With the rapid progression of additive manufacturing and the emergence of new 3D printing technologies, accuracy assessment is mostly being performed on isosymmetric test bodies. However, the ...accuracy of anatomic models can vary. The dimensional accuracy of root mean square values in terms of trueness and precision of 50 mandible replicas, printed with five common printing technologies, were evaluated. The highest trueness was found for the selective laser sintering printer (0.11 ± 0.016 mm), followed by a binder jetting printer (0.14 ± 0.02 mm), and a fused filament fabrication printer (0.16 ± 0.009 mm). However, highest precision was identified for the fused filament fabrication printer (0.05 ± 0.005 mm) whereas other printers had marginally lower values. Despite the statistically significance (
< 0.001), these differences can be considered clinically insignificant. These findings demonstrate that all 3D printing technologies create models with satisfactory dimensional accuracy for surgical use. Since satisfactory results in terms of accuracy can be reached with most technologies, the choice should be more strongly based on the printing materials, the intended use, and the overall budget. The simplest printing technology (fused filament fabrication) always scored high and thus is a reliable choice for most purposes.
Recent advancements in medical imaging, virtual surgical planning (VSP), and three-dimensional (3D) printing have potentially changed how today's craniomaxillofacial surgeons use patient information ...for customized treatments. Over the years, polyetheretherketone (PEEK) has emerged as the biomaterial of choice to reconstruct craniofacial defects. With advancements in additive manufacturing (AM) systems, prospects for the point-of-care (POC) 3D printing of PEEK patient-specific implants (PSIs) have emerged. Consequently, investigating the clinical reliability of POC-manufactured PEEK implants has become a necessary endeavor. Therefore, this paper aims to provide a quantitative assessment of POC-manufactured, 3D-printed PEEK PSIs for cranial reconstruction through characterization of the geometrical, morphological, and biomechanical aspects of the in-hospital 3D-printed PEEK cranial implants. The study results revealed that the printed customized cranial implants had high dimensional accuracy and repeatability, displaying clinically acceptable morphologic similarity concerning fit and contours continuity. From a biomechanical standpoint, it was noticed that the tested implants had variable peak load values with discrete fracture patterns and failed at a mean (SD) peak load of 798.38 ± 211.45 N. In conclusion, the results of this preclinical study are in line with cranial implant expectations; however, specific attributes have scope for further improvements.
Multiple sclerosis (MS) is a chronic neurological disease occurring mostly in women of childbearing age. Pregnant women with MS are usually excluded from clinical trials; as users of the internet, ...however, they are actively engaged in threads and forums on social media. Social media provides the potential to explore real-world patient experiences and concerns about the use of medicinal products during pregnancy and breastfeeding.
This study aimed to analyze the content of posts concerning pregnancy and use of medicines in online forums; thus, the study aimed to gain a thorough understanding of patients' experiences with MS medication.
Using the names of medicinal products as search terms, we collected posts from 21 publicly available pregnancy forums, which were accessed between March 2015 and March 2018. After the identification of relevant posts, we analyzed the content of each post using a content analysis technique and categorized the main topics that users discussed most frequently.
We identified 6 main topics in 70 social media posts. These topics were as follows: (1) expressing personal experiences with MS medication use during the reproductive period (55/70, 80%), (2) seeking and sharing advice about the use of medicines (52/70, 74%), (3) progression of MS during and after pregnancy (35/70, 50%), (4) discussing concerns about MS medications during the reproductive period (35/70, 50%), (5) querying the possibility of breastfeeding while taking MS medications (30/70, 42%), and (6) commenting on communications with physicians (26/70, 37%).
Overall, many pregnant women or women considering pregnancy shared profound uncertainties and specific concerns about taking medicines during the reproductive period. There is a significant need to provide advice and guidance to MS patients concerning the use of medicines in pregnancy and postpartum as well as during breastfeeding. Advice must be tailored to the circumstances of each patient and, of course, to the individual medicine. Information must be provided by a trusted source with relevant expertise and made publicly available.
Aim of the study was to prove the safety, accuracy characteristics of contact-free laser osteotomy executed with the cold ablation and robot-guided Er:YAG laser osteotome in a human cadaver test.
On ...six human cadavers mandible resections with a swallowtail like pattern were performed with the laser system on each side. The defects were reconstructed with a fibula graft of identical design and enlarged by 0.2 units. Mandibles and fibulas width as well surgery times were recorded. Additionally a Le Fort I and median mandible split were done. Macroscopically, the bone margins were examined for necrosis.
Laser osteotomies of the mandible up to a depth of 23 mm were possible without any thermal damage. Repeatability and precision of the system could be easily assessed. With the navigation system precise control of localization was achievable. Mean surgery time for the mandible resection was 13.32 min and for the fibula osteotomy 12.38 min.
The simply transmission of a cold ablation and robot-guided laser osteotome in an operation room identical environment for surgical interventions could be demonstrated. Precise osteotomy patterns with freedom in the design and carbonisation-free cut surfaces have been shown.
Pure orbital blowout fractures occur within the confines of the internal orbital wall. Restoration of orbital form and volume is paramount to prevent functional and esthetic impairment. The ...anatomical peculiarity of the orbit has encouraged surgeons to develop implants with customized features to restore its architecture. This has resulted in worldwide clinical demand for patient-specific implants (PSIs) designed to fit precisely in the patient's unique anatomy. Material extrusion or Fused filament fabrication (FFF) three-dimensional (3D) printing technology has enabled the fabrication of implant-grade polymers such as Polyetheretherketone (PEEK), paving the way for a more sophisticated generation of biomaterials. This study evaluates the FFF 3D printed PEEK orbital mesh customized implants with a metric considering the relevant design, biomechanical, and morphological parameters. The performance of the implants is studied as a function of varying thicknesses and porous design constructs through a finite element (FE) based computational model and a decision matrix based statistical approach. The maximum stress values achieved in our results predict the high durability of the implants, and the maximum deformation values were under one-tenth of a millimeter (mm) domain in all the implant profile configurations. The circular patterned implant (0.9 mm) had the best performance score. The study demonstrates that compounding multi-design computational analysis with 3D printing can be beneficial for the optimal restoration of the orbital floor.
In the bioarchaeological analysis of burials from a medieval graveyard at Hettstedt, Central Germany, a male skeleton of about 40 to 50 years at death with an unusual bony structure in the left ...maxillary sinus was discovered. Macroscopic examination exhibited a balloon‐shaped osseous lesion with solid cortical surface 2.5 × 1.5 cm in size. Micro‐CT scans revealed trabecular structures around a central cavity. The margins of the osseous lesion were well defined without infiltration of normal maxillary bone tissue. The histopathological analysis showed the presence of lamellar and woven bone. The structure and localisation of the tumour‐like lesion suggest that the formation was the result of chronic inflammation and that chronic dental sinusitis seems to have triggered a large reactive ossification.
The purpose of this study was to provide a quantitative accuracy assessment of soft tissue predictions generated by a computer-aided maxillofacial planning system in patients undergoing orthognathic ...surgery following the “surgery-first” treatment.
For this study, we looked at 16 patients with open bite dentofacial-dysmorphosis who underwent orthognathic surgery. Surgeries were planned using conventional sketches and the newly developed computer-assisted SOTIRIOS planning software (developed by the authors). Validation procedures were performed in the following steps: (1) Standardized registration of the pre- and postoperative CT volumes; (2) Automated adjustment of the bone-related preoperative planning to the actual postoperative bony displacement; (3) Simulation of soft tissue changes according to the definitive bony movements; and (4) Calculation of soft tissue differences between the predicted and the actual 6-month postoperative results by distance mapping.
The program produced a clinically satisfactory 3D soft tissue prediction, with a mean error of 1.46 mm ± 1.53 mm. The program was suitable for use in virtual surgical planning without technical assistance.
This study shows that the program is quite accurate, enabling the surgeon to predict the outcome of the soft tissue. This has the potential to promote the routine application of the surgery-first approach in patients suffering from open bite.
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