Customised titanium implant fabricated in additive manufacturing for craniomaxillofacial surgery

Abstract

Customised implants manufacture has always presented difficulties which result in high cost and complex fabrication, mainly due to patients' anatomical differences. The solution has been to produce prostheses with different sizes and use the one that best suits each patient. Additive manufacturing (AM) as a technology from engineering has been providing several advancements in the medical field, particularly as far as fabrication of implants is concerned. The use of additive manufacturing in medicine has added, in an era of development of so many new technologies, the possibility of performing the surgical planning and simulation by using a threedimensional (3D) physical model, very faithful to the patient's anatomy. AM is a technology that enables the production of models and implants directly from the 3D virtual model (obtained by a Computer-Aided Design (CAD) system, computed tomography or magnetic resonance) facilitating surgical procedures and reducing risks. Furthermore, additive manufacturing has been used to produce implants especially designed for a particular patient, with sizes, shapes and mechanical properties optimised, for areas of medicine such as craniomaxillofacial surgery. This work presents how AM technologies were applied to design and fabricate a biomodel and customised implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used for creation of an anatomic biomodel of the bone defect for the surgical planning and, finally, the design and manufacture of the patient-specific implant.

Antibacterial Behavior of Additively Manufactured Porous Titanium with Nanotubular Surfaces Releasing Silver Ions

“…Despite the fact that these materials have been developed recently, they have already made their way to actual clinical applications, see e.g. [45][46] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 …”

Laser and electron‐beam powder‐bed additive manufacturing of metallic implants: A review on processes, materials and designs

“…During the surgical procedure, which took 3 h, the implant was then placed into the patient. When non‐customized implants are used in similar surgery, the duration is approximately 6 h. The reduction in duration of surgery is due to preoperative planning of correct geometrical and anatomical details …”

Additive Technology: Update on Current Materials and Applications in Dentistry

“…The use of custom titanium implants, fabricated using DMLS additive technology, for such defects has been demonstrated to be much quicker to fabricate and place during surgery than conventional methods. This is due to high accuracy and ease in which various modifications are made to suit each case at the design stage . In implantology the use of surgical guides has been strongly recommended to facilitate better planning and reduce the risk of operative complications .…”