Patient-specific cranioplasty, by direct and indirect additive manufacturing of biopolymers and implantable materials

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-09-06 DOI:10.1002/rcs.2568

Barbara Flora, Alba Scerrati, Federica Trovalusci, Silvia Vesco

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引用次数: 0

Abstract

Background

Autologous bones are traditionally used in surgical reconstruction of skullcap. Since patients’ bones are often unavailable or cause of infections, implantable synthetic materials emerged as promising alternative. These can be shaped by different technologies, while 3D printing offers remarkable chances in terms of flexibility, accuracy, cost-saving and customizability.

Methods

This study aims to evaluate strengths and limitations of the three main strategies that imply additive manufacturing for the implementation of cranial prosthesis: (i) direct printing of PLA (polylactic acid) skullcaps, mould casting of poly(methyl methacrylate) (PMMA) prosthesis using (ii) silicone mould manufactured from a 3D printed master, (iii) 3Dprinted TPU (thermoplastic polyurethane) mould.

Results

All solutions achieved good geometric accuracy and excellent mechanical resistance. Direct printing of the PLA resulted in the fastest strategy, followed by PMMA casting in a silicone mould.

Conclusions

The use of silicone was overall more advantageous, due to lower costs and the possibility of sterilization by using autoclaving.

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通过生物聚合物和可植入材料的直接和间接增材制造，实现针对患者的颅骨成形术。

背景：自体骨传统上用于颅骨的外科重建。由于患者的骨骼往往无法获得或是感染的原因，植入式合成材料成为了一种很有前途的替代品。这些可以通过不同的技术来塑造，而3D打印在灵活性、准确性、成本节约和可定制性方面提供了非凡的机会。方法：本研究旨在评估三种主要策略的优势和局限性，这三种策略意味着增材制造用于颅骨假体的实施：（i）PLA（聚乳酸）无檐便帽的直接印刷，使用3D打印母模制造的聚甲基丙烯酸甲酯（PMMA）假体的模具铸造，（iii）3D打印的TPU（热塑性聚氨酯）模具。结果：所有解决方案都获得了良好的几何精度和良好的机械阻力。PLA的直接印刷产生了最快的策略，其次是在硅胶模具中浇铸PMMA。结论：硅胶的使用总体上更有利，因为它的成本更低，并且可以通过高压灭菌进行灭菌。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.