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

Detta arbete var delvis stöds av JSPS KAKENHI Grant nummer JP17K11914.

Denna studie godkändes av författarnas institutionella Granskningsnämnden, och skriftligt samtycke former var klara alla patienter.
1. beredning av material
<ol><li>Använda en persondator, beräknade tomografiska (CT) data facial bone och vadben, konvertering programvara såsom InVesalius20och tredimensionell (3-D) CAD-program (t.ex., Blender21). Obs: Rekommenderas en maximal tjocklek av 1 mm skivor av CT-data för en korrekt de...

<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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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>

CAD/CAM rekonstruktion anses bidra till att uppnå en korrekt osteotomi längd, bredd och vinkel i skära ben medan du använder skärande guider4,5,6,7,8 ,9,10,11,12,13,<sup ...

Användning av CAD/CAM teknik har nyligen ökat i tandvård och protes arbete. Efter denna utveckling av CAD/CAM, osteocutaneous lock överföringar med hjälp av CAD/CAM används nu i fältet av mandibular återuppbyggnad efter en onkologiska bred resektion av maligna tumörer1,2,3. Flera företag i västvärlden har börjat leverera och sälja ett CAD/CAM trim-guide för regionen underkäken. En CAD/CAM rekonstruktion av underkäken anses ha en fördel när det gäller noggrannhet4,5,6,7,8,9,10 ,11. En nackdel är dock att denna teknik är tillgängliga i begränsade områden i hela världen och det är mycket dyrt12. Således, CAD/CAM återuppbyggnad för maxillary lesioner inte ännu blivit populära. Antalet fall av maxillary återuppbyggnad är lägre än för underkäken och kommersiella guider är inte vanligt.
Eftersom kommersiella maxillary CAD/CAM guider inte säljs i Japan, har vi utvecklat CAD/CAM planeringshjälp med en egen metod. Den kliniska effektiviteten av CAD/CAM guider har redan rapporterade13,14,15,16,17,18,19, men det finns ingen rapport av hur att utforma dem. Syftet med föreliggande rapport är att Visa metoden för CAD/CAM-design med en låg kostnad intern metod.

<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

Datorstödd design/datorstödd tillverkning (CAD/CAM) är nu utvärderas som en förberedande teknik för käkkirurgi. Eftersom denna teknik är dyra och finns i endast begränsade områden av världen, utvecklat vi en roman CAD/CAM kirurgiska guide med en egen metod. Med hjälp av CAD-programvaran, bestäms området maxillary resektion och skärande plan och fibular skärande plan och vinklar. När området resektion är bestämt, extraheras de nödvändiga ansiktena med en boolesk modifierare. Dessa ytliga ansikten förenas att passa ytan av ben och förtjockad att stabilisera fasta. Inte bara styckning guider för vadben och överkäken men också läge ordningen av de överförda ben segment definieras av förtjockning ytliga ansikten. CAD design bokförs som .stl filer och tredimensionellt (3D) ut som riktiga planeringshjälp. För att kontrollera riktigheten av guider, utförs modell kirurgi med 3-D-tryckt ansiktet och fibular modeller. Dessa metoder kan användas för att hjälpa kirurger där kommersiella guider är inte tillgängliga.

Använda proceduren presenteras här, fastställdes resektion området först. Med hjälp av CAD-program, var resektion området helt omskrivna av ansikten. Detta område var subtraheras från ansiktsbehandling benet av en Boolesk operation. Fibula bilden placerades på felet och fibular skärande ansikten placerades i lämpliga rekonstruerade punkter. Alla fibular skärande ansikten var kopplade till fibula i en överordnad inställning. Dessa ansikten har gjorts mindre och var eniga att...

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

Metoder för att utforma en datorstödd design/datorstödd tillverkning (CAD/CAM) kirurgiska guide visas. Skärande plan är separerade, united och förtjockad för att enkelt visualisera nödvändigt ben överföringen. Dessa mönster kan vara tredimensionella skrivas ut och kontrolleras för noggrannhet.

Utforma CAD/CAM planeringshjälp för Maxillary återuppbyggnad med en intern strategi

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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