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The purpose of this paper is to propose an imperfect symmetry transform framework for orbital prosthesis modelling.

Current models of patients with orbital defects have imperfect symmetries. Commonly used methods, such as principal component analysis (PCA) or iterative closest points algorithm (ICP), do not detect perfect symmetries and therefore produce poor results. The authors propose an improved ICP algorithm based on the M‐estimator, which can remove outliers from the optimization and detect incorrect symmetry. Using this algorithm, the mid‐facial plane of a patient's facial model can be precisely obtained despite perturbation of the facial shape due to the defect.

The results showed that the orbital prosthesis fitted well to the patient's appearance. Clinical applications confirmed that this framework is attractive and has the potential for use in creating desired orbital prostheses or other bilateral maxillofacial prostheses in daily clinical practice.

The method described in this report will improve the fabrication accuracy of orbital prostheses or other bilateral maxillofacial prostheses.

This imperfect symmetry transform framework has great potential for use in clinical applications because of its advantages over other existing methods in terms of accuracy.

Orbital fractures are the most commonly encountered midfacial fractures, and usually, the fracture involves the floor and/or the medial wall of the orbit. This paper aims to present an innovative approach for primary and secondary reconstructions of fractured orbital walls through the use of computer-assisted techniques and additive manufacturing.

First, through the 3D anatomical modelling, the geometry of the implant is shaped to fill the orbital defect and recover the facial symmetry. Subsequently, starting from the modelled implant, a customised mould is designed taking into account medical and technological requirements.

The selective laser sintered mould is able to model and form several kind of prosthetic materials (e.g. titanium meshes and demineralised bone tissue), resulting in customised implants and allowing accurate orbital cavity reconstructions. The case study proved that this procedure, at the same time, reduces the morbidity on the patients, the duration of surgery and the related costs.

This innovative approach has great potential, as it is an easy and in-office procedure, and it offers several advantages over other existing methods.

Post-traumatic zygomatic osteotomy, fracture reduction, and orbital floor reconstruction pose many challenges for achieving a predictable, accurate, safe, and aesthetically pleasing result. This paper aims to describe the successful application of computer-aided design (CAD) and additive manufacturing (AM) to every stage of the process – from planning to surgery.

A multi-disciplinary team was used – comprising surgeons, prosthetists, technicians, and designers. The patient’s computed tomography scan data were segmented for bone and exported to a CAD software package. Medical models were fabricated using AM; for diagnosis, patient communication, and device verification. The surgical approach was modelled in the virtual environment and a custom surgical cutting guide, custom bone-repositioning guide, custom zygomatic implant, and custom orbital floor implant were each designed, prototyped, iterated, and validated using polymer AM prior to final fabrication using metal AM.

Post-operative clinical outcomes were as planned. The patient’s facial symmetry was improved, and their inability to fully close their eyelid was corrected. The length of the operation was reduced relative to the surgical team’s previous experiences. Post-operative scan analysis indicated a maximum deviation from the planned location for the largest piece of mobilised bone of 3.65 mm. As a result, the orbital floor implant which was fixed to this bone demonstrated a maximum deviation of 4.44 mm from the plan.

This represents the first application of CAD and AM to every stage of the process for this procedure – from diagnosis, to planning, and to surgery.

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.

Maxillofacial prosthetics is faced with increasing patient numbers and cost constraints leading to the need to explore whether computer‐aided techniques can increase efficiency. This need is addressed through a four‐year research project that identified quality, economic, technological and clinical implications of the application of digital technologies in maxillofacial prosthetics. The purpose of this paper is to address the aspects of this research that related to the application of rapid prototyping (RP).

An action research approach is taken, utilising multiple case studies to evaluate the current capabilities of digital technologies in the preparation, design and manufacture of maxillofacial prostheses.

The research indicates where RP has demonstrated potential clinical application and where further technical developments are required. The paper provides a technical specification towards which RP manufacturers can direct developments that would meet the needs of maxillofacial prosthetists.

Whilst research studies have explored digital technologies in maxillofacial prosthetics, they have relied on individual studies applying a single RP technology to one particular aspect of a prosthesis. Consequently, conclusions on the wider implications have not been possible. This research explored the application of digital technologies to every aspect of the design and manufacture of a series of maxillofacial prostheses. Unlike previous research, the cases described here addressed the application of RP to the direct manufacture of substructures, retention components and texture. This research analyses prosthetic requirements to ascertain target technical specifications towards which RP processes should be developed.

The purpose of this paper is to develop a workflow for 3D modeling and additive manufacturing (AM) of patient‐specific medical implants. The comprehensive workflow consists of four steps: medical imaging; 3D modelling; additive manufacturing; and clinical application. Implants are used to reconstruct bone damage or defects caused by trauma or disease. Traditionally, implants have been manually bent and shaped, either preoperatively or intraoperatively, with the help of anatomic solid models. The proposed workflow obviates the manual procedure and may result in more accurate and cost‐effective implants.

A patient‐specific implant was digitally designed to reconstruct a facial bone defect. Several test pieces were additive manufactured from stainless steel and titanium by direct metal laser sintering (DMLS) technology. An additive manufactured titanium EOS Titanium Ti64 ELI reconstruction plate was successfully implanted onto the patient's injured orbital wall.

This method enables exact fitting of implants to surrounding tissues. Creating implants before surgery improves accuracy, may reduce operation time and decrease patient morbidity, hence improving quality of surgery. By using AM methods it is possible to manufacture a volumetric net structure, which also allows cells and tissues to grow through it to and from surrounding tissues. The net is created from surface and its thickness and hole size are adjustable. The implant can be designed so that its mass is low and therefore sensitivity to hot and cold temperatures is reduced.

The paper describes a novel technique to create patient‐specific reconstruction implants for facial bony defects.

The purpose of this paper is to describe two different approaches for manufacturing pre-formed titanium meshes to assist prosthetically guided bone regeneration of atrophic maxillary arches. Both methods are based on the use of additive manufacturing (AM) technologies and aim to limit at the minimal intervention the bone reconstructive surgery by virtual planning the surgical intervention for dental implants placement.

Two patients with atrophic maxillary arches were scheduled for bone augmentation using pre-formed titanium mesh with particulate autogenous bone graft and alloplastic material. The complete workflow consists of four steps: three-dimensional (3D) acquisition of medical images and virtual planning, 3D modelling and design of the bone augmentation volume, manufacturing of biomodels and pre-formed meshes, clinical procedure and follow up. For what concerns the AM, fused deposition modelling (FDM) and direct metal laser sintering (DMLS) were used.

For both patients, a post-operative control CT examination was scheduled to evaluate the progression of the regenerative process and verify the availability of an adequate amount of bone before the surgical intervention for dental implants placement. In both cases, the regenerated bone was sufficient to fix the implants in the planned position, improving the intervention quality and reducing the intervention time during surgery.

A comparison between two novel methods, involving AM technologies are presented as viable and reproducible methods to assist the correct bone augmentation of atrophic patients, prior to implant placement for the final implant supported prosthetic rehabilitation.

This paper aims to present novel techniques for designing maxillofacial prostheses using computer-aided design (CAD) and additive manufacture (AM), focusing on the integration of osseointegrated retention components. A fully computer-aided approach is considered as a major step towards reducing patient consultation time and an efficient workflow.

The workflow was illustrated through a phantom model. 3D laser scanning was used to capture the phantom anatomy and pre-fabricated geometric features, which enabled the implant positions to be precisely reverse engineered in the data. A novel CAD workflow was used to design the retention mechanisms and a mould. The individual components were fabricated using AM. A definitive silicone prosthesis that incorporated a bar/clip retention mechanism was then fabricated.

The research demonstrated that retention components can be integrated into prostheses using appropriate CAD and AM technologies.

This study demonstrates the feasibility of a computer-aided workflow for designing facial prostheses that incorporate osseointegrated retention mechanisms. Novel techniques were developed to: digitise abutment details using custom scanning locators; design retention components; manufacture retention components using AM; integrate retention components into a CAD and AM prosthesis mould. This overcomes limitations identified in previously published cases and demonstrated significant potential to reduce patient consultation time and create a clinically viable process.

The purpose of this paper is to describe a computer‐aided design/manufacturing (CAD/CAM) system for fabricating facial prostheses.

The CAD/CAM system can be used for fabricating custom‐made facial prostheses with symmetrical or asymmetrical features. This system integrates non‐contact structured light scanning, reverse engineering and rapid prototyping manufacturing technology. Fringe projection based on the combination of the phase‐shift and grey‐code methods is used for data collection. A robust approach is proposed to calculate the mid‐plane of the human face without any knowledge of the centroid position or the principal axis in data processing.

Results show that the proposed method increases the fabrication accuracy and reduces the operating time. Patients were satisfied with the rehabilitation results as the custom‐made facial prostheses fitted them well.

This study improves the fabrication accuracy of facial prostheses. Three‐dimensional data of the facial surface of a patient needing a facial prosthesis were obtained with almost no harm to his body; after a series of robust processes, a precise and suitable aesthetic facial prosthesis was fabricated.

This system has bright prospects for clinical application because of its advantages over other methods in terms of speed, accuracy, safety, cost, etc.

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.