Virtual Surgical Planning and the “In-House” Rapid Prototyping Technique in Maxillofacial Surgery: The Current Situation and Future Perspectives

Maglitto, Fabio; Orabona, Giovanni Dell’Aversana; Committeri, Umberto; Salzano, Giovanni; Fazio, Gianluca Renato De; Vaira, Luigi Angelo; Abbate, Vincenzo; Bonavolontà, Paola; Piombino, Pasquale; Califano, Luigi

doi:10.3390/app11031009

Cited by 10 publications

(6 citation statements)

References 40 publications

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“…In the present study, the actual OT after VSP was significantly lower than the expected time by traditional methods (p =0.008) which came in line with many previous studies [7][8][9][10][11][12][13][14][15][16] . The witnessed decrease in OT could be clarified by preoperative proper surgical planning of the exact PSI shape, size and site of osteotomies to be performed.…”

Section: Discussionsupporting

confidence: 93%

Efficiency of virtual surgical planning in management of maxillofacial trauma

El‐Kady¹,

Shahen²,

Abdelaziz³

et al. 2023

Int. J. Adv. Res. Med.

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Background: Craniomaxillofacial (CMF) injuries has different patterns from simple to complicated ones. Surgeons usually spend time and effort planning the optimal surgical approach to avoid damage to vital structures that could otherwise lead to functional deficits. It is also imperative to optimize the skin incisions to avoid unfavourable scarring. The aim of this work is to assess the effectiveness and efficiency of virtual surgical planning (VSP) application in management of different types of CMF traumas, the advantages, and disadvantages of VSP, and the accuracy of three dimensional (3D) measures as a preoperative planning tool. Methods: This prospective consecutive series study enrolled 30 patients presented with different types of CMF trauma. All patients were subjected to CT scans. The obtained Digital imaging and communications in Medicine (DICOM) files were imported into the software for virtual planning. Results: The actual operative time (OT) after VSP was significantly lower than the expected time by traditional methods (p=0.008). There was no significant difference between the actual and expected number of incisions. The accuracy measures of preoperative VSP were very close postoperatively. The functional, anatomic reduction and patient satisfaction outcomes were very satisfying to the surgeon and the patient respectively. Conclusions: VSP can be a valuable tool for optimizing functional and aesthetic outcomes of the CMF trauma surgery. The accurate measurements obtained pre-operatively helped in reducing surgical time and minimizing the need for subsequent revision surgeries.

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Section: Discussionsupporting

confidence: 93%

Efficiency of virtual surgical planning in management of maxillofacial trauma

El‐Kady¹,

Shahen²,

Abdelaziz³

et al. 2023

Int. J. Adv. Res. Med.

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“…These factors may lead to limited use of rapid prototyping in the medical area. Low-cost 3D-printers have recently been introduced, providing a costand time-effective workflow and a more widely available alternative for daily clinical use [13][14][15]. In the present study, the models were fabricated using an in-house 3D-printer with a cost-effective workflow.…”

Section: Discussionmentioning

confidence: 99%

“…Modern technologies like medical additive manufacturing (MAM), also called medical three-dimensional (3D) printing, allow the fabrication of individual three-dimensional (3D) anatomical orbital models to better understand the specific anatomy and the preoperative planning of the surgical intervention. With the introduction of in-house 3Dprinters, orbital models' production has become more cost-effective over the years and is gaining more popularity for clinical use [13][14][15]. The titanium meshes that are preformed according to the patient's orbital model are an extremely precise, less time-consuming, and less tissue-damaging technique for orbital restorations.…”

Section: Introductionmentioning

confidence: 99%

Functional and Cosmetic Outcome after Reconstruction of Isolated, Unilateral Orbital Floor Fractures (Blow-Out Fractures) with and without the Support of 3D-Printed Orbital Anatomical Models

Sigron

Barba

Chammartin

et al. 2021

JCM

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The present study aimed to analyze if a preformed “hybrid” patient-specific orbital mesh provides a more accurate reconstruction of the orbital floor and a better functional outcome than a standardized, intraoperatively adapted titanium implant. Thirty patients who had undergone surgical reconstruction for isolated, unilateral orbital floor fractures between May 2016 and November 2018 were included in this study. Of these patients, 13 were treated conventionally by intraoperative adjustment of a standardized titanium mesh based on assessing the fracture’s shape and extent. For the other 17 patients, an individual three-dimensional (3D) anatomical model of the orbit was fabricated with an in-house 3D-printer. This model was used as a template to create a so-called “hybrid” patient-specific titanium implant by preforming the titanium mesh before surgery. The functional and cosmetic outcome in terms of diplopia, enophthalmos, ocular motility, and sensory disturbance trended better when “hybrid” patient-specific titanium meshes were used but with statistically non-significant differences. The 3D-printed anatomical models mirroring the unaffected orbit did not delay the surgery’s timepoint. Nonetheless, it significantly reduced the surgery duration compared to the traditional method (58.9 (SD: 20.1) min versus 94.8 (SD: 33.0) min, p-value = 0.003). This study shows that using 3D-printed anatomical models as a supporting tool allows precise and less time-consuming orbital reconstructions with clinical benefits.

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“…At present, the virtual reconstruction and rapid prototyping of missing parts are mainly used in maxillofacial surgery, where the design of customized implants using CT-derived 3D models, combined with the development of new biocompatible materials and rapid prototyping technologies, has led to multiple advantages over traditional surgical techniques (Aimar et al, 2019;Chua et al, 2020;Giovacchini et al, 2021;Maglitto et al, 2021;Sandeep Kumar et al, 2018;Touri et al, 2019;Zhou et al, 2010). The ability to use and manipulate digital data from CT scans and form an exact replica of an osteo-archaeological object in different materials (resin, polylactic acid (PLA), acrilonitrilebutadiene-stirene (ABS), etc.)…”

Section: Introductionmentioning

confidence: 99%