Generation of customized orbital implant templates using 3-dimensional printing for orbital wall reconstruction

Kang, Seok Jin; Kwon, Jaeyoung; Ahn, Changhyun; Esmaeli, Bita; Kim, Guk Bae; Kim, Namkug; Seok, Ho

doi:10.1038/s41433-018-0193-1

Cited by 53 publications

(53 citation statements)

References 17 publications

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“…The combination of 3D imaging and individually adjusted so-called "hybrid patient-specific" titanium meshes have recently been introduced for effective reconstruction of the orbit. Pre-bent implants with a 3D-printed prototype of an orbital model have been found to be more accurate than conventional, freehand bent plates for the reconstruction of orbital fractures [8][9][10][11][12]. Compared to directly printed patient-specific titanium implants, which are usually manufactured externally and are still time-and cost-intensive, the so-called hybrid implants represent an interesting customized alternative.…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Analysis of Isolated Orbital Floor Fractures Pre- and Post-Reconstruction with Standard Titanium Meshes and “Hybrid” Patient-Specific Implants

Sigron

Rüedi

Chammartin

et al. 2020

JCM

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The aim of this study was to compare the efficacy of the intraoperative bending of titanium mesh with the efficacy of pre-contoured “hybrid” patient-specific titanium mesh for the surgical repair of isolated orbital floor fractures. In-house 3D-printed anatomical models were used as bending guides. The main outcome measures were preoperative and postoperative orbital volume and surgery time. We performed a retrospective cohort study including 22 patients who had undergone surgery between May 2016 and November 2018. The first twelve patients underwent conventional reconstruction with intraoperative free-hand bending of an orbital floor mesh plate. The subsequent ten patients received pre-contoured plates based on 3D-printed orbital models that were produced by mirroring the non-fractured orbit of the patient using a medical imaging software. We compared the preoperative and postoperative absolute volume difference (unfractured orbit, fractured orbit), the fracture area, the fracture collapse, and the effective surgery time between the two groups. In comparison to the intraoperative bending of titanium mesh, the application of preformed plates based on a 3D-printed orbital model resulted in a non-significant absolute volume difference in the intervention group (p = 0.276) and statistically significant volume difference in the conventional group (p = 0.002). Further, there was a significant reduction of the surgery time (57.3 ± 23.4 min versus 99.8 ± 28.9 min, p = 0.001). The results of this study suggest that the use of 3D-printed orbital models leads to a more accurate reconstruction and a time reduction during surgery.

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Section: Introductionmentioning

confidence: 99%

Three-Dimensional Analysis of Isolated Orbital Floor Fractures Pre- and Post-Reconstruction with Standard Titanium Meshes and “Hybrid” Patient-Specific Implants

Sigron

Rüedi

Chammartin

et al. 2020

JCM

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“…The orbital literature concerning 3D-printed bony defect templates includes numerous reports of successful use in the orbital floor, medial wall, and lateral wall [ 67 , 78 – 81 ]. Chai et al published a study of 127 fracture repairs done with the aid of 3D-printed skull models [ 70 ].…”

Section: Methodsmentioning

confidence: 99%

3D Printing in Eye Care

2021

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Three-dimensional printing enables precise modeling of anatomical structures and has been employed in a broad range of applications across medicine. Its earliest use in eye care included orbital models for training and surgical planning, which have subsequently enabled the design of custom-fit prostheses in oculoplastic surgery. It has evolved to include the production of surgical instruments, diagnostic tools, spectacles, and devices for delivery of drug and radiation therapy. During the COVID-19 pandemic, increased demand for personal protective equipment and supply chain shortages inspired many institutions to 3D-print their own eye protection. Cataract surgery, the most common procedure performed worldwide, may someday make use of custom-printed intraocular lenses. Perhaps its most alluring potential resides in the possibility of printing tissues at a cellular level to address unmet needs in the world of corneal and retinal diseases. Early models toward this end have shown promise for engineering tissues which, while not quite ready for transplantation, can serve as a useful model for in vitro disease and therapeutic research. As more institutions incorporate in-house or outsourced 3D printing for research models and clinical care, ethical and regulatory concerns will become a greater consideration. This report highlights the uses of 3D printing in eye care by subspecialty and clinical modality, with an aim to provide a useful entry point for anyone seeking to engage with the technology in their area of interest.

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“…Features gleaned through CT images and intraoperative visual inspection often fall short, making the trimming of implants a tenuous feat. Mismatch between implants and fractures may then lead to various complications [ 46 ]. However, 3D printing technology is a powerful tool for personalized repairs, offering tangible models of fracture sites.…”

Section: Conclusion and Future Effortsmentioning

confidence: 99%

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

Chai

Zhang

Hua

et al. 2021

Bioactive Materials

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Pediatric orbital trapdoor fractures are common in children and adolescents and usually require emergency surgical intervention. Herein, a personalized 3D printing-assisted approach to surgical treatment is proposed, serving to accurately and effectively repair pediatric orbital trapdoor fractures. We first investigated stress distribution in external force-induced orbital blowout fractures via numerical simulation, determining that maximum stresses on inferior and medial walls exceed those on superior and lateral walls and thus confer higher probability of fracture. We also examined 36 pediatric patients treated for orbital trapdoor fractures between 2014 and 2019 to verify our theoretical construct. Using 3D printing technique, we then created orbital models based on computed tomography (CT) studies of these patients. Absorbable implants were tailor-made, replicating those of 3D-printed models during surgical repairs of fractured orbital bones. As follow-up, we compared CT images and clinical parameters (extraocular movements, diplopia, enophthalmos) before and 12 months after operative procedures. There were only two patients with diplopia and six with enophthalmos >2 mm at 12 months, attesting to the efficacy of our novel 3D printing-assisted strategy.

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Generation of customized orbital implant templates using 3-dimensional printing for orbital wall reconstruction

Cited by 53 publications

References 17 publications

Three-Dimensional Analysis of Isolated Orbital Floor Fractures Pre- and Post-Reconstruction with Standard Titanium Meshes and “Hybrid” Patient-Specific Implants

Three-Dimensional Analysis of Isolated Orbital Floor Fractures Pre- and Post-Reconstruction with Standard Titanium Meshes and “Hybrid” Patient-Specific Implants

3D Printing in Eye Care

Theoretical model of pediatric orbital trapdoor fractures and provisional personalized 3D printing-assisted surgical solution

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