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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 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.

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 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 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.

Although conformable devices are commonly designed to couple with the human body for personalized and localized medicine, their applications are expanding rapidly. This paper aims to delineate this expansion and predict greater implications in diverse fields.

Today’s device technologies continue to face fundamental obstacles preventing their seamless integration with target objects to effectively access, evaluate and alter self-specific physical patterns, while still providing physical comfort and enabling continuous data collection. Due to their extreme mechanical compliance, conformable devices permit the query of signals occurring at interfaces so as to decode and encode biological, chemical and mechanical patterns with high resolution, precision and accuracy. These unique and versatile capabilities allow for a marked change in the approach to tackling scientific questions, with the ability to address societal challenges at large.

Here, this study highlights the current state of these devices in a wide range of fields, such as interactive teaching, textiles, robotics, buildings and infrastructure, agriculture, climate and space, and further forecasts essential features of these devices in the near future.

This study justifies conformable devices’ growing utility through a novel quantitative analysis methodology that indexes peer-reviewed journal articles based on specific keywords, whereby this study tracks keyword frequency over time across specific fields in conjunction with conformability-like topics. The resulting trends’ trajectories provide the foundation for this study’s future projections. This study concludes with a perspective on the possible challenges concomitant with a ubiquitous presence of these technologies, including manufacturing, wireless communication, storage, compression, privacy and sharing of data, environmental sustainability, avoidance of inequality and bias and collaboration between stakeholders at all levels of impact.

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 study aims to identify 3D-printed medical model (3DPMM) supply chain barriers that affect the supply chain of 3DPMM in the Indian context and investigate the interdependencies between the barriers to establish hierarchical relations between them to improve the supply chain.

The methodology used interpretive structural modeling (ISM) and a decision-making trial and evaluation laboratory (DEMATEL) to identify the hierarchical and contextual relations among the barriers to the 3DPMM supply chain.

A total of 15 3DPMM supply chain barriers were identified in this study. The analysis identified limited materials options, slow production speed, manual post-processing, high-skilled data analyst, design and customization expert and simulation accuracy as the significant driving barriers for the medical models supply chain for hospitals. In addition, the authors identified linkage and dependent barriers. The present study findings would help to improve the 3DPMM supply chain.

There were no experts from other nations, so this study might have missed a few 3DPMM supply chain barriers that would have been significant from another nation’s perspective.

ISM would help practitioners minimize 3DPMM supply chain barriers, while DEMATEL allows practitioners to emphasize the causal effects of 3DPMM supply chain barriers.

This study minimizes the 3DPMM supply chain barriers for medical applications through a hybrid ISM and DEMATEL methodology that has not been investigated in the literature.

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.

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.