Mandibular Reconstruction after Resection of Ameloblastoma by Custom-Made CAD/CAM Mandibular Titanium Prosthesis: Two Case Reports, Finite Element Analysis and Discussion of the Technique

Cortese, Antonio; Spirito, Francesca; Claudio, Pier Paolo; Muzio, Lorenzo Lo; Ruggiero, Alessandro; Gargiulo, M.

doi:10.3390/dj11040106

Cited by 3 publications

(1 citation statement)

References 37 publications

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“…The methodology presented using 3D Slicer software together with 3D models could also be used in planning treatment of other conditions, e.g., in patients with high-riding dislocation developmental dysplasia of the hip [35,39] and even in cases where custom-made implants are used, as software for segmentation of bone structures [40]. Furthermore, the use of these techniques is not limited to pelvic surgery, but could be applied to spinal surgery for the purpose of planning pedicle insertion and osteotomy procedures in cases of spinal deformity [41], craniofacial surgery to prepare custom-made titanium mandibular protheses [42], as well as cancer treatment and the use of MRI-based three-dimensional models, e.g., planning of radical prostatectomy [43].…”

Section: Discussionmentioning

confidence: 99%

Optimization of Revision Hip Arthroplasty Workflow by Means of Detailed Pre-Surgical Planning Using Computed Tomography Data, Open-Source Software and Three-Dimensional-Printed Models

et al. 2023

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Background. In revision hip arthroplasty (RHA), establishing the center of rotation (COR) can be technically challenging due to the acetabular bone destruction that is usually present, particularly in severe cases such as Paprosky type II and III defects. The aim of this study was to demonstrate the use of open-source medical image reconstruction software and low-cost 3D anatomical models in pre-surgical planning of RHA. Methods. A total of 10 patients, underwent RHA and were included in the study. Computed tomography (CT) scans were performed for all cases, before surgery and approximately 1 week after the procedure. The reconstruction of CT data, 3D virtual planning of the COR and positioning of acetabular cups, including their inclination and anteversion angles, was carried out using the free open source software platform 3D Slicer. In addition, anatomical models of the pelvis were built on a desktop 3D printer from polylactic acid (PLA). Preoperative and postoperative reconstructed imaging data were compared for each patient, and the position of the acetabular cups as well as the COR were evaluated for each case. Results. Analysis of the pre- and post-op center of rotation position data indicated statistically insignificant differences for the location of the COR on the X-axis (1.5 mm, t = 0.5741, p = 0.5868) with a fairly strong correlation of the results (r = −0.672, p = 0.0982), whilst for the location of the COR in the Y and Z-axes, there was statistical dependence (Y axis, 4.7 mm, t = 3.168 and p = 0.0194; Z axis, 1.9 mm, t = 1.887 and p = 0.1081). A strong correlation for both axes was also observed (Y and Z) (Y-axis, r = 0.9438 and p = 0.0014; Z-axis, r = 0.8829 and p = 0.0084). Analysis of inclination angle values showed a statistically insignificant difference between mean values (3.9 degrees, t = 1.111, p = 0.3092) and a moderate correlation was found between mean values (r = −0.4042, p = 0.3685). Analysis of the anteversion angle showed a statistically insignificant difference between mean values (1.9 degrees, t = 0.8671, p = 0.4192), while a moderate correlation between mean values was found (r = −0.4782, p = 0.2777). Conclusions. Three-dimensional reconstruction software, together with low-cost anatomical models, are very effective tools for pre-surgical planning, which have great potential use in orthopedic surgery, particularly RHA. In up and in- and up and out-type defects, it is essential to establish a new COR and to identify three support points within the revision acetabulum in order to correctly position acetabular cups.

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Section: Discussionmentioning

confidence: 99%

Optimization of Revision Hip Arthroplasty Workflow by Means of Detailed Pre-Surgical Planning Using Computed Tomography Data, Open-Source Software and Three-Dimensional-Printed Models

et al. 2023

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Stress-strain and fatigue life numerical evaluation of two different dental implants considering isotropic and anisotropic human jaw

De Stefano,

Lanza,

Sbordone

et al. 2023

Proc Inst Mech Eng H

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Dental prostheses are currently a valid solution for replacing potential missing tooth or edentulism clinical condition. Nevertheless, the oral cavity is a dynamic and complex system: occlusal loads, external agents, or other unpleasant events can impact on implants functionality and stability causing a future revision surgery. One of the failure origins is certainly the dynamic loading originated from daily oral activities like eating, chewing, and so on. The aim of this paper was to evaluate, by a numerical analysis based on Finite Elements Method (FEM), and to discuss in a comparative way, firstly, the stress-strain of two different adopted dental implants and, subsequently, their fatigue life according to common standard of calculations. For this investigation, the jawbone was modeled accounting for either isotropic or anisotropic behavior. It was composed of cortical and cancellous regions, considering it completely osseointegrated with the implants. The impact of implants’ fixture design, loading conditions, and their effect on the mandible bone was finally investigated, on the basis of the achieved numerical results. Lastly, the life cycle of the investigated implants was estimated according to the well-established theories of Goodman, Soderberg, and Gerber by exploiting the outcomes obtained by the numerical simulations, providing interesting conclusions useful in the dental practice.

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A New Method to Design and Manufacture a Low-Cost Custom-Made Template for Mandible Cut and Repositioning Using Standard Plates in BSSO Surgery

Di Brigida,

Cortese,

Cataldo

et al. 2024

Bioengineering

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In this study, a new methodology for designing and creating a custom-made template for maxillofacial surgery has been developed. The custom-made template can be used both for cutting and repositioning of the mandible arches for executing a BSSO (bilateral sagittal split osteotomy) treatment. The idea was developed in order to give the possibility of using a custom-made template with standard plates, thus reducing long times, high costs and low availability of custom-made plates; this represents the proof of novelty of the proposed template, based on a well-established methodology. The methodology was completely developed in the CAD virtual environment and, after the surgeons’ assessment, an in-vitro experiment by a maxillofacial surgeon was performed in order to check the usability and the versatility of the system, thanks to the use of additive manufacturing technologies. When computer-aided technologies are used for orthognathic surgery, there are significant time and cost savings that can be realised, as well as improved performance. The cost of the whole operation is lower than the standard one, thanks to the use of standard plates. To carry out the procedures, the proposed methodology allows for inexpensive physical mock-ups that enable the BSSO procedure to be performed.

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Mandibular Reconstruction after Resection of Ameloblastoma by Custom-Made CAD/CAM Mandibular Titanium Prosthesis: Two Case Reports, Finite Element Analysis and Discussion of the Technique

Cited by 3 publications

References 37 publications

Optimization of Revision Hip Arthroplasty Workflow by Means of Detailed Pre-Surgical Planning Using Computed Tomography Data, Open-Source Software and Three-Dimensional-Printed Models

Optimization of Revision Hip Arthroplasty Workflow by Means of Detailed Pre-Surgical Planning Using Computed Tomography Data, Open-Source Software and Three-Dimensional-Printed Models

Stress-strain and fatigue life numerical evaluation of two different dental implants considering isotropic and anisotropic human jaw

A New Method to Design and Manufacture a Low-Cost Custom-Made Template for Mandible Cut and Repositioning Using Standard Plates in BSSO Surgery

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