Implementation of Cone Beam Computed Tomography, Digital Sculpting and Three-Dimensional Printing in Facial Epithesis—A Technical Note

Abstract

Prosthetic rehabilitation has hardly changed since the 1970s, and it is a time-consuming process that requires great skill and precision. This article presents the workflow related to the prosthetic reconstruction of patients with extensive maxillofacial defects using digital technologies such as cone beam computed tomography (CBCT), Zbrush software and three-dimensional (3D) printing. The use of CBCT captures a 3D image of a patient’s face in a few seconds, thus shortening the time to prepare an impression and increasing the patient’s comfort. Zbrush digital sculpting software enables one to quickly and efficiently design a prosthetic restoration. Printing a trial version for a try-on, as well as designing and printing pre-cast forms, improves workflow and eliminates the chances of an error. As shown in the example of a patient after a nasal resection, CBCT, digital sculpting, and 3D printing accelerate and improve the workflow of an anaplastologist when designing the epithesis. New technologies reduce costs and save time, while helping to overcome the technical obstacles that limit access to a facial prosthesis.

“Air Sign” in Misdiagnosed Mandibular Fractures Based on CT and CBCT Evaluation

“…Advancements in technology are reshaping numerous aspects of our society and industries, particularly within healthcare. Cutting-edge digital tools like computer-aided design/manufacturing, rapid prototyping, 3D bioprinting, augmented/virtual reality, artificial intelligence (AI) with deep learning models, and "omics" analysis are progressively finding applications across diverse medical fields, serving diagnostic and therapeutic functions [29,30]. Deep learning, a branch within machine learning, utilizes multi-layered artificial neural networks to comprehend data representations with various levels of abstraction [31].…”

Computational Human Nasal Reconstruction Based on Facial Landmarks

“…For patients with cancer or other diseases undergoing endoscopic skull base surgery, quality-of-life (QOL) parameters are important. Therefore, facial reconstructions through plastic surgery help patients with anterior cranial base malignancies preserve or improve their QOL [16]. Currently, facial reconstructions of patients with empty nose syndrome (ENS) have yielded satisfactory results compared with other methods [17].…”

Aditive Manufacturing in Maxillofacial Prosthodontics

“…AM has several advantages over conventional techniques as well a over the CAM subtractive techniques. Some of the main advantages are: the ability to rapid fabricate complex structures at a considerably reduced cost [3]; a full or partially digital workflow with integrating patient's data (Cone beam computed tomography-CBCT, intraoral scan, facial scan), design in a large variety of CAD software and manufacturing carried out directly by printing the prosthesis itself or indirectly by printing prosthesis prototypes or molds [4]; less material waste; possible to reprint molds without the need of designing them again [5]; availability of different type of materials mimicking the defects needing to be restored (soft or hard tissue) [2]; constant improvements in material characteristics by adding different components [6] or improving in manufacturing techniques [7].…”