relapse after condylar positioning. Conclusions Both the non‐computer‐assisted and computer‐assisted condylar positioning techniques reach considerable accuracy in locating the pre‐operative condyle position and preventing TMJ dysfunction and surgical relapse. Different levels of surgeons and cases can benefit from multiple suggested positioning methods. Further research with large samples and long‐term follow‐up is worth looking forward to upgrading the current methods, improving the clinical utility and developing new positioning techniques.

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“…Published evidence has established clinical and technical efficacy for computer-aided design (CAD), additive manufacturing (AM), and computer-aided manufacturing (CAM) in planning and producing patient-specific craniofacial surgical devices. CAD and AM or CAM have been successfully exploited to produce patient-specific anatomical models, 1–6 pre-operative and intra-operative shaping jigs, 7–13 digital surgical plans, 13–23 custom drilling guides, 21,24–29 custom cut-ting guides, 17,18,20,23,26,30,31 custom bone re-positioning guides, 18,19,21,32,33 and custom implants in titanium 32,34–42 or polyether ether ketone (PEEK). 22,34,38,43…”

Section: Introductionmentioning

confidence: 99%

Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants

Peel

Bhatia

Eggbeer

et al. 2016

Proc Inst Mech Eng H

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Previously published evidence has established major clinical benefits from using computer-aided design, computer-aided manufacturing, and additive manufacturing to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use, particularly by the UK National Health Service. Oft-cited reasons for this slow uptake include the following: a higher up-front cost than conventionally fabricated devices, material-choice uncertainty, and a lack of long-term follow-up due to their relatively recent introduction. This article identifies a further gap in current knowledge - that of design rules, or key specification considerations for complex computer-aided design/computer-aided manufacturing/additive manufacturing devices. This research begins to address the gap by combining a detailed review of the literature with first-hand experience of interdisciplinary collaboration on five craniofacial patient case studies. In each patient case, bony lesions in the orbito-temporal region were segmented, excised, and reconstructed in the virtual environment. Three cases translated these digital plans into theatre via polymer surgical guides. Four cases utilised additive manufacturing to fabricate titanium implants. One implant was machined from polyether ether ketone. From the literature, articles with relevant abstracts were analysed to extract design considerations. In all, 19 frequently recurring design considerations were extracted from previous publications. Nine new design considerations were extracted from the case studies - on the basis of subjective clinical evaluation. These were synthesised to produce a design considerations framework to assist clinicians with prescribing and design engineers with modelling. Promising avenues for further research are proposed.

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Clinical and radiographic evaluation of a computer-generated guiding device in bilateral sagittal split osteotomies

Cited by 21 publications

References 45 publications

3D-printing techniques in a medical setting: a systematic literature review

3D-printing techniques in a medical setting: a systematic literature review

Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants

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