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Srivastava G, Padhiary SK, Mohanty N, Patil PG, Panda S, Cobo-Vazquez C, Çakmak G, Molinero-Mourelle P. Digital workflow feasibility for the fabrication of intraoral maxillofacial prosthetics after surgical resection: a systematic literature review. Acta Odontol Scand 2024; 83:392-403. [PMID: 38895776 DOI: 10.2340/aos.v83.40870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for patients with partial or total maxillary and mandibular defects. MATERIALS AND METHODS An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed. RESULTS From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination. CONCLUSION Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
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Affiliation(s)
- Gunjan Srivastava
- Department of Prosthodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India.
| | - Subrat Kumar Padhiary
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be Univesity, Bhubaneswar, India
| | - Neeta Mohanty
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Pravinkumar G Patil
- Department of Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Saurav Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan, University, Bhubaneswar, India
| | - Carlos Cobo-Vazquez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Das D, Gupta R, Gill S, Saini A. A modified technique of using digital technology to fabricate surgical obturator in patients with limited mouth opening. J Oral Biol Craniofac Res 2023; 13:581-583. [PMID: 37545662 PMCID: PMC10403737 DOI: 10.1016/j.jobcr.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
This article presents a digital technique for the fabrication of an immediate surgical obturator for a patient with decreased mouth opening planned for maxillectomy. The amalgamation of pre-operative Cone Beam Computed Tomography (CBCT) data and 3D printing allowed for the fabrication of the immediate surgical obturator without conventional pre-surgical diagnostic impression. The surgical obturator was placed in position intraorally post tumor resection to complete the obturation. The procedure followed led to an accurate fit of the prosthesis without any need for relining during surgery.
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Affiliation(s)
- Divyajoti Das
- Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Rekha Gupta
- The Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shubhra Gill
- The Department of Prosthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Baghani MT, Neshati A, Sadafi M, Shidfar S. Evaluation of the accuracy of digital and conventional implant-level impression techniques for maxillofacial prosthesis. J Family Med Prim Care 2023; 12:446-451. [PMID: 37122657 PMCID: PMC10131967 DOI: 10.4103/jfmpc.jfmpc_1324_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/29/2022] [Accepted: 08/27/2022] [Indexed: 05/02/2023] Open
Abstract
Objectives This study aims to evaluate the accuracy of digital impression making based on trueness and precision measurements of dental implants placed in maxillofacial lesions to produce Maxillofacial prosthesis substructures. Methods Two intra-oral scanners (Trios 3 and CS 3700) and one Desktop scanner (open technology) were examined in this study. A Model of a patient with a lesion in the ear region was created as a reference. The reference model was scanned by each scanner 10 times. Standard Tessellation Language files were provided from each scanner and were examined in terms of Trueness and Precision aspects. Results In Distance 1, in the one-way analysis of variance test, there was a significant difference between the three scanners. The Trios group has less deviation than the Open Technology group (P = 0.015) compared with the CareStream (CS) group that showed more deviation (P < 0.000). There is a statistically significant difference in distance 2 among scanners. The Trios group showed more deviation as compared with the Open Technology group (P < 0.000). While this deviation is not statistically significant compared with the CS group (P = 0.0907). Open Technology Group compared with the CS group also has less deviation in distance 2, which has been statistically significant (P < 0.000). The preparation of a precise model of maxillofacial lesions is still difficult for some Intraoral scanners. Conclusion There were significant statistical differences in Trueness and Precision among scanners. Used scanners can be applied as an alternative to conventional impression methods.
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Affiliation(s)
- Mohammad Taghi Baghani
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
| | - Ammar Neshati
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Ammar Neshati, Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran. E-mail:
| | - Mehdi Sadafi
- Department of Prosthodontics, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran
| | - Shireen Shidfar
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Obturator Manufacturing for Oronasal Fistula after Cleft Palate Repair: A Review from Handicraft to the Application of Digital Techniques. J Funct Biomater 2022; 13:jfb13040251. [PMID: 36412892 PMCID: PMC9680338 DOI: 10.3390/jfb13040251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
An oronasal fistula (ONF) is an abnormal structure between the oral and nasal cavities, which is a common complication of cleft palate repair due to the failure of wound healing. When some patients with ONF are unsuitable for secondary surgical repair, the obturator treatment becomes a potential method. The objectives of the obturator treatment should be summarized as filling the ONF comfortably and cosmetically restoring the dentition with partial function. The anatomy of patients with cleft palate is complex, which may lead to a more complex structure of the ONF. Thus, the manufacturing process of the obturator for these patients is more difficult. For performing the design and fabrication process rapidly and precisely, digital techniques can help, but limitations still exist. In this review, literature searches were conducted through Medline via PubMed, Wiley Online Library, Science Direct, and Web of Science, and 122 articles were selected. The purpose of this review was to introduce the development of the obturator for treating patients with ONF after cleft palate repair, from the initial achievement of the obstruction of the ONF to later problems such as fixation, velopharyngeal insufficiency, and infection, as well as the application of digital technologies in obturator manufacturing.
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Nyirjesy SC, Heller M, von Windheim N, Gingras A, Kang SY, Ozer E, Agrawal A, Old MO, Seim NB, Carrau RL, Rocco JW, VanKoevering KK. The role of computer aided design/computer assisted manufacturing (CAD/CAM) and 3- dimensional printing in head and neck oncologic surgery: A review and future directions. Oral Oncol 2022; 132:105976. [PMID: 35809506 DOI: 10.1016/j.oraloncology.2022.105976] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/17/2022] [Indexed: 01/12/2023]
Abstract
Microvascular free flap reconstruction has remained the standard of care in reconstruction of large tissue defects following ablative head and neck oncologic surgery, especially for bony structures. Computer aided design/computer assisted manufacturing (CAD/CAM) and 3-dimensionally (3D) printed models and devices offer novel solutions for reconstruction of bony defects. Conventional free hand techniques have been enhanced using 3D printed anatomic models for reference and pre-bending of titanium reconstructive plates, which has dramatically improved intraoperative and microvascular ischemia times. Improvements led to current state of the art uses which include full virtual planning (VP), 3D printed osteotomy guides, and patient specific reconstructive plates, with advanced options incorporating dental rehabilitation and titanium bone replacements into the primary surgical plan through use of these tools. Limitations such as high costs and delays in device manufacturing may be mitigated with in house software and workflows. Future innovations still in development include printing custom prosthetics, 'bioprinting' of tissue engineered scaffolds, integration of therapeutic implants, and other possibilities as this technology continues to rapidly advance. This review summarizes the literature and serves as a summary guide to the historic, current, advanced, and future possibilities of 3D printing within head and neck oncologic surgery and bony reconstruction. This review serves as a summary guide to the historic, current, advanced, and future roles of CAD/CAM and 3D printing within the field of head and neck oncologic surgery and bony reconstruction.
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Affiliation(s)
- Sarah C Nyirjesy
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Margaret Heller
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Natalia von Windheim
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Amelia Gingras
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Stephen Y Kang
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Enver Ozer
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Amit Agrawal
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Matthew O Old
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Nolan B Seim
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Ricardo L Carrau
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - James W Rocco
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States
| | - Kyle K VanKoevering
- Department of Otolaryngology- Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Columbus, OH 43210, United States.
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Jamayet NB, Farook TH, Al-Oulabi A, Johari Y, Patil PG. Digital workflow and virtual validation of a 3D-printed definitive hollow obturator for a large palatal defect. J Prosthet Dent 2021; 129:798-804. [PMID: 34635339 DOI: 10.1016/j.prosdent.2021.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022]
Abstract
This clinical report describes how a hollow obturator prosthesis was designed and fabricated for an 82-year-old partially edentulous patient with a large palatal defect. Computer-aided design (CAD) was used to design, articulate, and align the mandibular denture with the obturator prosthesis. The prosthesis was printed, adjusted chairside, rescanned, and made hollow by using a CAD software program. The prosthesis was printed in resin with a dental 3D printer. Quantitative evaluations of clinical (prosthesis dimensions, rest, and occlusal vertical dimensions) and virtual (surface area, volume, weight, interpoint mismatches, spatial overlap) parameters found that the 3D-printed prosthesis required an additional 5% chairside modification. The greatest differences in volume (24.7% less) and weight (22.2% less) were observed when the modified obturator bulb was made hollow via CAD. Hollowing the bulb, therefore, reduced the spatial overlap in volume by 16.8%.
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Affiliation(s)
- Nafij Bin Jamayet
- Senior Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Taseef Hasan Farook
- Research Fellow, Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Ayman Al-Oulabi
- Clinical Fellow, Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yanti Johari
- Senior Lecturer in Prosthodontics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Pravinkumar G Patil
- Senior Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Farook TH, Jamayet NB, Asif JA, Din AS, Mahyuddin MN, Alam MK. Development and virtual validation of a novel digital workflow to rehabilitate palatal defects by using smartphone-integrated stereophotogrammetry (SPINS). Sci Rep 2021; 11:8469. [PMID: 33875672 PMCID: PMC8055911 DOI: 10.1038/s41598-021-87240-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 03/25/2021] [Indexed: 12/16/2022] Open
Abstract
Palatal defects are rehabilitated by fabricating maxillofacial prostheses called obturators. The treatment incorporates taking deviously unpredictable impressions to facsimile the palatal defects into plaster casts for obturator fabrication in the dental laboratory. The casts are then digitally stored using expensive hardware to prevent physical damage or data loss and, when required, future obturators are digitally designed, and 3D printed. Our objective was to construct and validate an economic in-house smartphone-integrated stereophotogrammetry (SPINS) 3D scanner and to evaluate its accuracy in designing prosthetics using open source/free (OS/F) digital pipeline. Palatal defect models were scanned using SPINS and its accuracy was compared against the standard laser scanner for virtual area and volumetric parameters. SPINS derived 3D models were then used to design obturators by using (OS/F) software. The resultant obturators were virtually compared against standard medical software designs. There were no significant differences in any of the virtual parameters when evaluating the accuracy of both SPINS, as well as OS/F derived obturators. However, limitations in the design process resulted in minimal dissimilarities. With further improvements, SPINS based prosthetic rehabilitation could create a viable, low cost method for rural and developing health services to embrace maxillofacial record keeping and digitised prosthetic rehabilitation.
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Affiliation(s)
- Taseef Hasan Farook
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Nafij Bin Jamayet
- Division of Clinical Dentistry (Prosthodontics), School of Dentistry, International Medical University, Jalan Jalil Perkasa-19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Jawaad Ahmed Asif
- Consultant Oral and Maxillofacial Surgeon, Prince Mutaib Bin Abdul Aziz Hospital, Ministry of Health, Al-Jouf, Kingdom of Saudi Arabia
| | - Abdul Sattar Din
- School of Electrical and Electronic Engineering, Universiti Sains Malaysia, Penang, Malaysia
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Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11030973] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories.
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The use of 3D virtual surgical planning and computer aided design in reconstruction of maxillary surgical defects. Curr Opin Otolaryngol Head Neck Surg 2020; 28:122-128. [PMID: 32102008 DOI: 10.1097/moo.0000000000000618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The present review describes the latest development of 3D virtual surgical planning (VSP) and computer aided design (CAD) for reconstruction of maxillary defects with an aim of fully prosthetic rehabilitation. The purpose is to give an overview of different methods that use CAD in maxillary reconstruction in patients with head and neck cancer. RECENT FINDINGS 3D VSP enables preoperative planning of resection margins and osteotomies. The current 3D VSP workflow is expanded with multimodal imaging, merging decision supportive information. Development of more personalized implants is possible using CAD, individualized virtual muscle modelling and topology optimization. Meanwhile the translation of the 3D VSP towards surgery is improved by techniques like intraoperative imaging and augmented reality. Recent improvements of preoperative 3D VSP enables surgical reconstruction and/or prosthetic rehabilitation of the surgical defect in one combined procedure. SUMMARY With the use of 3D VSP and CAD, ablation surgery, reconstructive surgery, and prosthetic rehabilitation can be planned preoperatively. Many reconstruction possibilities exist and a choice depends on patient characteristics, tumour location and experience of the surgeon. The overall objective in patients with maxillary defects is to follow a prosthetic-driven reconstruction with the aim to restore facial form, oral function, and do so in accordance with the individual needs of the patient.
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Beh YH, Farook TH, Jamayet NB, Dudley J, Rashid F, Barman A, Alam MK. Evaluation of the Differences Between Conventional and Digitally Developed Models Used for Prosthetic Rehabilitation in a Case of Untreated Palatal Cleft. Cleft Palate Craniofac J 2020; 58:386-390. [PMID: 32808548 DOI: 10.1177/1055665620950074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The virtual cone beam computed tomography-derived 3-dimensional model was compared with the scanned conventional model used in the fabrication of a palatal obturator for a patient with a large palatal defect. DESIGN A digitally derived 3-dimensional maxillary model incorporating the palatal defect was generated from the patient's existing cone beam computerized tomography data and compared with the scanned cast from the conventional impression for linear dimensions, area, and volume. The digitally derived cast was 3-dimensionally printed and the obturator fabricated using traditional techniques. Similarly, an obturator was fabricated from the conventional cast and the fit of both final obturator bulbs were compared in vivo. RESULTS The digitally derived model produced more accurate volumes and surface areas within the defect. The defect margins and peripheries were overestimated which was reflected clinically. CONCLUSION The digitally derived model provided advantages in the fabrication of the palatal obturator; however, further clinical research is required to refine consistency.
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Affiliation(s)
- Yew Hin Beh
- Prosthodontic Unit, School of Dental Sciences, 65271Universiti Sains Malaysia, Kelantan, Malaysia.,Centre for Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Taseef Hasan Farook
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, 65271Universiti Sains Malaysia, Kota bharu, Kelantan, Malaysia
| | - Nafij Bin Jamayet
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, 65271Universiti Sains Malaysia, Kota bharu, Kelantan, Malaysia
| | - James Dudley
- Adelaide Dental School, 1066The University of Adelaide, South Australia, Australia
| | - Farah Rashid
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, 65271Universiti Sains Malaysia, Kota bharu, Kelantan, Malaysia
| | - Aparna Barman
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, 65271Universiti Sains Malaysia, Kota bharu, Kelantan, Malaysia
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Hermeticity of a hollow obturator model using CAD and rapid prototyping technologies. J Prosthet Dent 2020; 124:123-127. [DOI: 10.1016/j.prosdent.2019.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 11/24/2022]
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12
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Vosselman N, Alberga J, Witjes MHJ, Raghoebar GM, Reintsema H, Vissink A, Korfage A. Prosthodontic rehabilitation of head and neck cancer patients-Challenges and new developments. Oral Dis 2020; 27:64-72. [PMID: 32343862 PMCID: PMC7818410 DOI: 10.1111/odi.13374] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/27/2020] [Accepted: 04/20/2020] [Indexed: 01/23/2023]
Abstract
Head and neck cancer treatment can severely alter oral function and aesthetics, and reduce quality of life. The role of maxillofacial prosthodontists in multidisciplinary treatment of head and neck cancer patients is essential when it comes to oral rehabilitation and its planning. This role should preferably start on the day of first intake. Maxillofacial prosthodontists should be involved in the care pathway to shape and outline the prosthetic and dental rehabilitation in line with the reconstructive surgical options. With the progress of three‐dimensional technology, the pretreatment insight in overall prognosis and possibilities of surgical and/or prosthetic rehabilitation has tremendously increased. This increased insight has helped to improve quality of cancer care. This expert review addresses the involvement of maxillofacial prosthodontists in treatment planning, highlighting prosthodontic rehabilitation of head and neck cancer patients from start to finish.
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Affiliation(s)
- Nathalie Vosselman
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Jamie Alberga
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Max H J Witjes
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Harry Reintsema
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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13
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Koyama S, Kato H, Harata T, Sasaki K. A workflow for fabricating a hollow obturator by using 3D digital technologies. J Prosthet Dent 2020; 123:648-652. [DOI: 10.1016/j.prosdent.2019.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 04/27/2019] [Accepted: 05/01/2019] [Indexed: 11/24/2022]
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14
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Farook TH, Jamayet NB, Abdullah JY, Asif JA, Rajion ZA, Alam MK. Designing 3D prosthetic templates for maxillofacial defect rehabilitation: A comparative analysis of different virtual workflows. Comput Biol Med 2020; 118:103646. [PMID: 32174323 DOI: 10.1016/j.compbiomed.2020.103646] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To design and compare the outcome of commercial (CS) and open source (OS) software-based 3D prosthetic templates for rehabilitation of maxillofacial defects using a low powered personal computer setup. METHOD Medical image data for five types of defects were selected, segmented, converted and decimated to 3D polygon models on a personal computer. The models were transferred to a computer aided design (CAD) software which aided in designing the prosthesis according to the virtual models. Two templates were designed for each defect, one by an OS (free) system and one by CS. The parameters for analyses were the virtual volume, Dice similarity coefficient (DSC) and Hausdorff's distance (HD) and were executed by the OS point cloud comparison tool. RESULT There was no significant difference (p > 0.05) between CS and OS when comparing the volume of the template outputs. While HD was within 0.05-4.33 mm, evaluation of the percentage similarity and spatial overlap following the DSC showed an average similarity of 67.7% between the two groups. The highest similarity was with orbito-facial prostheses (88.5%) and the lowest with facial plate prosthetics (28.7%). CONCLUSION Although CS and OS pipelines are capable of producing templates which are aesthetically and volumetrically similar, there are slight comparative discrepancies in the landmark position and spatial overlap. This is dependent on the software, associated commands and experienced decision-making. CAD-based templates can be planned on current personal computers following appropriate decimation.
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Affiliation(s)
- Taseef Hasan Farook
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Nafij Bin Jamayet
- Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia.
| | - Johari Yap Abdullah
- Craniofacial Imaging and Design, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Jawaad Ahmed Asif
- Oral and Maxillofacial Surgery, School of Dental Sciences, Hospital Universiti Sains Malaysia, Kelantan, 16150, Malaysia
| | - Zainul Ahmad Rajion
- Kulliyah of Dentistry, Dept. of Oral Maxillofacial Surgery and Oral Diagnosis, IIUM, Bandar Indera Mahkota, 25200, Kuantan, Malaysia
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15
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Palin CL, Huryn JM, Golden M, Booth PR, Randazzo JD. Three-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report. J Prosthet Dent 2018; 121:353-357. [PMID: 30392749 DOI: 10.1016/j.prosdent.2018.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/15/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
For patients with head and neck cancer requiring a maxillectomy, obturator prostheses help with quality of life. These patients routinely require adjuvant oncologic treatments with significant adverse effects. Treatment sequelae can leave patients with difficulty speaking and swallowing, reduced salivary function, reduction in maximal incisal opening, and at risk of osteoradionecrosis. A 55-year-old African-American woman presented with significant trismus and reduction in maximal incisal opening after treatment for squamous cell carcinoma of the left maxillary sinus. She had received a left total maxillectomy with adjuvant chemotherapy and radiation treatments. With her reduced opening, she was no longer able to insert her interim obturator prosthesis, which caused difficulty speaking and nasal regurgitation. A cone beam computed tomography scan was made of the patient's maxillectomy defect. From the Digital Imaging and Communications in Medicine file, a definitive cast was 3-dimensionally printed to fabricate a flexible silicone obturator prosthesis. This treatment has allowed the patient to return to a functional quality of life and could help other patients in similar situations.
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Affiliation(s)
- Charles L Palin
- Maxillofacial Prosthetics Fellow, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph M Huryn
- Chief, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marjorie Golden
- Maxillofacial Prosthetics Technician, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul R Booth
- Supervisor, Biomedical Systems Section, Biomedical Engineering, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joseph D Randazzo
- Maxillofacial Prosthetics Director, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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16
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Koyama S, Kato H, Harata T, Sato N, Hanawa S, Sasaki K. Evaluation of water absorption properties and fabrication of hollow obturator model using 3D digital dentistry. Dent Mater J 2018; 37:521-525. [PMID: 29491201 DOI: 10.4012/dmj.2017-241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Fluid accumulation in the hollow spaces of obturator is a continuing problem when fabricating hollow obturator prostheses using the conventional method. To address this problem, the three-dimensional (3D) digital technology was used to evaluate water absorption in the inner hollow obturator spaces. Solid and hollow obturator specimens were fabricated using a 3D printer with photocurable resin. Then, the hermeticity was examined by leak testing. These specimens were immersed in distilled water at 37°C. Each specimen was weighed every 24 h for 120 days, and weight changes between each group were compared. Water accumulation in the hollow obturator was not visually observed. Although water absorption was significantly higher in solid specimens, the weight increase rate was also significantly higher in hollow specimens. Applying a laminating 3D photo fabrication made the fabrication of a completely unified hollow obturator model possible.
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Affiliation(s)
- Shigeto Koyama
- Maxillofacial Prosthetics Clinic, Tohoku University Hospital
| | | | | | - Naoko Sato
- Maxillofacial Prosthetics Clinic, Tohoku University Hospital
| | - Soshi Hanawa
- Division of Advanced Prosthodontics, Tohoku University Graduate School of Dentistry
| | - Keiichi Sasaki
- Division of Advanced Prosthodontics, Tohoku University Graduate School of Dentistry
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17
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Kortes J, Dehnad H, Kotte ANT, Fennis WMM, Rosenberg AJWP. A novel digital workflow to manufacture personalized three-dimensional-printed hollow surgical obturators after maxillectomy. Int J Oral Maxillofac Surg 2018; 47:1214-1218. [PMID: 29636308 DOI: 10.1016/j.ijom.2018.03.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/07/2018] [Accepted: 03/19/2018] [Indexed: 11/19/2022]
Abstract
Partial or complete resection of the maxilla during tumour surgery causes oronasal defects, leading to oral-maxillofacial dysfunction, for which the surgical obturator (SO) is an important treatment option. Traditional manufacturing of SOs is complex, time-consuming, and often results in inadequate fit and function. This technical note describes a novel digital workflow to design and manufacture a three-dimensional (3D)-printed hollow SO. Registered computed tomography and magnetic resonance imaging images are used for gross tumour delineation. The produced RTStruct set is exported as a stereolitography (STL) file and merged with a 3D model of the dental status. Based on these merged files, a personalized and hollow digital SO design is created, and 3D printed. Due to the proper fit of the prefabricated SO, a soft silicone lining material can be used during surgery to adapt the prosthesis to the oronasal defect, instead of putty materials that are not suitable for this purpose. An STL file of this final SO is created during surgery, based on a scan of the relined SO. The digital workflow results in a SO weight reduction, an increased fit, an up-to-date digital SO copy, and overall easier clinical handling.
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Affiliation(s)
- J Kortes
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - H Dehnad
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A N T Kotte
- Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W M M Fennis
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
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