Use of additively manufactured patient-specific instruments in clinical praxis

Abstract

Using a combination of Computer-Assisted Design (CAD), expert surgical knowledge and Additive-Manufacturing (AM) technologies, it is nowadays possible to offer patients an individualized treatment that is better planned, more predictable and more reliable than traditional surgical procedures. Regardless of the specifics of different medical fields, planning is common to all of them when it comes to an invasive intervention into the human body. Surgical planning is always based on diagnostic data that need to be gathered, presented and evaluated in a way that best suits the final purpose. To understand the general needs of the surgical planning process, several surgical cases have been explored and analyzed in the Additive Manufacturing Laboratory (AML) at the Faculty of Mechanical Engineering, University of Maribor over the past 10 years. The common denominator in all cases is the reconstruction of diagnostic data into a 3D model that is later used for planning and is, after the confirmation of the planned therapeutic parameters, transformed into tangible surgical equipment by means of AM. The 3D planning process has a lot of benefits but requires some skills uncommon among the medical experts. The results of the presented research summarize the particularities of medical 3D planning and provide guidelines for the wider adoption of medical 3D planning and the use of additively manufactured patient-specific instruments. Keywords: additive manufacturing in medicine, 3D medical planning, surgical guides, patient-specific instruments and implants Uporaba ra~unalni{ko podprtega konstruiranja, specialisti~nih kirur{kih znanj in tehnologij dodajalne izdelave nudi pacientom individualno, bolje na~rtovano, predvidljivej{o in zanesljivej{o obravnavo kot tradicionalna kirurgija. Natan~no na~rtovanje operacij je skupno vsem medicinskim podro~jem, kadar gre za invaziven poseg v~lovekovo telo, ne glede na medicinsko specializacijo. Na~rtovanje kirur{kih posegov vedno temelji na diagnosti~nih podatkih, ki jih morajo zajeti, predstaviti in ovrednotiti na na~in, ki ustreza kon~nemu cilju. Da bi razumeli splo{ne potrebe na~rtovanja kirur{kih posegov, so v zadnjih 10 letih v Laboratoriju za dodajalno izdelavo Fakultete za strojni{tvo Univerze v Mariboru raziskali in analizirali precej kirur{kih primerov. Vsem primerom je skupna rekonstrukcija diagnosti~nih podatkov v trirazse`ne modele, ki jih kasneje uporabijo za na~rtovanje, po potrditvi na~rtovanih terapevtskih parametrov pa preoblikujejo v otipljiv kirur{ki pripomo~ek s pomo~jo dodajalne izdelave. Proces trirazse`nega na~rtovanja ima mnogo prednosti, zahteva pa nekaj znanj in spretnosti, ki med zdravniki niso obi~ajne. Rezultati prikazanih raziskav povzemajo posebnosti trirazse`nega na~rtovanja in podajajo smernice za bolj raz{irjeno uporabo pacientom prilagojenih medicinskih pripomo~kov, narejenih s tehnologijami dodajalne izdelave. Klju~ne besede: dodajalna izdelava v medicini, trirazse`no medicinsko na~rtovanje, kirur{ka vodila, pacientu prilagojeni instrumenti in vsadki

Modern technologies enable treatment planning and the fabrication of clear aligners for the correction of misaligned teeth

“…Once a CAD sketch is created, the AM machine reads the data from the CAD file and deposits layer upon layer of liquid, powder, sheet material or other materials to produce a 3D object (1,2). Recently, AM has been used for the production of medical implants, tools, and dentures, and also in orthodontics (3)(4)(5)(6)(7). Clear aligner treatment is already well known in orthodontics, but it is limited to a small number of companies offering this type of treatment (8,9).…”