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

この作品は、日本学術振興会科研費助成番号 JP17K11914 によって支えられた部分的。

この研究は筆者らの施設検討委員会によって承認され、すべての患者同意書フォームが完成しました。
1 材料の準備
<ol><li>パソコン、顔面骨、腓骨、InVesalius20など変換ソフトウェアおよび三次元 (3 D) CAD ソフトウェア (例えば、ブレンダー21) の計算された断層撮影 (CT) データを使用します。 注: 正確な設計のためには、最大?...

<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. 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CAD/CAM 復興は切断ガイド4,5,6,7,8 を使用している間正確な骨切りの長さ、幅、および骨の切削角度の達成に貢献すると考えられて ,9,10、11,12,13</sup...

CAD/CAM 技術の使用には、最近増加の歯科と義歯があります。このような CAD/CAM の進化、次は、CAD/CAM を使用して柄フラップ転送今悪性腫瘍1,2,3腫瘍広範切除後の下顎骨再建のフィールドで使用されます。欧米諸国でいくつかの企業は、供給し、下顎骨地域向けの CAD/CAM 切削ガイドを販売し始めています。顎骨の CAD/CAM の再建は精度4,5,6,7,8,9,10 面で利点を持っているとみなされて ,11。しかし、欠点は、限られた分野で世界的にこの手法があり、非常に高価な12です。したがって、上顎病変の CAD/CAM 復興しないまだ人気となっています。上顎再建の症例数が、下顎よりも低く、商業ガイドは一般的ではありません。
商業上顎 CAD/CAM ガイドは日本では販売されていない、ため社内のアプローチを使用して CAD/CAM サージカル ガイドを開発しました。CAD/CAM ガイドの臨床的有効性が既に報告された13,14,15,16,17,18,19, がないです。それらを設計する方法のレポートです。本報告の目的は、低コストの社内アプローチを用いた CAD/CAM の設計法を示すことです。

<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

コンピューター援用設計/コンピューター支援製造 (CAD/CAM) が今口腔外科の分取技法として評価されます。世界の限られた区域だけでこの技は安価で利用できるので、社内のアプローチを使用して CAD/CAM サージカル ガイド小説を開発しました。CAD ソフトウェアを使用して、上顎骨切除領域と切断面と腓骨の切断面と角度が決定されます。一度切除領域を決定すると、必要な面は、ブール修飾子を使用して抽出されます。これらの表面的な面に合わせて骨の表面や肥厚した固形物を安定させるために団結しています。切断ガイドの腓骨と上顎だけ、表面的な面を厚くことにより転送された骨のセグメントの配置を定義するも。CAD 設計は、.stl ファイルとして記録され、三次元 (3 D) が実際手術ガイドとして印刷します。ガイドの精度をチェックするには、3 D 印刷の顔と腓骨モデルを用いたモデル手術が実行されます。これらのメソッドは、商業ガイドがご利用いただけませんの外科医を支援するために使用可能性があります。

ここに示す手順を使用して、切除領域は最初に決定されます。CAD ソフトウェアを使用して切除領域は完全に顔に囲まれました。このエリアは、ブール演算によって顔面骨から減算しました。欠損、腓骨イメージが置かれ、腓骨の切断面は、適切な復元ポイントに置かれました。すべて腓骨の切断面は、親の設定で腓骨にリンクされていた。これらの面はより小さくな...

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

コンピューター援用設計/計算機援用製造 (CAD/CAM) 手術ガイドを設計する方法のとおりです。切断面が分離、ユナイテッド、および必要な骨移動を簡単に視覚化するために厚きます。これらのデザインは、印刷し、精度の確認立体化することができます。

社内の取り組みを用いた上顎再建の CAD/CAM サージカル ガイドの設計

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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社内の取り組みを用いた上顎再建の CAD/CAM サージカル ガイドの設計

社内の取り組みを用いた上顎再建の CAD/CAM サージカルガイドの設計