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

Este trabalho foi parcialmente suportado pelo JSPS KAKENHI Grant número JP17K11914.

Este estudo foi aprovado pelo Conselho de revisão institucional dos autores, e formulários de consentimento escrito foram completados por todos os pacientes.
1. preparação de materiais
<ol><li>Use um computador pessoal, dados de (CT) tomográficos computados de osso facial e fíbula e software de conversão como o InVesalius20tridimensional (3D) software de CAD (e.g., liquidificador,21). Nota: Recomenda-se uma espessura máxima ...

<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>

Reconstrução de CAD/CAM é considerada para contribuir para a realização de uma osteotomia exato comprimento, largura e ângulo em ossos de corte durante o uso de corte guias4,5,6,7,8 ,9,10,11,12,<sup class...

O uso de técnicas de CAD/CAM tem recentemente aumento na dental e trabalho da dentadura. Acompanhando esta evolução do CAD/CAM, osteocutaneous flap transferências usando CAD/CAM agora são usadas no campo da reconstrução mandibular após uma ressecção ampla oncológica de tumores malignos1,2,3. Várias empresas em países ocidentais começaram a fornecer e vender um guia de corte de CAD/CAM para a região da mandíbula. Uma reconstrução de CAD/CAM da mandíbula é considerada para ter uma vantagem em termos de precisão4,5,6,7,8,9,10 ,11. No entanto, uma desvantagem é que esta técnica está disponível em áreas limitadas em todo o mundo e é muito caro,12. Assim, reconstrução de CAD/CAM para lesões maxilares não ainda se tornou popular. O número de casos de reconstrução maxilar é menor do que para a mandíbula, e guias comerciais não são comuns.
Porque guias comerciais de CAD/CAM maxilares não são vendidos no Japão, nós desenvolvemos guias cirúrgicos CAD/CAM, usando uma abordagem in-house. A eficácia clínica dos guias de CAD/CAM já foi relatado13,14,15,16,17,18,19, mas não há nenhuma relatório de como projetá-los. O objetivo do presente relato é apresentar o método de projeto do CAD/CAM usando uma abordagem de baixo custo em casa.

<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

Fabricação de projeto/computadorizada auxiliada por computador (CAD/CAM) agora está sendo avaliada como uma técnica preparativa para cirurgia maxilo-facial. Porque esta técnica é caro e está disponível em apenas zonas limitadas do mundo, nós desenvolvemos um romance guia cirúrgica CAD/CAM, usando uma abordagem in-house. Usando o software de CAD, a área de ressecção maxilar e planos de corte e o corte fibular aviões e ângulos são determinados. Uma vez que a área de ressecção é decidida, os rostos necessários são extraídos usando um modificador de Boolean. Estes rostos superficiais estão Unidos para caber na superfície dos ossos e engrossado para estabilizar os sólidos. Não só o corte orienta-se para a fíbula e maxilar mas também a disposição de localização dos segmentos ósseos transferidos é definida pelo espessamento as faces superficiais. O desenho do CAD é registrado como arquivos. STL e tridimensional (3D) impresso como guias cirúrgicos reais. Para verificar a exactidão dos guias, é realizada a cirurgia de modelo usando modelos 3-D-impresso do faciais e fibulares. Esses métodos podem ser usados para auxiliar os cirurgiões onde guias comerciais não estão disponíveis.

Usando o procedimento aqui apresentado, a área de ressecção determinou-se primeiro. Usando o software de CAD, a área de ressecção foi completamente circunscrita por rostos. Esta área foi subtraída do osso facial por uma operação booleana. A imagem da fíbula foi colocada sobre o defeito e fibular corte rostos foram colocados nos pontos adequados reconstruídos. Corte tudo fibular rostos estavam ligados à fíbula em um pai de configuração. Esses caras foram feitas menores e se...

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

Métodos para a concepção de um computer aided design/computer aided manufacturing (CAD/CAM) guia cirúrgica são mostrados. Planos de corte são separados, Unidos e engrossados para visualizar facilmente a transferência de osso necessário. Estes projetos podem ser tridimensionais, impresso e verificados quanto à precisão.

Concepção CAD/CAM guias cirúrgicos para reconstrução maxilar usando uma abordagem 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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