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Computer-aided design and additive manufacture (CAD/AM) technologies are sufficiently refined and meet the necessary regulatory requirements for routine incorporation into the medical field, with long-standing application in surgeries of the maxillofacial and craniofacial regions. They have resulted in better medical care for patients and faster, more accurate procedures. Despite ever-growing evidence about the advantages of computer-aided planning, CAD and AM in surgery, detailed reporting on critical design decisions that enable methodological replication and the development and establishment of guidelines to ensure safety are limited. This paper aims to present a novel application of CAD and AM to a single-stage resection and reconstruction of fibrous dysplasia in the zygoma and orbit.

It is reported in sufficient fidelity to permit methods replication and design guideline developments in future cases, wherever they occur in the world. The collaborative approach included engineers, designers, surgeons and prosthetists to design patient-specific cutting guides and a custom implant. An iterative design process was used, until the desired shape and function were achieved, for both of the devices. The surgery followed the CAD plan precisely and without problems. Immediate post-operative subjective clinical judgements were of an excellent result.

At 19 months post-op, a CT scan was undertaken to verify the clinical and technical outcomes. Dimensional analysis showed maximum deviation of 4.73 mm from the plan to the result, while CAD-Inspection showed that the deviations ranged between −0.1 and −0.8 mm and that the majority of deviations were located around −0.3 mm.

Improvements are suggested and conclusions drawn regarding the design decisions considered critical to a successful outcome for this type of procedure in the future.

Pores and shrink holes are unavoidable defects in the die-casting mass production process which may significantly influence the strength, fatigue and fracture behaviour as well as the life span of structures, especially if they are subjected to high static and dynamic loads. Such defects should be considered during the design process or after production, where the defects could be detected with the help of computed tomography (CT) measurements. However, this is usually not done in today's mass production environments. This paper deals with the stress analysis of die-cast structural parts with pores found from CT measurements or that are artificially placed within a structure.

In this paper the authors illustrate two general methodologies to take into account the porosity of die-cast components in the stress analysis. The detailed geometry of a die-cast part including all discontinuities such as pores and shrink holes can be included via STL data provided by CT measurements. The first approach is a combination of the finite element method (FEM) and the finite cell method (FCM), which extends the FEM if the real geometry cuts finite elements. The FCM is only applied in regions with pores. This procedure has the advantage that all simulations with different pore distributions, real or artificial, can be calculated without changing the base finite element mesh. The second approach includes the pore information as STL data into the original CAD model and creates a new adapted finite element mesh for the simulation. Both methods are compared and evaluated for an industrial problem.

The STL data of defects which the authors received from CT measurements could not be directly applied without repairing them. Therefore, for FEM applications an appropriate repair procedure is proposed. The first approach, which combines the FEM with the FCM, the authors have realized within the commercial software tool Abaqus. This combination performs well, which is demonstrated for test examples, and is also applied for a complex industrial project. The developed in-house code still has some limitations which restrict broader application in industry. The second pure FEM-based approach works well without limitations but requires increasing computational effort if many different pore distributions are to be investigated.

A new simulation approach which combines the FEM with the FCM has been developed and implemented into the commercial Abaqus FEM software. This approach the authors have applied to simulate a real engineering die-cast structure with pores. This approach could become a preferred way to consider pores in practical applications, where the porosity can be derived either from CT measurements or are artificially adopted for design purposes. The authors have also shown how pores can be considered in the standard FEM analysis as well.