Customized design and manufacturing of chin implant based on rapid prototyping

Abstract

Purpose -To develop a computer-assisted prefabricated implant design and manufacturing system to improve the esthetic outcome in chin surgery. Design/methodology/approach -Design methods for medical rapid prototyping (RP) of custom-fabricated chin augmentation implant are presented in this paper. After a careful preoperative planning based on cephalometric tracing for esthetic assessment, helical computed tomography data were used to create a three-dimensional model of the deficient mandible. Based on these data, the inner surface of the prosthesis was designed to fit the bone surface exactly. The outer geometry was generated from a dried human mandible to create anatomically correct shape prosthesis. The inner and outer surfaces were then connected, and a solid model resulted. A RP system was used for production of the physical models. The surgical planning was performed using the implants and skull models. The resulting SLA implant is used for the production of a mold, which is used to cast the titanium part. Three patients with a congenital small chin or a small and asymmetric mandible underwent reconstruction with individual prefabricated implant. Mean follow-up period was 1.5 years. Findings -This approach showed significant results in chin augmentation. Compared with traditional methods, the intra-operative fit was excellent. The operating time was reduced. Postoperatively, the patients experienced the restoration of a natural chin contour, so the esthetic outcome was pleasing. Over the mean follow-up period of 1.5 years, there were no complications and no implant had to be removed. Long-term excellent esthetic outcomes by using this new technique have recently been reported.Research limitations/implications -The methods described above suffer from certain limitations. The registration of the mandible template to create the augmentation image requires high skills of the designer. In addition, the use of RP model in preoperative preparation is expensive. Practical implications -This method not only demonstrates the significant progress in the reconstruction of chin defects using CAD/CAM RP and RT, compared with the conventional methods of chin augmentation surgery, but also provides natural geometrical prosthesis contour design and accurate fabrication and precise fitting of the prosthesis. The advantages of using this technique are that the physical model of the implant is fitted on the skull model so that the surgeon can plan and rehearse the surgery in advance and a less invasive surgical procedure and less time-consuming reconstructive and an adequate esthetic can result. Originality/value -This clinical case demonstrated the potential value of CAD/CAM and RP-based custom fitted and anatomically correct shape prosthesis fabrication and presurgical planning in craniofacial surgery.

Prototyping: Major Advance in Surgical Planning and Customizing Prostheses in Patients with Bone Tumors of the Head and Neck

“…In practical implications, this method not only demonstrates the significant progress in the reconstruction of chin defects using RP, compared with the conventional methods of chin augmentation surgery, but also provides natural geometrical prosthesis contour design and accurate fabrication and precise fitting of the prosthesis. The advantages of using this technique are that the physical model of the implant is fitted on the skull model so that the surgeon can plan and rehearse the surgery in advance and a less invasive surgical procedure and less time-consuming reconstructive and an adequate aesthetic can result [17]. In addition, this method improves the reconstructive surgery and reduces the risk of a second intervention decreasing psychological stress of the patient [18].…”

The use of 3D printing technology in human defect reconstruction-a review of cases study

“…A customized medical implant and surgical resection template that matches skeletal anatomy can now be accurately designed using the CAD technique. The physical model of the individual implant, template, or skull replica can be produced through 3D printing, rapid tooling (RT), and computer aided manufacturing/computer numerical control (CAM/ CNC) processes [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. This paper presents some clinical cases, where virtual models have been used for surgical preparations and 3D printing models for manufacturing of implants.…”

The Benefit of 3D Printing in Medical Field: Example Frontal Defect Reconstruction

“…Several studies have reported the use of CAD and advance manufacturing platforms such as computer aided manufacturing/computer numerical control (CAM/CNC), 3D printing and Rapid Tooling (RT) in the production of customized prosthesis and surgical resection template [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. This paper presents a clinical cases study of frontal reconstruction using CT/RE/3D printing, with skull template to design the prosthesis geometry.…”