Upload
sirris
View
11.480
Download
1
Tags:
Embed Size (px)
DESCRIPTION
Using rapid manufacturing to reconstruct facial damage and scull fractures
Citation preview
RAPID MANUFACTURING IN MEDICINEProf. dr. Jules PoukensProf. dr. Ivo Lambrichts
University Hasselt, Dep. Basic Medical Science, BelgiumMaastricht UniversityMedical Center Sittard / Heerlen, the Netherlands
OVERVIEW OF PRESENTATION
1 DESCRIPTION CLINICAL DEFECTS
2 RECONSTRUCTION PAST AND PRESENT
3 CASE STUDY SKULL DEFECT
4 CASE STUDY TEMPERO-MANDIBULAR JOINT
5 CASE STUDY MANDIBULAR DEFECT
6 CONCLUSION
WHAT ARE CRANIO-MAXILLOFACIAL DEFECTS ?
GOOD OLD FASHIONED WAYPRE-OPERATIVE MANUFACTURED IMPLANT
CT SCAN RAPID PROTOTYPING MODEL
MANUAL MANUFACTURED WAX MODELIMPLANT PMMA INJECTION MOULDED
– Standard design to customized design– Computer assistance in design and
manufacturing of implants (CAD-CAM)
5
SHIFT IN MEDICAL TREATMENT
SIMPLANT CMF SOFTWARE
SEGMENTATION VISUALISATION
3D VISUALISATION OF BONE AND SOFT TISSUE
Case study
SKULL DEFECT
RAPID PROTOTYPING MODEL
ONLY FOR VALIDATION OF IMPLANT
PATIENT
Young girl
- Car accident with large skull defect
- Reconstruction with titanium
implant
(electron beam melting)
DESIGN
Final design
ImplantTi6Al4V
ELECTRON BEAM MELTING (ARCAM)
Now follows operation video and pics
Not suited for sensitive viewers !
VIDEO SKULL
EXAMPLE CLINICAL RESULT
Case Study
CUSTOM TEMPERO-MANDIBULAR JOINT IMPLANT
Anatomy TMJFOSSA
CONDYLE
Diseases involving condylar bone lossOsteoarthrosis Cancer
Congenital Removal former implants
FOSSA part
• Titaniumsheet with 4 layers titanium mesh (custom fit) – Purpose: allow bone and soft
tissue ingrowth → maximize long-term stability of the fossa
• UHMW polyethylene with posterior stop– Flat functional surface– Provide a centric relation posititon
for the condyle
CONDYLE part
• Shaft: titanium(custom fit)
• Head: cobalt-chrome molybdene
Manufacturing(TMJ Concepts, USA)
• Construction of TMJ prosthesis
Manufacturing
Manufacturing
Surgical technique
• Approach: preauricular incision
Surgical technique
• Applying fossa– Fixation to zygomatic arch– 3-4 titanium screws 2.0mm
Surgical technique
• Applying mandible part– Fixation with 4-12 titanium
screws 2.0mm
Poukens- Lambrichts
Surgical technique
• Fitting condyle in fossa• Manipulating mandibula to
check movement possibilities
Case StudyMANDIBULAR IMPLANT
• Female , 83years old• Patient visited the out-patient clinic with
a large purulent wound on the chin • Diagnosis : massive osteomyelitis of the
mandible caused by tooth infection
Patient
Pre-operative
Anatomy (muscles)Movement of temporomandibular joint
Current treatment I• Free Bone transplants • Vascularized bone transplants
• Rib• Iliac crest• Radius• Fibula
Current treatment IICustom bended reconstruction plate with condylar
head part
Custom-made implant
Custom-made implantDesign I
Custom-made implant
Custom-made implant
Hydroxy-apatite coating
• ALERT!!!Not suited for sensitive viewers
Video
VIDEO
POSTOP
“
CONCLUSION
Computer aided engineering applied tomedicine: That's one small step for anengineer, one giant leap in medicalhistory"
Thanks for your attention