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This paper aims to provide an overview of applications of medical rapid prototyping (MRP)-assisted customized surgical guides (CSGs) and shows the potential of this technology in complex surgeries. This review paper also reports two case studies from open literature where MRP-assisted CSGs have been successfully used in complex surgeries.

Key publications from the past two decades have been reviewed.

This study concludes that the use of MRP-assisted CSGs improves the accuracy of surgery. Additionally, MRP-assisted CSGs make the surgery much faster, accurate and cheaper than any other technique. The outcome based on literature review and two case studies strongly suggested that MRP-assisted CSGs might become part of a standard protocol in the medical sector to operate the various complex surgeries, in the near future.

Advanced technologies like radiology, image processing, virtual surgical planning (VSP), computer-aided design (CAD) and MRP made it possible to fabricate the CSGs. MRP-assisted CSGs can easily transfer the VSP into the actual surgery.

This paper is beneficial to study the development and applications of MRP-assisted CSGs in complex surgeries.

This study aims to assess the design, manufacturing and surgical implantation of three-dimensional (3D) customized implants, including surgical preoperative planning, surgery and postoperative results, for cranioplasty along with zygomatic and orbital floor implants using additive manufacturing (AM) technics for a 23-year-old female who suffered from severe craniomaxillofacial trauma.

The skull biomodel was produced in polyamide while implants were made of Ti-6Al-4V alloy by AM.

The method enabled perfectly fitting implants and anatomical conformance with the craniomaxillofacial defect, providing complete healing for the patient. Surgical planning using a customized 3D polyamide biomodel was effective. This proved to be a powerful tool for medical planning and manufacturing of customized implants, as complete healing and good craniofacial aesthetic results were observed.

Satisfactory surgical procedures, regarding surgery time reduction and good craniofacial aesthetic results, were achieved. Furthermore, the 3D titanium customized implants represented a favorable alternative for the repair of craniomaxillofacial defects.

The purpose of this paper is to develop a workflow for design and fabrication of customized surgical guides (CSGs) for placement of the bidirectional extraoral distraction instruments (EDIs) in bilateral mandibular distraction osteogenesis (MDO) surgery to treat the bilateral temporomandibular joint ankylosis with zero mouth opening.

The comprehensive workflow consists of six steps: medical imaging; virtual surgical planning (VSP); computer aided design; rapid prototyping (RP); functional testing of CSGs and mock surgery; and clinical application. Fused deposition modeling, an RP process was used to fabricate CSGs in acrylonitrile butadiene styrene material. Finally, mandibular reconstruction with MDO was performed successfully using RP-assisted CSGs.

Design and development of CSGs prior to the actual MDO surgery improves accuracy, reduces operation time and decreases patient morbidity, hence improving the quality of surgery. Manufacturing of CSG is easy using RP to transfer VSP into the actual surgery.

This study describes an RP-assisted CSGs fabrication for exact finding of both; osteotomy site and drilling location to fix EDI’s pins accurately in the mandible; for accurate osteotomy and placement of the bidirectional EDIs in MDO surgery to achieve accurate distraction.

The purpose of this paper is to demonstrate the route to digitize the customized mandible implants consisting of image acquisition, processing, implant design, fitting rehearsal and fabrication using fused deposition modeling and electron beam melting methodologies.

Recent advances in the field of rapid prototyping, reverse engineering, medical imaging and image processing have led to new heights in the medical applications of additive manufacturing (AM). AM has gained a lot of attention and interest during recent years because of its high potential in medical fields.

Produced mandible implants using casting, milling and machining are of standard sizes and shapes. As each person’s physique and anatomical bone structure are unique, these commercially produced standard implants are manually bent before surgery using trial and error methodology to custom fit the patient’s jaw. Any mismatch between the actual bone and the implant results in implant failure and psychological stress and pain to the patient.

The novelty in this paper is the construction of the customized mandibular implant from the computed tomography (CT) scan which includes surface reconstruction, implant design with validation and simulation of the mechanical behavior of the design implant using finite element analysis (FEA). There has been few research studies on the design and customization of the implants before surgery, but there had been hardly any study related to customized design implant and evaluating the biomechanical response on the newly designed implant using FEA. Though few studies are related to FEA on the reconstruction plates, but their paper lacks the implant design model and the reconstruction model. In this research study, an integrated framework is developed for the implant design, right from the CT scan of the patient including the softwares involved through out in the study and then performing the biomechanical study on the customized design implant to prove that the designed implant can withstand the biting and loading conditions. The proposed research methodology which includes the interactions between medical practitioners and the implant design engineers can be incorporated to any other reconstruction bone surgeries.

During the repair of compound skull fractures or penetrating wounds to the brain, removal of significant portions of the skull may be required. Conventional prefabricated alloplastic implants require the use of complicated procedures during surgery, which can endanger a patient. Since prior rehearsals of the surgery are next to impossible, the surgery is usually complicated and lengthy. This paper aims to outline the importance of rapid prototyping (RP) in medicine, and also it details the use of RP for a cranioplastic surgery that was conducted in the South East Asian region. RP offers an easier way to design customized implants and manufacture them within a very short period. Rapid Prototyping can be used as an effective tool to generate complex 3D medical models from computed tomographic (CT) images. The models can be used for didactic purposes, as it helps the surgeons plan and rehearse the surgery well in advance. The RP prototype was used to successfully complete a cranioplastic surgery and realize the desired results. The operation time was also significantly reduced.

The purpose of this paper is to identify the key design process factors acting as drivers or barriers to routine health service adoption of additively manufactured (AM) patient-specific devices. The technical efficacy of, and clinical benefits from, using computer-aided design (CAD) and AM in the production of such devices (implants and guides) has been established. Despite this, they are still not commonplace. With AM equipment and CAD tool costs largely outside of the clinician’s or designer’s control, the opportunity exists to explore design process improvement routes to facilitate routine health service implementation.

A literature review, new data from three separate clinical case studies and experience from an institute working on collaborative research and commercial application of CAD/AM in the maxillofacial specialty, were analysed to extract a list and formulate models of design process factors.

A semi-digital design and fabrication process is currently the lowest cost and shortest duration for cranioplasty implant production. The key design process factor to address is the fidelity of the device design specification.

Further research into the relative values of, and best methods to address the key factors is required; to work towards the development of new design tools. A wider range of benchmarked case studies is required to assess costs and timings beyond one implant type.

Design process factors are identified (building on previous work largely restricted to technical and clinical efficacy). Additionally, three implant design and fabrication workflows are directly compared for costs and time. Unusually, a design process failure is detailed. A new model is proposed – describing design process factor relationships and the desired impact of future design tools.

The internal fixation plate of bone fractures by using polylactic acid (PLA) has attracted the attention of many researchers, as it is biodegradable and biocompatible to the human body. However, its brittleness has led to implant fracture. On the contrary, polypropylene carbonate (PPC), which is also biodegradable and biocompatible, has an excellent elongation at break. The purpose of this paper is to compare the PLA fixation plate with the new fixation plate made up of PLA/PPC blends by using finite element analysis (FEA).

The mandible bone from CT data set and fixation plate was designed by using the MIMICS, Amira and Solidworks softwares. Abaqus software was used for FEA of PLA/PPC fixation plate applied on the fractured mandible bone. A model of mandibular bone with a fracture in the body was subjected to incisor load. The analysis was run to determine the von Mises stress, elongation of the fixation plate and the displacement of the fractured gap of PLA/PPC blends fixation plate.

The von Mises stress predicted that all the blend compositions were safe to be used as a fixation plate since the stress values were less than the yield strength. In addition, the stress value of the fixation plate was gradually decreased up to 20 percent when the amount of PPC increased to 30 percent. This indicates that the stress shielding effect was successfully reduced. The elongation of the fixation plate was gradually increased from 11.54 to 12.55 µm as the amount of PPC in the blends increased from 0 to 30 percent, thereby illustrating that the flexibility of the fixation plate was improved by the addition of PPC. Finally, the measured displacement of the fractured gap for all compositions of PLA/PPC blends fixation plate is less than 150 µm, which proves the likely success of fracture fixation by using the PLA/PPC blends.

An optimum solution of PLA/PPC blends and another new material such as compatibilizer need to be introduced in the blends in order to improve the performance of PLA/PPC blends as a new material for a fixation plate. Besides, by using the same method of producing PLA/PPC blends, longer durations for in vitro degradation of PLA/PPC blends are essential to further understand the degradation behavior of the blends applied in the human body. Finally, it is also important to further test the mechanical strength of PLA/PPC blends during the degradation period to know the current strength of the implant in the healing process of the bone.

PLA fixation plate and screw can commercially be used in CMF surgery since they reduce cost because of the elimination of secondary surgery to remove the fixation plate and screw after the healing process.

It is hoped that the advantages of this research will ensure the market of PLA product to continue expanding in medical application.

This study is one of the alternative ways for the biomedical researchers to improve the elongation break of PLA. Currently, many researchers focus on polymeric materials such as PLA, poly(glycolic) acid and polydioxanone blends, which were extensively being used in CMF surgery. However, the work on PLA/PPC blends to be used as one of the materials for the CMF fixation plate is very limited, if any. PPC, the proposed material for this research, will improve the mechanical performance of PLA fixation plate and screw to become more sustainable and flexible when applied on human mandible bone.

The purpose of this study is to develop and apply clinically relevant methods of analysing the accuracy of dental appliances fabricated using additive manufacture (AM) compared to the computer-aided design (CAD) geometry. The study also compared fit between conventionally laboratory-fabricated and AM-produced base plates.

The techniques were applied to two types of dental devices where AM fabrication methods could foreseeably be used as an alternative to laboratory production. “L” and cubic shapes of defined dimensions and spatial locations were positioned on the devices which were fabricated using AM. For assessing the dimensions, the “L” and cubic shapes were then measured on the physical builds ten times and compared to the CAD model. To assess the fit of AM and lab-produced devices, three upper and three lower conventionally fabricated acrylic base plates were compared to three upper and three lower plates. Silicone impression material was allowed to set between the casts and the base plates which filled any discrepancy between the two surfaces. The thickness of this silicone media was measured ten times at five different points on each base plate type and the results compared.

The results indicated that the evaluated CAD/AM technique is able to produce dental appliance components that are consistent with tolerance levels that would be expected with conventional methods of baseplate design. This research demonstrated that a fully CAD/AM methodology represents a potentially viable alternative to conventional lab-based methods for two types of dental appliances.

This work is original. The authors do not believe any previous papers similar to the one submitted have been published.

This study aims to provide an overview of rapid prototyping (RP) and shows the potential of this technology in the field of medicine as reported in various journals and proceedings. This review article also reports three case studies from open literature where RP and associated technology have been successfully implemented in the medical field.

Key publications from the past two decades have been reviewed.

This study concludes that use of RP-built medical model facilitates the three-dimensional visualization of anatomical part, improves the quality of preoperative planning and assists in the selection of optimal surgical approach and prosthetic implants. Additionally, this technology makes the previously manual operations much faster, accurate and cheaper. The outcome based on literature review and three case studies strongly suggests that RP technology might become part of a standard protocol in the medical sector in the near future.

The article is beneficial to study the influence of RP and associated technology in the field of medicine.

The last decade has seen major advances in rapid prototyping (RP), with it becoming a multi‐disciplinary technology, crossing various research fields, and connecting continents. Process and material advancements open up new applications and manufacturing (through RP) is serving non‐traditional industries. RP technology is used to support rapid product development (RPD). The purpose of this paper is to describe how the Integrated Product Development research group of the Central University of Technology, Free State, South Africa is applying various CAD/CAM/RP technologies to support a medical team from the Grootte Schuur and Vincent Palotti hospitals in Cape Town, to save limbs – as a last resort at a stage where conventional medical techniques or practices may not apply any longer.

The paper uses action research to justify the proposal of a new method to use CAD/CAM/RP related technologies to substitute lost/damaged bone regions through the use of CT to CAD to.STL manipulation.

A case study where RP related technologies were used to support medical product development for a patient with severe injuries from a road accident is discussed.

The paper considers current available technologies, and discusses new advancements in direct metal freeform fabrication, and its potential to revolutionise the medical industry.