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This study aims to find the usefulness of the customized surgical osteotomy guide (CSOG) for accurate mandibular tumor resection for boosting the accuracy of prefabricated customized implant fixation in mandibular reconstructions.

In all, 30 diseased mandibular RP models (biomodels) were allocated for the study (for experimental group [n = 15] and for control group [n = 15]). To reconstruct the mandible with customized implant in the experimental group, CSOGs and in control group, no CSOG were used for accurate tumor resections. In control group, only preoperative virtual surgical planning (VSP) and reconstructed RP mandible model were used for the reference. Individually each patient’s preoperative mandibular reconstructions data of both the groups were superimposed to the preoperative VSP of respective patient by registering images with the non-surgical side of the mandible. In both the groups, 3D measurements were taken on the reconstructed side and compared the preoperative VSP and postoperative reconstructed mandible data. The sum of the differences between pre and postoperative data was considered as the total error. This procedure was followed for both the groups and compared the obtained error between the two groups using statistical analysis.

The use of CSOG for accurate tumor resection and exact implant fixation in mandibular reconstruction produced a smaller total error than without using CSOG.

The results showed that, benefits provided with the use of CSOG in mandibular reconstruction justified its use over the without using CSOG, even in free hand tumor resection using rotating burr.

The purpose of this study is to test the concept of a relatively low cost but biocompatible customized surgical guide printing method using a new composite material for the FDM process to support accurate virtual model reconstruction in CT.

Current additive manufacturing printed surgical guides have problems of scanning artifacts or low computed tomography (CT) values for virtual model reconstruction in CT-assisted surgical operations. These tools always face difficulties in precise positioning due to the effect of human soft tissues and manually made unstable landmarks. To solve this problem, this paper proposes a modified material, polyetheretherketone powder mixed with barium sulfate powder, for printing customized surgical guides with relatively low cost to support a synchronized scanning strategy, for the accurate reconstruction of human tissues and in vitro models.

A set of benchmarking experiments and clinical simulation cases were conducted. The results showed that the proposed solution can be used to print surgical guides to form stable and clear CT graphs for three-dimensional digital model reconstruction. Human tissues and in vitro models can be accurately reconstructed using clear CT graphs without any scanning artifacts or difficulties in image segmentation for virtual model reconstruction, thus facilitating accurate operation guidance and positioning.

This method has wide application potential for printing modular or customized surgical guides with low cost and reusability, especially for surgical operations using CT-assisted navigation systems in underdeveloped regions where medical device costs are a critical issue.

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.

The purpose of this research is to (1) analyse the effect of customised on-demand 3DP on surgical flow time, its variability and clinical outcomes (2) provide a framework for hospitals to decide whether to invest in 3DP or to outsource.

The research design included interviews, workshops and field visits. Design science approach was used to analyse the impact of the 3D printing (3DP) interventions on specific outcomes and to develop frameworks for hospitals to invest in 3DP, which were validated through further interviews with stakeholders.

Evidence from this research shows that deploying customised on-demand 3DP can reduce surgical flow time and its variability while improving clinical outcomes. Such outcomes are obtained due to rapid development of the anatomical model and surgical guides along with precise cutting during surgery.

We outline multiple opportunities for research on supply chain design and performance assessment for surgical 3DP. Further empirical research is needed to validate the results.

The decision to implement 3DP in hospitals or to engage service providers will require careful analysis of complexity, demand, lead-time criticality and a hospital's own objectives. Hospitals can follow different paths in adopting 3DP for surgeries depending on their context.

The operations and supply chain management community has researched on-demand distributed manufacturing for multiple industries. To the best of our knowledge, this is the first paper on customised on-demand 3DP for surgeries.

This paper aims to fill a research gap by presenting design and 3D printing guidelines and considerations which apply to the development process of patient-specific osteotomy guides for orthopaedic surgery.

Analysis of specific constraints related to patient-specific surgical guides design and 3D printing, lessons learned during the development process of osteotomy guides for orthopaedic surgery, literature review of recent studies in the field and data gathered from questioning a group of surgeons for capturing their preferences in terms of surgical guides design corresponding to precise functionality (materializing cutting trajectories, ensuring unique positioning and stable fixation during surgery), were all used to extract design recommendations.

General design rules for patient-specific osteotomy guides were inferred from examining each step of the design process applied in several case studies in relation to how these guides should be designed to fulfill medical and manufacturing (fused deposition modelling process) constraints. Literature was also investigated for finding other information than the simple reference that the surgical guide is modelled as negative of the bone. It was noticed that literature is focussed more on presenting and discussing medical issues and on assessing surgical outcomes, but hardly at all on guides’ design and design for additive manufacturing aspects. Moreover, surgeons’ opinion was investigated to collect data on different design aspects, as well as interest and willingness to use such 3D-printed surgical guides in training and surgery.

The study contains useful rules and recommendations for engineers involved in designing and 3D printing patient-specific osteotomy guides.

A synergetic approach to identify general rules and recommendations for the patient-specific surgical guides design is presented. Specific constraints are identified and analysed using three case studies of wrist, femur and foot osteotomies. Recent literature is reviewed and surgeons’ opinion is investigated.

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.

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 the paper was to present a specific case study of how 3D printing was introduced in the chest wall construction process of a specific patient with unique medical condition. A life-size 3D model of the patient’s chest wall was 3D printed for pre-surgical planning. The intent was to eliminate the need for operative exposure to map the pathological area. The model was used for preoperative visualization and formation of a 1-mm thick titanium plate implant, which was placed in the patient during chest wall reconstructive surgery. The purpose of the surgery was to relive debilitating chronic pain due to right scapular entrapment.

The patient was born with a twisted spine. Over time, it progressed to severe and debilitating scoliosis, which required the use of a thoracic brace. Computerized tomography (CT) data were converted to a 3D printed model. The model was used to size and form a 1-mm thick titanium plate implant. It was also used to determine the ideal location for placement of the plate during thoracotomy preoperatively.

The surgery, aided by the model, was successful and resulted in a significantly smaller incision. The techniques reduced invasiveness and enabled the doctors to conduct the procedure efficiently and decreased surgery time. The patient experienced relief of the chronic debilitating pain and no longer need the thoracic brace.

The 3D model facilitated pre-operative planning and modeling of the implant. It also enabled accurate incision locations of the thoracotomy site and placement of the implant. Although chest wall reconstruction surgeries have been undertaken, this paper documents a specific case study of chest wall construction fora specific patient with unique pathological conditions.

This review paper aims to provide an overview of applications of direct rapid manufacturing assisted mold with conformal cooling channels (CCCs) and shows the potential of this technique in different manufacturing processes.

Key publications from the past two decades have been reviewed.

This study concludes that direct rapid manufacturing technique plays a dominant role in the manufacturing of mold with complicated CCC structure which helps to improve the quality of final part and productivity. The outcome based on literature review and case study strongly suggested that in the near future direct rapid manufacturing method might become standard procedure in various manufacturing processes for fabrication of complex CCCs in the mold.

Advanced techniques such as computer-aided design, computer-aided engineering simulation and direct rapid manufacturing made it possible to easily fabricate the effective CCC in the mold in various manufacturing processes.

This paper is beneficial to study the direct rapid manufacturing technique for development of the mold with CCC and its applications in different manufacturing processes.

The purpose of this paper is to discuss the current state-of-the-art in additive manufacturing, more commonly known as 3D printing, from the business perspectives. The primary drivers behind the development of the associated technologies are considered along with features that limit growth.

The approach is a personal perspective, based on approximately 25-years study of the development of the associated technologies and applications.

The discussion has found that the technology is still growing healthily, but with an understanding that there are numerous application areas that should be considered separately. Some areas are significantly more mature than others and success in some areas does not guarantee success in others.

This viewpoint has been prepared for the current state-of-the-art and can be compared with earlier viewpoints to see how things may have changed in the past. This should be of value to those interested to explore how the technology has developed in recent times and how it may move into the future.