Name: designing cad/cam surgical guides for maxillary reconstruction using an in-house approach
Uploaded: 2018-08-24T13:00:00
Description: Watch this Scientific Journal Video about Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach at JoVE.com

Questo lavoro è stato parzialmente supportato da JSP KAKENHI Grant numero JP17K11914.

Questo studio è stato approvato dal comitato di revisione istituzionale degli autori, e consenso scritto forme sono state completate da tutti i pazienti.
1. preparazione dei materiali
<ol><li>Utilizzare un personal computer, dati (CT) tomografici computati delle ossa facciali e del perone, software di conversione ad esempio InVesalius20e tridimensionale (3D) software di CAD (ad es., frullatore21). Nota: Uno spessore massimo di sezi...

<ol>
	<li>Hirsch, D. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+computer-aided+design+and+computer-aided+manufacturing+to+produce+orthognathically+ideal+surgical+outcomes:+A+paradigm+shift+in+head+and+neck+reconstruction.">Use of computer-aided design and computer-aided manufacturing to produce orthognathically ideal surgical outcomes: A paradigm shift in head and neck reconstruction.</a> Journal of Oral and Maxillofacial Surgery. 67 (10), 2115-2122 (2009).</li><li>Hanasono, M. M., Skoracki, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer-assisted+design+and+rapid+prototype+modeling+in+microvascular+mandible+reconstruction.">Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction.</a> The Laryngoscope. 123 (3), 597-604 (2013).</li><li>Roser, S. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+accuracy+of+virtual+surgical+planning+in+free+fibula+mandibular+reconstruction:+Comparison+of+planned+and+final+results.">The accuracy of virtual surgical planning in free fibula mandibular reconstruction: Comparison of planned and final results.</a> Journal of Oral and Maxillofacial Surgery. 68 (11), 2824-2832 (2010).</li><li>Ayoub, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+computer+assisted+mandibular+reconstruction+with+vascularized+iliac+crest+bone+graft+compared+to+conventional+surgery:+A+randomized+prospective+clinical+trial.">Evaluation of computer assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: A randomized prospective clinical trial.</a> Trials. 15, 114 (2014).</li><li>Stirling, C. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Simulated+surgery+and+cutting+guides+enhance+spatial+positioning+in+free+fibular+mandibular+reconstruction.">Simulated surgery and cutting guides enhance spatial positioning in free fibular mandibular reconstruction.</a> Microsurgery. 35 (1), 29-33 (2015).</li><li>Schepers, R. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+fibula+reconstruction+using+patient-specific+CAD/CAM+reconstruction+plates+and+dental+implants:+a+new+modality+for+functional+reconstruction+of+mandibular+defects.">Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants: a new modality for functional reconstruction of mandibular defects.</a> Journal of Cranio-Maxillofacial Surgery. 43 (5), 649-657 (2015).</li><li>Tarsitano, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mandibular+reconstructions+using+computer-aided+design/computer-aided+manufacturing:+a+systematic+review+of+a+defect-based+reconstructive+algorithm.">Mandibular reconstructions using computer-aided design/computer-aided manufacturing: a systematic review of a defect-based reconstructive algorithm.</a> Journal of Cranio-Maxillofacial Surgery. 43 (9), 1785-1791 (2015).</li><li>Wilde, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multicenter+study+on+the+use+of+patient-specific+CAD/CAM+reconstruction+plates+for+mandibular+reconstruction.">Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction.</a> International Journal of Computer Assisted Radiology and Surgery. 10 (12), 2035-2051 (2015).</li><li>Huang, J. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preliminary+clinic+study+on+computer+assisted+mandibular+reconstruction:+the+positive+role+of+surgical+navigation+technique.">Preliminary clinic study on computer assisted mandibular reconstruction: the positive role of surgical navigation technique.</a> Maxillofacial Plastic and Reconstructive Surgery. 37 (1), 20 (2015).</li><li>Numajiri, T., Nakamura, H., Sowa, Y., Nishino, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low-cost+design+and+manufacturing+of+surgical+guides+for+mandibular+reconstruction+using+a+fibula.">Low-cost design and manufacturing of surgical guides for mandibular reconstruction using a fibula.</a> Plastic and Reconstructive Surgery - Global Open. 4 (7), 805 (2016).</li><li>Numajiri, T., Tsujiko, S., Morita, D., Nakamura, H., Sowa, Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+fixation+guide+for+the+accurate+insertion+of+fibular+segments+in+mandibular+reconstruction.">A fixation guide for the accurate insertion of fibular segments in mandibular reconstruction.</a> Journal of Plastic, Reconstructive &amp; Aesthetic Surgery. Open. 12 (8), 1-8 (2017).</li><li>Toto, J. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+operative+efficiency+of+free+fibula+flap+mandible+reconstruction+with+patient+specific,+computer-guided+preoperative+planning.">Improved operative efficiency of free fibula flap mandible reconstruction with patient specific, computer-guided preoperative planning.</a> Head &amp; Neck. 37 (11), 1660-1664 (2015).</li><li>Avraham, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+outcomes+of+virtually+planned+free+fibula+flap+reconstruction+of+the+mandible.">Functional outcomes of virtually planned free fibula flap reconstruction of the mandible.</a> Plastic and Reconstructive Surgery. 134 (628), 634 (2014).</li><li>Sieira, G. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+planning+and+microvascular+reconstruction+of+the+mandible+with+a+fibular+flap+using+computer-aided+design,+rapid+prototype+modeling,+and+precontoured+titanium+reconstruction+plates:+A+prospective+study.">Surgical planning and microvascular reconstruction of the mandible with a fibular flap using computer-aided design, rapid prototype modeling, and precontoured titanium reconstruction plates: A prospective study.</a> British Journal of Oral and Maxillofacial Surgery. 53 (1), 49-55 (2015).</li><li>Seruya, M., Fisher, M., Rodriguez, E. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer-assisted+versus+conventional+free+fibula+flap+technique+for+craniofacial+reconstruction:+An+outcomes+comparison.">Computer-assisted versus conventional free fibula flap technique for craniofacial reconstruction: An outcomes comparison.</a> Plastic and Reconstructive Surgery. 132 (5), 1219-1225 (2013).</li><li>Metzler, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+virtual+surgery+accuracy+for+free+fibula+mandibular+reconstruction:+Planned+versus+actual+results.">Three-dimensional virtual surgery accuracy for free fibula mandibular reconstruction: Planned versus actual results.</a> Journal of Oral and Maxillofacial Surgery. 72 (12), 2601-2604 (2014).</li><li>Numajiri, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+an+in-house+approach+to+CAD/CAM+reconstruction+of+the+maxilla.">Using an in-house approach to CAD/CAM reconstruction of the maxilla.</a> Journal of Oral and Maxillofacial Surgery. 76 (6), 1361-1369 (2018).</li><li>Bosc, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mandibular+reconstruction+after+cancer:+An+in-house+approach+to+manufacturing+cutting+guides.">Mandibular reconstruction after cancer: An in-house approach to manufacturing cutting guides.</a> International Journal of Oral and Maxillofacial Surgery. 46 (1), 24-29 (2017).</li><li>Ganry, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+surgical+modeling+with+an+open-source+software+protocol:+Study+of+precision+and+reproducibility+in+mandibular+reconstruction+with+the+fibula+free+flap.">Three-dimensional surgical modeling with an open-source software protocol: Study of precision and reproducibility in mandibular reconstruction with the fibula free flap.</a> International Journal of Oral and Maxillofacial Surgery. 46 (8), 946-950 (2017).</li><li>. InVesalius Available from: <a target="_blank" href="https://www.cti.gov.br/en/invesalius">https://www.cti.gov.br/en/invesalius</a> (2018)</li><li>. Blender Available from: <a target="_blank" href="https://www.blender.org/">https://www.blender.org/</a> (2018)</li><li>. Free3D Available from: <a target="_blank" href="https://free3d.com/3d-models/human">https://free3d.com/3d-models/human</a> (2018)</li><li>. MakerBot Replicator+ Available from: <a target="_blank" href="https://www.makerbot.com/replicator/">https://www.makerbot.com/replicator/</a> (2018)</li><li>. Artec Eva Lite Available from: <a target="_blank" href="https://www.artec3d.com/portable-3d-scanners/artec-eva-lite">https://www.artec3d.com/portable-3d-scanners/artec-eva-lite</a> (2018)</li><li>Guerrero-de-Mier, A., Espinosa, M. M., Dominguez, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bricking:+A+new+slicing+method+to+reduce+warping.">Bricking: A new slicing method to reduce warping.</a> Procedia Engineering. 132, 126-131 (2015).</li><li>Petropolis, C., Kozan, D., Sigurdson, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+medical+models+made+by+consumer-grade+fused+deposition+modeling+printers.">Accuracy of medical models made by consumer-grade fused deposition modeling printers.</a> Plastic Surgery. 23 (2), 91-94 (2015).</li><li>Alsoufi, M. S., Elsayed, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Warping+deformation+of+desktop+3D+printed+parts+manufactured+by+open+source+fused+deposition+modeling+(FDM)+system.">Warping deformation of desktop 3D printed parts manufactured by open source fused deposition modeling (FDM) system.</a> International Journal of Mechanical and Mechatronics Engineering (IJMME) - International Journal of Engineering and Sciences (IJENS). 17 (4), 7-16 (2017).</li><li>Maschio, F., Pandya, M., Olszewski, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+validation+of+plastic+mandible+models+produced+by+a+"low-cost"+3-dimensional+fused+deposition+modeling+printer.">Experimental validation of plastic mandible models produced by a "low-cost" 3-dimensional fused deposition modeling printer.</a> Medical Science Monitor. 22, 943-957 (2016).</li><li>Rendon-Medina, M. A., Andrade-Delgado, L., Telich-Tarriba, J. E., Fuente-Del-Campo, A., Altamirano-Arcos, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dimensional+error+in+rapid+prototyping+with+open+source+software+and+low-cost+3D-printer.">Dimensional error in rapid prototyping with open source software and low-cost 3D-printer.</a> Plastic and Reconstructive Surgery - Global Open. 6 (1), 1646 (2018).</li><li>Nizam, A., Gopal, R. N., Naing, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dimensional+accuracy+of+the+skull+models+produced+by+rapid+prototyping+technology+using+stereolithography+apparatus.">Dimensional accuracy of the skull models produced by rapid prototyping technology using stereolithography apparatus.</a> Archives of Orofacial Sciences. 1, 60-66 (2006).</li></ol>

Ricostruzione di CAD/CAM è considerata di contribuire al conseguimento di un'osteotomia accurata lunghezza, larghezza e angolo nelle ossa di taglio durante l'utilizzo di taglio guide4,5,6,7,8 ,9,10,11,12,<sup ...

L'uso di tecniche CAD/CAM ha recentemente aumentato in odontoiatria e protesi. A seguito di questa evoluzione del CAD/CAM, i trasferimenti di falda osteocutaneous utilizzando CAD/CAM sono ora utilizzati nel campo della ricostruzione mandibular dopo un'ampia resezione oncologica di tumori maligni1,2,3. Diverse aziende nei paesi occidentali hanno cominciato a fornire e vendere una guida di taglio CAD/CAM per la regione di mandibola. Una ricostruzione di CAD/CAM della mandibola è considerata di avere un vantaggio in termini di precisione4,5,6,7,8,9,10 ,11. Tuttavia, uno svantaggio è che questa tecnica è disponibile in alcune aree in tutto il mondo ed è molto costoso12. Così, ricostruzione di CAD/CAM per le lesioni mascellare non è ancora diventata popolare. Il numero dei casi di ricostruzione mascellari è inferiore a quella per la mandibola, e guide commerciali non sono comuni.
Perché commerciale guide di CAD/CAM mascellare non sono vendute in Giappone, abbiamo sviluppato guide chirurgiche CAD/CAM, utilizzando un approccio in-House. L'efficacia clinica delle guide CAD/CAM è già stato segnalato13,14,15,16,17,18,19, ma non c'è nessun relazione di come progettarli. Lo scopo della presente relazione è quello di mostrare il metodo di progettazione CAD/CAM utilizzando un approccio in-House di basso costo.

<table border="0" cellpadding="0" cellspacing="0" style="width:1292px;" width="1291">
	<tbody>
		<tr height="66">
			<td height="66" style="height:66px;width:523px;">Information Technology Center, Renato Archer, Campinas, Brazil</td>
			<td style="width:316px;">InVesalius</td>
			<td style="width:383px;">Free software https://www.cti.gov.br/en/invesalius</td>
			<td style="width:71px;"></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;">The Blender Foundation, Amsterdam, Netherlands</td>
			<td>Blender</td>
			<td style="width:383px;">Free software https://www.blender.org/</td>
			<td></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;">TurboSquid, Inc. 935 Gravier St., Suite 1600, New Orleans, LA.</td>
			<td>Free 3D skeletal data file</td>
			<td style="width:383px;">Free3D https://free3d.com/3d-models/human</td>
			<td></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;">MakerBot Industries, LLC One MetroTech Center, 21st Fl, Brooklyn, NY.</td>
			<td>MakerBot Replicator+</td>
			<td>https://www.makerbot.com/replicator/</td>
			<td></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;width:523px;">YouTube (Google, Inc.), 901 Cherry Ave. San Bruno, CA</td>
			<td>video sharing website.</td>
			<td>https://www.youtube.com/results?search_query=invesalius+dicom+to+stl</td>
			<td></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;">Artec 3D, 2, rue Jean Engling, Luxembourg</td>
			<td>Artec Eva Lite</td>
			<td>https://www.artec3d.com/portable-3d-scanners/artec-eva-lite</td>
			<td></td>
		</tr>
		<tr height="66">
			<td height="66" style="height:66px;">CloudCompare</td>
			<td>CloudCompare</td>
			<td>http://www.danielgm.net/cc/</td>
			<td></td>
		</tr>
	</tbody>
</table>

designing cad/cam surgical guides for maxillary reconstruction using an in-house approach

Computer-aided design/computer-assistita produzione (CAD/CAM) sta ora valutando come tecnica preparativa per chirurgia maxillo-facciale. Poiché questa tecnica è costoso e disponibile in solo alcune aree del mondo, abbiamo sviluppato un romanzo guida chirurgica CAD/CAM, utilizzando un approccio in-House. Utilizzando il software di CAD, l'area di resezione mascellare e piani di taglio e i piani di taglio fibular e angoli sono determinati. Una volta l'area di resezione è deciso, le facce necessarie vengono estratti mediante un modificatore Boolean. Queste facce superficiali sono unite per adattarla alla superficie delle ossa e ispessita per stabilizzare i solidi. Non solo il taglio guide per il perone e la mascella superiore, ma anche la disposizione di posizione dei segmenti dell'osso trasferito è definita da ispessimento le facce superficiale. La progettazione CAD è registrata come file. STL e tridimensionale (3D) stampato come effettive guide chirurgiche. Per verificare la precisione delle guide, modello chirurgia utilizzando modelli 3-D-stampati facciali e fibular viene eseguita. Questi metodi possono essere utilizzati per aiutare i chirurghi dove guide commerciali non sono disponibili.

Utilizzando la procedura qui presentata, l'area di resezione è stata determinata in primo luogo. Utilizzando software CAD, l'area di resezione è stato completamente circoscritto dai volti. Questa zona è stato sottratto l'osso facciale di un'operazione booleana. L'immagine del perone è stato disposto sul difetto e taglio fibular volti sono stati collocati nei punti appropriati ricostruiti. Facce di taglio tutto fibular erano legate al perone in un impostazione di padre. Questi volti so...

Watch this Scientific Journal Video about Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach at JoVE.com

Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach

Metodi per la progettazione di una computer-aided design/computer aided manufacturing (CAD/CAM) guida chirurgica sono mostrati. Piani di taglio sono separati, Uniti e ispessiti per visualizzare facilmente il trasferimento di osso necessario. Questi disegni possono essere tridimensionali stampata e controllato per precisione.

Progettazione CAD/CAM di guide chirurgiche per ricostruzione mascellari utilizzando un approccio in-House

Computer-aided design/computer-assisted manufacturing (CAD/CAM) is now being evaluated as a preparative technique for maxillofacial surgery. Because this ...

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