How useful is 3D printing in maxillofacial surgery?
How useful is 3D printing in maxillofacial surgery?
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DOI：
10.1016/j.jormas.2017.07.002
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发表时间：
2017-09-01
影响因子：
2.2
通讯作者：
Meyer, C.
中科院分区：
文献类型：
--
作者：
Louvrier, A.;Marty, P.;Meyer, C.
简介：3D打印似乎在颌面外科（MFS）中有越来越多的应用，特别是自从几年前通用3D打印机在市场上发布以来。本研究的目的是回答4个问题：1。谁在MFS中使用3D打印，它是常规还是非常规？2. MFS中3D打印的主要临床适应症是什么？使用的物体类型是什么？3.这些物品是否由官方医疗器械（MD）制造商打印或直接在部门或实验室内制造？4.有哪些优点和缺点？方法学：于2017年1月1日在PubMed上进行了两项文献检索，没有时间限制，第一项和第二项分别使用“颌面外科”和“3D打印”以及“计算机辅助设计”和“计算机辅助制造”作为关键词。选择了与3D打印的人类临床应用有关的英文或法文文章。发表日期，作者的国籍，治疗的患者人数，临床适应症（S），打印对象的类型（S），打印类型（实验室/医院制造或专业/行业）和优点/缺点被recorded.Results：来自35个国家的297篇文章符合标准。最具代表性的国家是中华人民共和国（占文章的16%）。共有2889名患者（平均每篇文章10名）受益于3D打印物体。最常见的临床适应症是牙种植手术和下颌骨重建。最常打印的对象是手术指南和解剖模型。百分之四十五的指纹是专业的。主要优点是提高了精确度和缩短了手术时间。主要缺点是物体的成本和制造周期。讨论：低成本打印机的上市增加了3D打印在MFS中的使用。解剖模型不被视为MD，无需遵守任何法规。如今，它们很容易用低成本打印机打印。它们允许更好的术前规划和手术培训以及接骨板的预成形。咬合夹板和手术导板用于将计划顺利转移到手术室。它们被认为是MD，即使它们很容易打印，它们也必须遵守适用于MD的规定。患者特定植入物（定制板和骨骼重建模块）是要求更高的对象，其制造目前仍掌握在行业手中。医院内3D打印的主要限制是适用于MD的限制性规定。专业3D打印的主要限制是成本和交货时间。3D打印物体现在很容易在MFS中获得。然而，它们永远不会取代外科医生的技能，只应被视为有用的工具。(C)2017 Elsevier Masson SAS。All rights reserved.
Introduction: 3D printing seems to have more and more applications in maxillofacial surgery (MFS), particularly since the release on the market of general use 3D printers several years ago. The aim of our study was to answer 4 questions: 1. Who uses 3D printing in MFS and is it routine or not? 2. What are the main clinical indications for 3D printing in MFS and what are the kinds of objects that are used? 3. Are these objects printed by an official medical device (MD) manufacturer or made directly within the department or the lab? 4. What are the advantages and drawbacks?Methodology: Two bibliographic researches were conducted on January the 1st, 2017 in PubMed, without time limitation, using "maxillofacial surgery'' AND "3D printing'' for the first and for the second "maxillofacial surgery'' AND "computer-aided design'' AND "computer-aided manufacturing'' as keywords. Articles in English or French dealing with human clinical use of 3D printing were selected. Publication date, nationality of the authors, number of patients treated, clinical indication(s), type of printed object(s), type of printing (lab/hospital-made or professional/industry) and advantages/drawbacks were recorded.Results: Two hundred and ninety-seven articles from 35 countries met the criteria. The most represented country was the People's Republic of China (16% of the articles). A total of 2889 patients (10 per article on average) benefited from 3D printed objects. The most frequent clinical indications were dental implant surgery and mandibular reconstruction. The most frequently printed objects were surgical guides and anatomic models. Forty-five percent of the prints were professional. The main advantages were improvement in precision and reduction of surgical time. The main disadvantages were the cost of the objects and the manufacturing period when printed by the industry.Discussion: The arrival on the market of low-cost printers has increased the use of 3D printing in MFS. Anatomic models are not considered to be MDs and do not have to follow any regulation. Nowadays, they are easily printed with low-cost printers. They allow for better preoperative planning and training for the procedures and for pre-shaping of plates. Occlusal splints and surgical guides are intended for the smooth transfer of planning to the operating room. They are considered to be MDs and even if they are easy to print, they have to follow the regulations applying to MDs. Patient specific implants (custommade plates and skeletal reconstruction modules) are much more demanding objects and their manufacturing remains nowadays in the hands of the industry. The main limitation of in-hospital 3D printing is the restrictive regulations applying to MDs. The main limitations of professional 3D printing are the cost and the lead time. 3D printed objects are nowadays easily available in MFS. However, they will never replace a surgeon's skill and should only be considered as useful tools. (C) 2017 Elsevier Masson SAS. All rights reserved.