Mandible reconstruction using the calcium-sulphate three-dimensional model and rubber stick: A new method, ‘mould technique’, for more accurate, efficient and simplified fabrication

Katsuragi, Yoko; Kayano, Shuji; Akazawa, Satoshi; Nagamatsu, Shogo; Koizumi, Toru; Matsui, Takahiro; Onitsuka, Tetsuro; Yurikusa, Takashi; Huang, Wei-Chao; Nakagawa, Masahiro

doi:10.1016/j.bjps.2010.08.010

Cited by 28 publications

(20 citation statements)

References 26 publications

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“…Currently, the standard method of vascularized bone transfer involves fixation with titanium reconstruction plates or miniplates. When the reconstruction plate is bent to fit the native mandible, it acts as a 3D template for reconstruction [25]. …”

Section: Methodsmentioning

confidence: 99%

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

et al. 2014

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BackgroundThe occurrence of mandibular defects caused by tumors has been continuously increasing in China in recent years. Conversely, results of the repair of mandibular defects affect the recovery of oral function and patient appearance, and the requirements for accuracy and high surgical quality must be more stringent. Digital techniques — including model reconstruction based on medical images, computer-aided design, and additive manufacturing — have been widely used in modern medicine to improve the accuracy and quality of diagnosis and surgery. However, some special software platforms and services from international companies are not always available for most of researchers and surgeons because they are expensive and time-consuming.MethodsHere, a new technical solution for guided surgery for the repair of mandibular defects is proposed, based on general popular tools in medical image processing, 3D (3 dimension) model reconstruction, digital design, and fabrication via 3D printing. First, CT (computerized tomography) images are processed to reconstruct the 3D model of the mandible and fibular bone. The defect area is then replaced by healthy contralateral bone to create the repair model. With the repair model as reference, the graft shape and cutline are designed on fibular bone, as is the guide for cutting and shaping. The physical model, fabricated via 3D printing, including surgical guide, the original model, and the repair model, can be used to preform a titanium locking plate, as well as to design and verify the surgical plan and guide. In clinics, surgeons can operate with the help of the surgical guide and preformed plate to realize the predesigned surgical plan.ResultsWith sufficient communication between engineers and surgeons, an optimal surgical plan can be designed via some common software platforms but needs to be translated to the clinic. Based on customized models and tools, including three surgical guides, preformed titanium plate for fixation, and physical models of the mandible, grafts for defect repair can be cut from fibular bone, shaped with high accuracy during surgery, and fixed with a well-fitting preformed locking plate, so that the predesigned plan can be performed in the clinic and the oral function and appearance of the patient are recovered. This method requires 20% less operating time compared with conventional surgery, and the advantages in cost and convenience are significant compared with those of existing commercial services in China.ConclusionsThis comparison between two groups of cases illustrates that, with the proposed method, the accuracy of mandibular defect repair surgery is increased significantly and is less time-consuming, and patients are satisfied with both the recovery of oral function and their appearance. Until now, more than 15 cases have been treated with the proposed methods, so their feasibility and validity have been verified.

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Section: Methodsmentioning

confidence: 99%

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

et al. 2014

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“…CT scans have been the most commonly used imaging modality for medical 3D printing. Since they readily differentiate bones, 3D printing bony structures has become well established in various surgical disciplines, such as maxillofacial surgery (20, 21, 33, 128–130), neurosurgery (35, 68, 86), and orthopedic surgery (131–135). Using Osirix and Cube 2 printer, our research group 3D printed a model of a subluxed first carpometacarpal joint.…”

Section: D Printing In Plastic and Reconstructive Surgerymentioning

confidence: 99%

Emerging Applications of Bedside 3D Printing in Plastic Surgery

et al. 2015

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Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.

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“…The four main flap donor sites were the fibula with 6178 flaps (8, 12, 16-18, 20-22, 24, 26-28, 32-55, 57-59, 61-64, 66-, 79, 81-83, 85, 87-89, 93, 94, 96-104, 106, 108 -131, 131, 133, 135, 137-141, 143, 145-154, 156, 158-169, 171-175, 179-184, 186-193, 195, 196, 198-200, 202-207, 209, 210, 212-216, 218-223, and 225-229), the iliac crest with 1380 flaps (8, 12-15, 17-20, 26, 29,31, 36, 38, 41, 45, 48, 50, 53, 54, 57-60, 62, 63, 65, 67, 72, 74, 75, 77, 79, 83, 84, 86, 87, 92, 96, 98, 99, 102, 105, 112-115, 121, 132, 149, 151, 152, 155, 157, 158, 161, 168, 170, 171, 173, 174, 177, 178, 181, 183, 186, 201, 211, 212, 216, 219, 227), composite radius with 1127 flaps (8, 10-12, 17, 20, 23, 25, 30, 32, 33, 48, 50, 56, 62, 67, 72, 75, 77, 80, 85, 87, 91, 93, 95, 96, 98, 99, 104, 113, 114, 133, 150, 152 154, 165, 176, 180, 183, 185, 203, 213, and scapula with 709 flaps (8,9,12,14,17,26,32,45,46,48,50,53,58,59,63,67,70,74,77,85,87,90,93,96,99,113,114,134,136,142,144,151,156,169,172,189,191,194,…”

Section: Flap Optionsmentioning

confidence: 99%

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

Brown

Lowe

Kanatas³

et al. 2017

British Journal of Oral and Maxillofacial Surgery

137

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A systematic review was undertaken to explore the mandibular reconstruction techniques and outcomes, using composite free flaps.A total of 9499 mandibular defects were reconstructed with 6178 fibulas, 1380 iliac crests, 1127 composite radials, 709 scapulas, 63 serratus anterior and rib, 32 metatarsals and 10 lateral arm flaps including humerus. The flap failure rate was higher for the iliac crest at 6.2% (66/1059) compared to 3.4% (202/6018) if the fibula, radial or scapula was used (p<0.001). Details relating to osteotomy rate, non-union and fistula rates were evaluated. Iliac crest was most often rehabilitated with implantretained prosthesis (44%, 100/229), compared to 26% (605/2295) (p<0.001) if another flap was used. Changing trends over the study period were not apparent, regarding flap choice or related complications.Although we are able to show some significant differences relating to the type of flap used, it is disappointing to present the underreporting of fundamental outcomes such as the osteotomy rate, non-union and fistula rates. This review demonstrates the need for more comprehensive and consistent outcome reporting, that will allow the comparison of different techniques for similar defects.

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Mandible reconstruction using the calcium-sulphate three-dimensional model and rubber stick: A new method, ‘mould technique’, for more accurate, efficient and simplified fabrication

Cited by 28 publications

References 26 publications

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing

Emerging Applications of Bedside 3D Printing in Plastic Surgery

Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years

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