Issue
Copyright (c) 2021 Diana Carolina Navarro León, Genny Liliana Meléndez Flórez y Clara Isabel López Gualdrón
This work is licensed under a Creative Commons Attribution 4.0 International License.
Craniofacial bone defects characterization with tridimensional reconstruction software and CAD/CAM technology
Corresponding Author(s) : Diana Carolina Navarro León
Ciencia e Innovación en Salud,
2021
Abstract
Introducción: Analizar y describir las características óseas en pacientes con defectos óseos cráneo-faciales complejos, utilizando un software de reconstrucción tridimensional. Determinar la utilidad y aplicabilidad en el planeamiento y tratamiento quirúrgico de los pacientes. Métodos: Se realizó muestreo poblacional de pacientes con defectos óseos cráneo-faciales complejos tomando datos de historia clínica y tomografías computarizadas, determinando las características físicas y densitométricas de los huesos y realizando el análisis diagnóstico y planeación de tratamiento. Se realizó recolección de datos y posterior análisis usando el software Stata 12.0, cuantitativo y cualitativo, demostrando significancia estadística con prueba de chi2. Resultados: Se recolectó información de 50 pacientes de los cuales el 70% correspondían a hombres, la edad promedio fue de 37 años, la causa más frecuente fue traumática secundaria a accidente de tránsito, el hueso comprometido en la mayoría de los pacientes fue la mandíbula y el tamaño del defecto llego a ser hasta de 234 mm. El análisis de los pacientes con software de reconstrucción tridimensional permitió crear un algoritmo de enfoque diagnóstico y tratamiento. Se muestran algunos casos. Conclusiones: La utilidad de la implementación de tecnología CAD/CAM en el manejo de reconstrucciones óseas cráneo-faciales está demostrada, representan un alto costo para el paciente y el sistema de salud. Es posible mediante la implementación de software gratuitos y el trabajo multidisciplinario con servicios como biomedicina, diseño industrial e ingenierías, aplicar esta tecnología en pacientes, aprovechando sus beneficios en la reconstrucción de defectos complejos así como disminuyendo sus costos
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- Lübbers HT, Matthews F, Kruse AL. Modern technologies in cranio-maxillofacial surgery. Praxis (Bern 1994). 2014 Feb 26; 103(5):257-64. DOI: 10.1024/1661-8157/a001570
- Bell B. Computer Planning and Intraoperative Navigation in Cranio-Maxillofacial Surgery. Oral Maxillofacial Surg Clin N Am 22 (2010) 135–156. DOI: 10.1016/j.coms.2009.10.010
- Chim H., Wetjen N., Mardini S., Virtual Surgical Planning in Craniofacial Surgery. Semin Plast Surg 2014; 28:150–158. DOI: 10.1055/s-0034-1384811
- Tack P., Jan V., Gemmel P., Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. BioMed Eng OnLine (2016) 15:115. DOI: 10.1186/s12938-016-0236-4
- Carlos G. Landaeta-Quinones C., Hernández N. Zarroug N. Computer-Assisted Surgery Applications in Dentistry and Oral and Maxillofacial Surgery. Dent Clin N Am 62 (2018) 403–420. DOI: 10.1016/j.cden.2018.03.009
- Fuertes L., Mafla A., López E. Análisis epidemiológico de trauma maxilofacial en Nariño, Colombia Rev.CES Odont. (2010); 23(2)33-40. DOI: 10.1016/j.cden.2018.03.009
- Ortiz G., Arango J., Giralgo C., Ramírez D., Uribe J. Análisis Retrospectivo de historias clínicas de pacientes intervenidos por Cirugía Maxilofacial en el Hospital General de Medellín. Rev.CES Odont. (2007); 20(2)17-21. DOI: 10.21615/99
- Foley B., Thayer W., Honeybrook A., McKenna S., Press S. Mandibular Reconstruction Using Computer-Aided Design and Computer-Aided Manufacturing: An Analysis of Surgical Results, J Oral Maxillofac Surg 71: e111-e119, 2013. DOI: 10.1016/j.joms.2012.08.022
- Bell R., Markiewicz M. Computer-Assisted Planning, Stereolithographic Modeling, and Intraoperative Navigation for Complex Orbital Reconstruction: A Descriptive Study in a Preliminary Cohort. J Oral Maxillofac Surg 67:2559-2570, 2009. DOI: 10.1016/j.joms.2009.07.098
- R. Bosc, B. Hersant, R. Carloni, J. Niddam, J. Bouhassira, H. De Kermadec, E. Bequignon, T. Wojcik, M. Julieron, J.-P. Meningaud: Mandibular reconstruction after cancer: an in-house approach to manufacturing cutting guides. Int. J. Oral Maxillofac. Surg. 2016. DOI: 10.1016/j.ijom.2016.10.004
- Kim N., Kim H., Kim H. J., Cha I., Nam W. Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap. Maxillofac Plast Reconstr Surg 2014; 36(4):161-167. DOI: 10.14402/jkamprs.2014.36.4.161
- Gray R., Gougoutas A., Nguyen V., Taylor J., Bastidas N. Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population, International. Journal of Pediatric Otorhinolaryngology 97 (2017) 163-169. DOI: 10.1016/j.ijporl.2017.04.004
- Dell’Aversana Orabona G, Abbate V, Maglitto F, Bonavolontà P, Salzano G,Romano A, Reccia A, Committeri U, Iaconetta G, Califano L. Low-cost, self-made CAD/CAM-guiding system for mandibular reconstruction. Surgical Oncology (2018), DOI: 10.1016/j.suronc.2018.03.007
- Tarsitano A, Mazzoni S, Cipriani R, Scotti R, Marchetti C, Ciocca L, The CADCAM technique for mandibular reconstruction: an 18 patients oncological case-series, Journal of Cranio-Maxillofacial Surgery (2014). DOI: 10.1016/j.jcms.2014.04.011
- M. Visocchi et al. (eds.), Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement 124, 137, 2017. DOI 10.1007/978-3-319-39546-3_21
- Futran N., Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol 2006; 7: 249–58. DOI: 10.1016/S1470-2045(06)70616-7
- Costa H, Zenha H, Sequeira H, Coelho G, Gomes N, Pinto C, Martins J, Santos D, Andresen C. Microsurgical Reconstruction Of The Maxilla – Algorithm And Concepts. British Journal of Plastic Surgery (2015), DOI: 10.1016/j.bjps.2014.12.002.
- Liu X., Gui L., Mao C., Peng X., Yu G. Applying Computer Techniques in Maxillofacial Reconstruction Using a Fibula Flap: A Messenger and an Evaluation Method. The Journal of Craniofacial Surgery & Volume 20, Number 2, March 2009. DOI: 10.1097/SCS.0b013e31819b9443
- Park E. Et al. Cranioplasty Enhanced by Three-Dimensional Printing: Custom-Made Three-Dimensional-Printed Titanium Implants for Skull Defects. J Craniofac Surg 2016; 00: 00–00. DOI: 10.1097/SCS.0000000000002656
- Tepper O. et al. Use of Virtual 3-Dimensional Surgery in Post-Traumatic Craniomaxillofacial Reconstruction. J Oral Maxillofac Surg 69:733-741, 2011. DOI: 10.1016/j.joms.2010.11.028
- Singara S., Et al. Individually Prefabricated Prosthesis for Maxilla Reconstruction. Journal of Prosthodontics XX (2007). DOI: 10.1111/j.1532-849X.2007.00266.x
- McCarthy C., Cordeiro P. Microvascular Reconstruction of Oncologic Defects of the Midface. Plast. Reconstr. Surg. 126: 1947, 2010. DOI: 10.1097/PRS.0b013e3181f446f1
- Xia J., Et al., Cost-Effectiveness Analysis for Computer-Aided Surgical Simulation in Complex Cranio-Maxillofacial Surgery. J Oral Maxillofac Surg 64:1780-1784, 2006. DOI: 10.1016/j.joms.2005.12.072
- Popescu D., Laptoiu D. Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review. J Engineering in Medicine, 2016, Vol. 230(6) 495–515. DOI: 10.1177/0954411916636919
- Maschio F., Pabdya M., Olszewski R. Experimental Validation of Plastic Mandible Models Produced by a “Low-Cost” 3-Dimensional Fused Deposition Modeling Printer. Med Sci Monit, 2016; 22: 943-957. DOI: 10.12659/MSM.895656
- Fuller S., Strong B. Computer applications in facial plastic and reconstructive surgery (2007). Curr Opin Otolaryngol Head Neck Surg 15:233–237 DOI: 10.1097/MOO.0b013e3281df2c5f
- Alessandro Marro BSc, Taha Bandukwala MD, Walter Mak MD, 3d Printing and Medical Imaging: A Review of the Methods and Aplications, Current Problems in Diagnostic Radiology. DOI: 10.1067/j.cpradiol.2015.07.009
References
Lübbers HT, Matthews F, Kruse AL. Modern technologies in cranio-maxillofacial surgery. Praxis (Bern 1994). 2014 Feb 26; 103(5):257-64. DOI: 10.1024/1661-8157/a001570
Bell B. Computer Planning and Intraoperative Navigation in Cranio-Maxillofacial Surgery. Oral Maxillofacial Surg Clin N Am 22 (2010) 135–156. DOI: 10.1016/j.coms.2009.10.010
Chim H., Wetjen N., Mardini S., Virtual Surgical Planning in Craniofacial Surgery. Semin Plast Surg 2014; 28:150–158. DOI: 10.1055/s-0034-1384811
Tack P., Jan V., Gemmel P., Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. BioMed Eng OnLine (2016) 15:115. DOI: 10.1186/s12938-016-0236-4
Carlos G. Landaeta-Quinones C., Hernández N. Zarroug N. Computer-Assisted Surgery Applications in Dentistry and Oral and Maxillofacial Surgery. Dent Clin N Am 62 (2018) 403–420. DOI: 10.1016/j.cden.2018.03.009
Fuertes L., Mafla A., López E. Análisis epidemiológico de trauma maxilofacial en Nariño, Colombia Rev.CES Odont. (2010); 23(2)33-40. DOI: 10.1016/j.cden.2018.03.009
Ortiz G., Arango J., Giralgo C., Ramírez D., Uribe J. Análisis Retrospectivo de historias clínicas de pacientes intervenidos por Cirugía Maxilofacial en el Hospital General de Medellín. Rev.CES Odont. (2007); 20(2)17-21. DOI: 10.21615/99
Foley B., Thayer W., Honeybrook A., McKenna S., Press S. Mandibular Reconstruction Using Computer-Aided Design and Computer-Aided Manufacturing: An Analysis of Surgical Results, J Oral Maxillofac Surg 71: e111-e119, 2013. DOI: 10.1016/j.joms.2012.08.022
Bell R., Markiewicz M. Computer-Assisted Planning, Stereolithographic Modeling, and Intraoperative Navigation for Complex Orbital Reconstruction: A Descriptive Study in a Preliminary Cohort. J Oral Maxillofac Surg 67:2559-2570, 2009. DOI: 10.1016/j.joms.2009.07.098
R. Bosc, B. Hersant, R. Carloni, J. Niddam, J. Bouhassira, H. De Kermadec, E. Bequignon, T. Wojcik, M. Julieron, J.-P. Meningaud: Mandibular reconstruction after cancer: an in-house approach to manufacturing cutting guides. Int. J. Oral Maxillofac. Surg. 2016. DOI: 10.1016/j.ijom.2016.10.004
Kim N., Kim H., Kim H. J., Cha I., Nam W. Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap. Maxillofac Plast Reconstr Surg 2014; 36(4):161-167. DOI: 10.14402/jkamprs.2014.36.4.161
Gray R., Gougoutas A., Nguyen V., Taylor J., Bastidas N. Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population, International. Journal of Pediatric Otorhinolaryngology 97 (2017) 163-169. DOI: 10.1016/j.ijporl.2017.04.004
Dell’Aversana Orabona G, Abbate V, Maglitto F, Bonavolontà P, Salzano G,Romano A, Reccia A, Committeri U, Iaconetta G, Califano L. Low-cost, self-made CAD/CAM-guiding system for mandibular reconstruction. Surgical Oncology (2018), DOI: 10.1016/j.suronc.2018.03.007
Tarsitano A, Mazzoni S, Cipriani R, Scotti R, Marchetti C, Ciocca L, The CADCAM technique for mandibular reconstruction: an 18 patients oncological case-series, Journal of Cranio-Maxillofacial Surgery (2014). DOI: 10.1016/j.jcms.2014.04.011
M. Visocchi et al. (eds.), Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement 124, 137, 2017. DOI 10.1007/978-3-319-39546-3_21
Futran N., Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol 2006; 7: 249–58. DOI: 10.1016/S1470-2045(06)70616-7
Costa H, Zenha H, Sequeira H, Coelho G, Gomes N, Pinto C, Martins J, Santos D, Andresen C. Microsurgical Reconstruction Of The Maxilla – Algorithm And Concepts. British Journal of Plastic Surgery (2015), DOI: 10.1016/j.bjps.2014.12.002.
Liu X., Gui L., Mao C., Peng X., Yu G. Applying Computer Techniques in Maxillofacial Reconstruction Using a Fibula Flap: A Messenger and an Evaluation Method. The Journal of Craniofacial Surgery & Volume 20, Number 2, March 2009. DOI: 10.1097/SCS.0b013e31819b9443
Park E. Et al. Cranioplasty Enhanced by Three-Dimensional Printing: Custom-Made Three-Dimensional-Printed Titanium Implants for Skull Defects. J Craniofac Surg 2016; 00: 00–00. DOI: 10.1097/SCS.0000000000002656
Tepper O. et al. Use of Virtual 3-Dimensional Surgery in Post-Traumatic Craniomaxillofacial Reconstruction. J Oral Maxillofac Surg 69:733-741, 2011. DOI: 10.1016/j.joms.2010.11.028
Singara S., Et al. Individually Prefabricated Prosthesis for Maxilla Reconstruction. Journal of Prosthodontics XX (2007). DOI: 10.1111/j.1532-849X.2007.00266.x
McCarthy C., Cordeiro P. Microvascular Reconstruction of Oncologic Defects of the Midface. Plast. Reconstr. Surg. 126: 1947, 2010. DOI: 10.1097/PRS.0b013e3181f446f1
Xia J., Et al., Cost-Effectiveness Analysis for Computer-Aided Surgical Simulation in Complex Cranio-Maxillofacial Surgery. J Oral Maxillofac Surg 64:1780-1784, 2006. DOI: 10.1016/j.joms.2005.12.072
Popescu D., Laptoiu D. Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review. J Engineering in Medicine, 2016, Vol. 230(6) 495–515. DOI: 10.1177/0954411916636919
Maschio F., Pabdya M., Olszewski R. Experimental Validation of Plastic Mandible Models Produced by a “Low-Cost” 3-Dimensional Fused Deposition Modeling Printer. Med Sci Monit, 2016; 22: 943-957. DOI: 10.12659/MSM.895656
Fuller S., Strong B. Computer applications in facial plastic and reconstructive surgery (2007). Curr Opin Otolaryngol Head Neck Surg 15:233–237 DOI: 10.1097/MOO.0b013e3281df2c5f
Alessandro Marro BSc, Taha Bandukwala MD, Walter Mak MD, 3d Printing and Medical Imaging: A Review of the Methods and Aplications, Current Problems in Diagnostic Radiology. DOI: 10.1067/j.cpradiol.2015.07.009