The use of patient-specific implants in orthognathic surgery: A series of 32 maxillary osteotomy patients

Suojanen, Juho; Leikola, Junnu; Stoor, Patricia

doi:10.1016/j.jcms.2016.09.008

Cited by 109 publications

(109 citation statements)

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“…Globally, customized metal plates for jaw deformation and reconstruction are made with CAD/CAM based on preoperative computer simulations [5–7]. However, in Japan, only premade reconstructive plates can be used in patients.…”

Section: Discussionmentioning

confidence: 99%

Novel condylar repositioning method for 3D-printed models

Sugahara

Yoshiharu

Koyachi

et al. 2018

Maxillofac Plast Reconstr Surg

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BackgroundAlong with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation. The purpose of this study is to introduce and asses the novel condylar repositioning method in 3D model preoperational simulation.MethodsOur novel condylar repositioning method is simple to apply two irregularities in 3D models. Three oral surgeons measured and evaluated one linear distance and two angles in 3D models.ResultsThis study included two patients who underwent sagittal split ramus osteotomy (SSRO) and two benign tumor patients who underwent segmental mandibulectomy and immediate reconstruction. For each SSRO case, the mandibular condyles were designed to be convex and the glenoid cavities were designed to be concave. For the benign tumor cases, the margins on the resection side, including the joint portions, were designed to be convex, and the resection margin was designed to be concave. The distance from the mandibular ramus to the tip of the maxillary canine, the angle created by joining the inferior edge of the orbit to the tip of the maxillary canine and the ramus, the angle created by the lines from the base of the mentum to the endpoint of the condyle, and the angle between the most lateral point of the condyle and the most medial point of the condyle were measured before and after simulations. Near-complete matches were observed for all items measured before and after model simulations of surgery in all jaw deformity and reconstruction cases.ConclusionsWe demonstrated that 3D models manufactured using our method can be applied to simulations and fully restore the position of the condyle without the need for special devices.

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Section: Discussionmentioning

confidence: 99%

Novel condylar repositioning method for 3D-printed models

Sugahara

Yoshiharu

Koyachi

et al. 2018

Maxillofac Plast Reconstr Surg

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“…Однак, під час засверлювання хірург не може точно визначити реальну позицію фрагментів, не контрольована глибина засверлювання може призвести до пошкодження структур СНЩС чи навколишніх судин, а неправильне положення гвинтів може не забезпечити достатньої стабільності системи, особливо у випадку гвинтової фіксації (Yang et al, 2013). Wang et al (2013) Yang et al (2013), Smolka et al (2018), Han et al (2018. Усі вони обмежуються прямими вимірюваннями та віртуальним моделюванням хірургічних процедур у програмному забезпеченні.…”

Section: вступunclassified

“…Існуючі клінічні дослідження свідчать про те, що додаткове виготовлення та застосування пацієнт специфічних індивідуалізованих фіксаторів, а також застосування хірургічних шаблонів для точності співставлення фрагментів, встановлення пластин та гвинтів значно підвищує точність та передбачуваність хірургічних втручань в ортогнатичній хірургії, рекон-структивно-відновних операцях, включаючи лікування переломів основи виросткового відростка та шийки (Suojanen et al, 2016;Chepurnyi et al, 2019;Yang et al, 2018;Aquilina et al, 2015). Це полегшує реалізацію віртуального плану та робить його реалізацію менш залежною від навичок та досвіду оператора.…”

Section: вступunclassified

“…Хірургічні шаблони та пацієнто-специфічні фіксатори успішно використовувалисьSuojanen et al (2016), Chepurnyi et al (2019,Yang et al. (2018) в ортогнатичній хірургії, реконструкції орбіти, середньої зони обличчя та нижньої щелепи.…”

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The Use of Cad/Cam Technology in Surgical Treatment of Condylar Head Fracture

Pavlychuk

Chepurnyi

Копчак

2019

USMYJ

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Management of the condylar head fractures is still one of the most controversial issues of the maxillofacial surgery. The aim of the present study was to increase the accuracy and quality of the surgical treatment of condylar head fracture with the use of navigation surgical guide and patient specific reinforcement two-component plate and individualized fixator with the use of CAD/CAM technology. In study was included 8 patient with 10 condylar head fractured. In 5 cases was used navigation guides, in 4 cases (the biomechanical unfavorable) was used the patient specific two-component plate and only in one case we used individualized patient specific plate. A CT scan was done immediately after the operation. The reduction of the fragments and the location of the screws, plate and fixator were checked on the same view in the preoperative and postoperative pictures on the computer. The relation between the screw and the cortical bones was clearly shown on CT, and the sizes of the bicortical screws were suitable with no injury to the articular cartilage or surrounding tissue. The three-dimensional objects showed that the screw was in the designated position and the condyle had been replaced and fixed in the normal position. The height of the ramus on the fractured side was restored immediately postoperatively. The malocclusion was corrected and the passive mouth opening of each patient was never less than 3 cm. One patients had transient paralysis of the temporal branch of the facial nerve postoperatively, which gradually recovered within a 2 month. Postoperative clinical examination showed good occlusion and mouth opening of at least 3 cm in all patients after 3 months without pain. All patients regained normal mandibular movements and had short and invisible scars at 6 months’ follow-up. Given the small number of patients, this issue needs further study in randomized prospective studies involving more patients and evaluating long-term postoperative outcomes

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“…Three-dimensional (3D) printing from DICOM images has become easier with advancement of technologies such as medical engineering, imaging engineering, and the evolution and decreasing costs of hardware and software. Patient-specific 3D models are now being used in many situations within the oral and maxillofacial surgery fields, including education, surgical planning, and surgical simulation [1][2][3][4].…”

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confidence: 99%

DICOM segmentation and STL creation for 3D Printing: A Process and Software Package Comparison for Osseous Anatomy

Kamio

Suzuki²,

ASAUMI³

et al. 2020

Preprint

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Background: Extracting and three-dimensional (3D) printing an organ in a region of interest in DICOM images typically calls for segmentation in support of 3D printing as a first step. The DICOM images are not exported to STL data immediately, segmentation masks are exported to STL models. After primary and secondary processing, including noise removal and hole correction, the STL data can be 3D printed. The quality of the 3D model is directly related to the quality of the STL data. This study focuses and reports on DICOM to STL segmentation performance for nine software packages.Methods: Multi-detector row CT scanning was performed on a dry human mandible with two 10-mmdiameter bearing balls as a phantom. The DICOM images file was then segmented and exported to a STL file using nine different commercial/open-source software packages. Once the STL models were created, the data (file) properties and the size and volume of each were measured and differences across the software packages were noted. Additionally, to evaluate differences between the shapes of the STL models by software package, each pair of STL models was superimposed, with observed differences between their shapes characterized as shape error.Results: The data (file) size of the STL file and the number of triangles that constitute each STL model were different across all software packages, there was no statistically significant difference were found across software packages. The created ball STL model expanded in the X-, Y-, and Z-axis directions, with the length in the Z-axis direction (body axis direction) being slightly longer than other directions. There were no significant differences in shape error across software packages for the mandible STL model. Conclusions:The different characteristics of each software package were noticeable, such as different effects in the thin cortical bone area, likely due to the partial volume effect, which may reflect differences in image binarization algorithms. Although the shape of the STL model differs slightly depending on the software, our results indicate that shape error in 3D printing for clinical use in the operation of osseous structures. BackgroundDigital Imaging and COmmunications in Medicine (DICOM) is the leading standard around the world Author informationAffiliations

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The use of patient-specific implants in orthognathic surgery: A series of 32 maxillary osteotomy patients

Cited by 109 publications

References 10 publications

Novel condylar repositioning method for 3D-printed models

Novel condylar repositioning method for 3D-printed models

The Use of Cad/Cam Technology in Surgical Treatment of Condylar Head Fracture

DICOM segmentation and STL creation for 3D Printing: A Process and Software Package Comparison for Osseous Anatomy

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