Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population

Gray, Rachel; Gougoutas, Alexander J.; Nguyen, Vinh; Taylor, Jesse A.; Bastidas, Nicholas

doi:10.1016/j.ijporl.2017.04.004

Cited by 28 publications

(19 citation statements)

References 25 publications

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“…The entire procedure, to be followed in case of complex craniofacial cases, envisage two surgical interventions and two CT scans of the patient even when Virtual Surgical Planning or 3D printed skull replica are used [27,30,31].…”

Section: Traditional Customized Approachesmentioning

confidence: 99%

Surgery of complex craniofacial defects: A single-step AM-based methodology

Volpe

Furferi

Governi

et al. 2018

Computer Methods and Programs in Biomedicine

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Background and objectiveThe purpose of the present paper is to pave the road to the systematic optimization of complex craniofacial surgical intervention and to validate a design methodology for the virtual surgery and the fabrication of cranium vault custom plates. Recent advances in the field of medical imaging, image processing and additive manufacturing (AM) have led to new insights in several medical applications. The engineered combination of medical actions and 3D processing steps, foster the optimization of the intervention in terms of operative time and number of sessions needed. Complex craniofacial surgical intervention, such as for instance severe hypertelorism accompanied by skull holes, traditionally requires a first surgery to correctly "resize" the patient cranium and a second surgical session to implant a customized 3D printed prosthesis. Between the two surgical interventions, medical imaging needs to be carried out to aid the design the skull plate. Instead, this paper proposes a CAD/AM-based one-in-all design methodology allowing the surgeons to perform, in a single surgical intervention, both skull correction and implantation. MethodsA strategy envisaging a virtual/mock surgery on a CAD/AM model of the patient cranium so as to plan the surgery and to design the final shape of the cranium plaque is proposed. The procedure relies on patient imaging, 3D geometry reconstruction of the defective skull, virtual planning and mock surgery to determine the hypothetical anatomic 3D model and, finally, to skull plate design and 3D printing. ResultsThe methodology has been tested on a complex case study. Results demonstrate the feasibility of the proposed approach and a consistent reduction of time and overall cost of the surgery, not to mention the huge benefits on the patient that is subjected to a single surgical operation. ConclusionsDespite a number of AM-based methodologies have been proposed for designing cranial implants or to correct orbital hypertelorism, to the best of the authors' knowledge, the present work is the first to simultaneously treat osteotomy and titanium cranium plaque.

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Section: Traditional Customized Approachesmentioning

confidence: 99%

Surgery of complex craniofacial defects: A single-step AM-based methodology

Volpe

Furferi

Governi

et al. 2018

Computer Methods and Programs in Biomedicine

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“…With increasing scrutiny of health care spending, a decision will need to be made regarding the cost/benefit profile of this expenditure. Fortunately, previous studies have shown significant benefit to the use of 3DCT for presurgical planning in orthognathic surgery, 3 cranial vault remodeling, 3,5 head and neck oncologic reconstruction, 4,8 and maxillofacial trauma. 6,7 The current study reveals that study subjects learned more readily with and preferred 3DCT over 2DCT.…”

Section: Costmentioning

confidence: 99%

Improving Patient Education of Facial Fractures Using 3‐Dimensional Computed Tomography

Wickwire¹,

Kahlon

Kazemi

et al. 2021

Otolaryngol.--head neck surg.

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Objective Advances in 3-dimensional modeling have revolutionized presurgical planning for maxillofacial reconstruction, yet little is known about how this technology may affect patient education. This study was designed to evaluate the efficacy of 2-dimensional computed tomography versus 3-dimensional computed tomography for patient education in maxillofacial reconstruction. Study Design Crossover study. Setting General otolaryngology outpatients from a tertiary referral center were recruited. Methods A single computed tomography data set of a zygomaticomaxillary complex fracture was used to generate 2 educational video tutorials: one in a 2-dimensional format and one in a 3-dimensional format. The tutorials were embedded into the QualtricsXM platform. Participants were randomly assigned into 2 groups. Group 1 viewed the 2-dimensional tutorial, took a self-assessment survey, took an information recall survey, viewed the 3-dimensional tutorial, and finally took a tutorial comparison survey. Group 2 followed the same sequence but viewed the 3-dimensional tutorial followed by the 2-dimensional tutorial. Results Group 2 participants (viewing the 3-dimensional tutorial first) scored better on the self-assessment survey than their counterparts in group 1 did ( P = .023). Group 2 also scored better on the recall survey ( P = .042). Of all participants, 61% preferred the 3-dimensional tutorial, and 31% preferred the use of both tutorials together in the comparison survey. Conclusions Three-dimensional patient educational tutorial regarding a zygomaticomaxillary complex fracture resulted in better knowledge retention and was preferred over the 2-dimensional format.

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“…Also a method of treatment of mandibular fractures using CAD/CAM systems (Computer-Aided Design/Computer-Aided Manufacture) based on computed tomography was developed. These systems allow to create a model of fracture and determine the optimal ways to eliminate it [20][21][22].…”

Section: Suggested Solution To the Problemmentioning

confidence: 99%

Results of using 3-D simulation methods in treatment of midfacial fractures

Grigorov

2021

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The article publishes the results of treatment of 27 patients with fractures of the face middle area, of which 14 used standard titanium mini-plates to reposition the fragments, and 13 – individual 3D simulated titanium mini-plates / grids. Before and after treatment, its effectiveness was assessed by the values of the displacements of bone fragments and the index of the visual-analog scale, which allows determining the functional and cosmetic effect of the surgery. It was found that the use of individual 3D simulated titanium mini-plates / grids allowed obtaining in 85 % of patients displacements not exceeding 3 mm. In 72 % of patients in whom standard titanium mini-plates were used, the displacement after surgery was 3.1–6 mm, which is significantly greater than in the group with individual modeling of structures. On the 7th day after surgery in the first group (treatment with standard mini-plates), the index on the visual-analog scale was 11 (7; 13), which was significantly (p=0.00147) less than before surgery. In the second group (treatment using individual 3D simulated titanium mini-plates / grids) the index on the visual analog scale was 4 (6; 8) points, which was significantly (Z=3.3; p=0.00098) less than before surgery. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. The obtained results testify to the greater efficiency of individual 3D modeled titanium mini-plates / grids in comparison with standard titanium mini-plates. The object of the research: fractures of the middle area of the face. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. Investigated problem: the comparative evaluation of the effectiveness of the middle area of the face fractures treatment using individual 3D simulated titanium mini-plates / grids and standard titanium mini-plates. The main scientific results: Optimizing the treatment of fractures of the face middle area will help to achieve good cosmetic and functional results. The area of practical use of the research results: Department of Surgical Dentistry and Maxillofacial Surgery. Innovative technological product: The proposed technique using individual 3D-simulated titanium miniplates will help to optimize the treatment of patients with traumatic fractures of the face middle area. Scope of the innovative technological product: Clinical practice.

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Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population

Cited by 28 publications

References 25 publications

Surgery of complex craniofacial defects: A single-step AM-based methodology

Surgery of complex craniofacial defects: A single-step AM-based methodology

Improving Patient Education of Facial Fractures Using 3‐Dimensional Computed Tomography

Results of using 3-D simulation methods in treatment of midfacial fractures

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