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Molnár B, Würsching T, Sólyom E, Pálvölgyi L, Radóczy-Drajkó Z, Palkovics D, Nagy K. Alveolar cleft reconstruction utilizing a particulate autogenous tooth graft and a novel split-thickness papilla curtain flap - A retrospective study. J Craniomaxillofac Surg 2024; 52:77-84. [PMID: 37926606 DOI: 10.1016/j.jcms.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/20/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
During secondary alveolar cleft grafting, the use of autogenous cancellous bone harvested from the iliac crest is still considered the gold standard. Due to the risk of donor-site morbidity and excessive graft resorption, alternative grafting materials (e.g. intraoral bone, xenografts) have been tested. Autogenous tooth bone graft (ATB) is a novel material derived from extracted teeth. ATB has successfully been used in pre-prosthetic and periodontal surgery for hard-tissue reconstruction. Seven patients with unilateral cleft lip and palate were treated with ATB, using their own deciduous teeth for grafting. Defects were accessed utilizing a novel split-thickness papilla curtain flap. Cone-beam computed tomography scans were taken prior to and 3 months following cleft surgery to assess graft integration, graft stability, and the volume of the newly formed hard tissues. Hard-tissue gain, as measured at the 3-month follow-up, averaged 0.65 cm3 ± 0.26 cm3. Results showed acceptable graft integration and stability at the 3-month follow-up, with no adverse effects or excessive resorption of the graft. The use of ATB might be a feasible alternative for alveolar cleft grafting. However, long-term studies using a large sample size are required to derive further conclusions.
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Affiliation(s)
- Bálint Molnár
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Tamás Würsching
- Centre for Facial Reconstruction, Department of Pediatrics, Semmelweis University Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary.
| | - Eleonóra Sólyom
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Laura Pálvölgyi
- Centre for Facial Reconstruction, Department of Pediatrics, Semmelweis University Budapest, Hungary
| | | | - Dániel Palkovics
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Krisztián Nagy
- Centre for Facial Reconstruction, Department of Pediatrics, Semmelweis University Budapest, Hungary; Cleft and Craniofacial Centre, Division of Maxillo-Facial Surgery, General Hospital St. Jan, Bruges, Belgium; OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging AndPathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Makiyama K, Komeya M, Tatenuma T, Noguchi G, Ohtake S. Patient-specific simulations and navigation systems for partial nephrectomy. Int J Urol 2023; 30:1087-1095. [PMID: 37622340 DOI: 10.1111/iju.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
Partial nephrectomy (PN) is the standard treatment for T1 renal cell carcinoma. PN is affected more by surgical variations and requires greater surgical experience than radical nephrectomy. Patient-specific simulations and navigation systems may help to reduce the surgical experience required for PN. Recent advances in three-dimensional (3D) virtual reality (VR) imaging and 3D printing technology have allowed accurate patient-specific simulations and navigation systems. We reviewed previous studies about patient-specific simulations and navigation systems for PN. Recently, image reconstruction technology has developed, and commercial software that converts two-dimensional images into 3D images has become available. Many urologists are now able to view 3DVR images when preparing for PN. Surgical simulations based on 3DVR images can change surgical plans and improve surgical outcomes, and are useful during patient consultations. Patient-specific simulators that are capable of simulating surgical procedures, the gold-standard form of patient-specific simulations, have also been reported. Besides VR, 3D printing is also useful for understanding patient-specific information. Some studies have reported simulation and navigation systems for PN based on solid 3D models. Patient-specific simulations are a form of preoperative preparation, whereas patient-specific navigation is used intraoperatively. Navigation-assisted PN procedures using 3DVR images have become increasingly common, especially in robotic surgery. Some studies found that these systems produced improvements in surgical outcomes. Once its accuracy has been confirmed, it is hoped that this technology will spread further and become more generalized.
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Affiliation(s)
- Kazuhide Makiyama
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Mitsuru Komeya
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Tomoyuki Tatenuma
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Go Noguchi
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shinji Ohtake
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Kesztyűs A, Würsching T, Nemes B, Pálvölgyi L, Nagy K. Evaluation of 3D visualization, planning and printing techniques in alveolar cleft repair, and their effect on patients' burden. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:484-489. [PMID: 34678495 DOI: 10.1016/j.jormas.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUNDS The aim of this study was to describe our auxiliary surgical techniques in alveolar cleft reconstruction and evaluate the patients burden after 3 years of surgical experience. METHODS At the Cleft center, Semmelweis University Budapest, 28 patients underwent alveolar bone grafting between September 2017 and September 2020. We have used CBCT scans and computer software to perform 3D simulation of the alveolar defect and planning of patient- and defect specific grafts. An individual graft mold was designed for each alveolar defect and 3D printed for intra-operative use. During the surgical intervention, the mold was used to harvest the most appropriate amount and precise shape of graft material. We used cancellous iliac crest graft. After performing a descriptive statistical analysis of our patient group, we used a quality-of-life questionnaire to measure the patient's self-perception. RESULTS In all cases the treatment sequence could be applied, planning and surgery was successful and uneventful. Patients did not experience more pain, bleeding or any feeding impairment. No inflammatory or wound healing reactions were observed. There were no major adverse effects causing permanent problems. CONCLUSIONS Our follow-up and patient satisfaction questionnaire showed that our treatment sequence with auxiliary techniques brought no further burden to the patients care and hospitalization, even though it is more complex. Efficacy of this treatment method and improvement in graft integration has yet to be determined.
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Affiliation(s)
- Artúr Kesztyűs
- The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Tamás Würsching
- The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University Budapest, Hungary.
| | - Bálint Nemes
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary
| | - Laura Pálvölgyi
- The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary
| | - Krisztián Nagy
- The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University Budapest, Hungary; The Cleft Centre, 1st Department of Pediatrics, Semmelweis University Budapest, Hungary; OMFS-IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium, Cleft and Craniofacial Centre, Division of Maxillo-Facial Surgery, General Hospital St. Jan, Bruges, Belgium.
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Kihara H, Sugawara S, Yokota J, Takafuji K, Fukazawa S, Tamada A, Hatakeyama W, Kondo H. Applications of three-dimensional printers in prosthetic dentistry. J Oral Sci 2021; 63:212-216. [PMID: 34078769 DOI: 10.2334/josnusd.21-0072] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This narrative review aims to provide an overview of recent studies and case reports on three-dimensional (3D) printing, and to verify the applicability of 3D printers in the field of dental prostheses. This review was performed by conducting a search of PubMed. The clinical application of fabricating a prosthesis made with cobalt-chromium is considered possible depending on the material and hardware of the 3D printer. However, it is currently difficult to assess the clinical use of 3D-printed zirconia crowns. Further research is required, such as verification of materials used, margin morphology, and hardware. Clinically acceptable results have been reported for patterns using 3D printers. Interim restorations made using a 3D printer have been reported with good results that are considered clinically usable. Dentures made with 3D printers need further verification in terms of strength and deformation. Custom trays made with 3D printers are clinically useful, however, issues remain with design time and effort. Although several studies have reported the usefulness of 3D printers, further verification is required since 3D printers are still considered new technology.
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Affiliation(s)
- Hidemichi Kihara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Shiho Sugawara
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Jun Yokota
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Kyoko Takafuji
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Shota Fukazawa
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Ayaka Tamada
- Department of Dysphagia Rehabilitation, Nagasaki University Hospital
| | - Wataru Hatakeyama
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
| | - Hisatomo Kondo
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University
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Virani FR, Chua EC, Timbang MR, Hsieh TY, Senders CW. Three-Dimensional Printing in Cleft Care: A Systematic Review. Cleft Palate Craniofac J 2021; 59:484-496. [PMID: 33960208 DOI: 10.1177/10556656211013175] [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: 11/16/2022] Open
Abstract
OBJECTIVE To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. DESIGN Retrospective systematic review. METHODS Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. MAIN OUTCOME MEASURES Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. RESULTS Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. CONCLUSION 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.
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Affiliation(s)
- Farrukh R Virani
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, CA, USA
| | - Evan C Chua
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Mary Roz Timbang
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Craig W Senders
- Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, CA, USA
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Komai Y, Sugimoto M, Gotohda N, Matsubara N, Kobayashi T, Sakai Y, Shiga Y, Saito N. Patient-specific 3-dimensional Printed Kidney Designed for “4D” Surgical Navigation: A Novel Aid to Facilitate Minimally Invasive Off-clamp Partial Nephrectomy in Complex Tumor Cases. Urology 2016; 91:226-33. [DOI: 10.1016/j.urology.2015.11.060] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/22/2015] [Accepted: 11/12/2015] [Indexed: 01/20/2023]
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