Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects

Rustemeyer, Jan; Melenberg, Alex; Sari-Rieger, Aynur

doi:10.1016/j.jcms.2014.09.014

Cited by 27 publications

(16 citation statements)

References 27 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, the creation and delivery of the guides may last even up to a few weeks; consequently, the cutting guide‐supported procedures cannot be conducted in many trauma or cancer patients. Furthermore, CAD/CAM services generate substantial costs, $2,000 to $5,000 US per procedure . In turn, development of the VSP for intraoperative navigation system costs nothing.…”

Section: Discussionmentioning

confidence: 99%

“…This latter disadvantage plausibly could be eliminated with the implementation of AR technology and superimposition of the VSP components or positions of the anatomical structures directly onto the surgeon's visual field. Many researchers tried to implement the AR‐based technologies to the head and neck surgery, primarily to support oncological and orthognathic procedures …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

View full text Add to dashboard Cite

Objective: To analyze a novel navigation system utilizing augmented reality (AR) as a supporting method for fibula free flap (FFF) harvest and fabrication.Methods: A total of 126 simulated osteotomies supported with a cutting guide or one of two AR-based intraoperative navigation modules-simple AR (sAR) or navigated AR (nAR)-were carried out on 18 identical models of the fibula (42 osteotomies per method). After fusing postoperative computed tomography scans of the operated fibulas with the virtual surgical plan based on preoperative images, the objective outcomes-angular deviations from the planned osteotomy trajectory ( o ) and deviations of control points marked on the trajectory (mm)-were determined.Results: All analyzed methods provided similar accuracy of assisted osteotomies. The only significant difference referred to angular deviation in the sagittal plane, which was smaller after the cutting guide-assisted procedures than after the application of sAR and nAR (4.1 AE 2.29 vs. 5.08 AE 3.64 degrees, P = 0.031 and 4.1 AE 2.29 vs. 4.97 AE 2.91, P = 0.002, respectively). Mean deviation of control points after the cutting guide-assisted procedures was 2.76 AE 1.06 mm, as compared with 2.67 AE 1.09 mm for sAR and 2.95 AE 1.11 mm for nAR.Conclusion: Our study demonstrated that both novel AR-based methods provided similar accuracy of assisted harvesting and contouring of the FFF as the cutting guides. This fact, as well as the acceptability of the concept by clinicians, justify their further development and evaluation in preclinical settings.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…More than four screw holes were secured at both end of the planned resection range in order to secure more than three screws even if the size of resection is changed during the operation. Resin is commonly used as a restorative material in the field of dentistry, and costs less than other surgical guides (Rustemeyer, Melenberg, & Sari-Rieger, 2014).…”

Section: Discussionmentioning

confidence: 99%

Microsurgical mandibular reconstruction using a resin surgical guide combined with a metal reconstructive plate

et al. 2019

View full text Add to dashboard Cite

Introduction In mandibular reconstruction, repositioning the mandibular position is still challenging and time consuming. We invented a new re‐positioning technique using a resin plate combined with a reconstructive plate in reconstructing the mandible with an osteocutaneous free flap. The purpose of this report is to introduce this technique and evaluate the accuracy of mandibular reconstruction using free flaps. We hypothesized that this technique is precise and can reduce intraoperative plate bending at a low cost and short preparation period. Methods Mandibular reconstruction was successfully performed in a total of 10 cases without any complications. In this technique, a pre‐bent reconstructive plate was prepared in accordance with a three‐dimensional model, and then coated with resin. Intraoperatively, the mandibles were secured by fitting these plates snugly and fixing them using a reconstructive plate. Then the resin was removed and free osteocutaneous free flaps were transfer to the defect. Ten patients with a mean age of 68.2 who underwent mandibular resection for aggressive benign (n = 1) or malignant disease (n = 9) were reconstructed using this technique. Seven cases were reconstructed using fibular osteocutaneous free flaps, while scapular osteocutaneous free flaps were used in the remaining cases. The resections entailed: unilateral symphysis and lateral body in four cases, angle to ipsilateral angle in two, ramus to symphysis in two, and lateral body plus angle to symphysis in one case. The deviation of the mandible was evaluated by measuring the preoperative versus postoperative differences in the distances between six bilateral landmarks. Results There were no complications and flap failure in any of the 10 cases. No further intraoperative plate bending was required. One case underwent additional mucosal resection due to recurrence of cancer. Three cases were referred to postoperative chemoradiotherapy. Two patients expired during follow‐up due to recurrence of cancer. Six cases were put back on a normal diet. The other cases who lacked opposing teeth had to remain on a soft diet. The mean follow‐up period was 46.2 months. The average of the absolute deviation values was 1.45 mm. This value was 0.94 mm in six cases with mandibular body defects and 2.26 mm in four cases with mandibular defects involving the ramus. Conclusions The present novel technique is simple, quick to prepare, and accurate. This technique can be a viable option for microsurgical mandibular reconstruction.

show abstract

“…Depending on the skill and routine of the surgeon, preoperative planning and the use of stereolithographic models can reduce operation by about 1–1.5 h (Toro et al 2007; Zweifel et al 2015). One minute in the operation room during a mandibular reconstruction costs between 48 and 103 dollars, depending on the hospital (Haddock et al 2012; Rustemeyer et al 2014). Furthermore, in several countries reimbursement fees provided by statutory health insurance covered 172% of the costs (Rustemeyer et al 2014).…”

Section: Discussionmentioning

confidence: 99%

“…One minute in the operation room during a mandibular reconstruction costs between 48 and 103 dollars, depending on the hospital (Haddock et al 2012; Rustemeyer et al 2014). Furthermore, in several countries reimbursement fees provided by statutory health insurance covered 172% of the costs (Rustemeyer et al 2014). Thus, although equipment for virtual planning is more expensive, costs can be regained through saving surgery time or from reimbursement.…”

Section: Discussionmentioning

confidence: 99%

Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model

Gutwald

Jaeger

Lambers

2016

Computer Methods in Biomechanics and Biomedical Engineering

View full text Add to dashboard Cite

The purpose of this paper was to analyze the biomechanical performance of customized mandibular reconstruction plates with optimized strength. The best locations for increasing bar widths were determined with a sensitivity analysis. Standard and customized plates were mounted on mandible models and mechanically tested. Maximum stress in the plate could be reduced from 573 to 393 MPa (−31%) by increasing bar widths. The median fatigue limit was significantly greater (p < 0.001) for customized plates (650 ± 27 N) than for standard plates (475 ± 27 N). Increasing bar widths at case-specific locations was an effective strategy for increasing plate fatigue performance.

show abstract

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects

Cited by 27 publications

References 27 publications

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Microsurgical mandibular reconstruction using a resin surgical guide combined with a metal reconstructive plate

Customized mandibular reconstruction plates improve mechanical performance in a mandibular reconstruction model

Contact Info

Product

Resources

About