In-House 3D Printing and Model Processing Technique for Creating High-Fidelity Transparent Craniofacial Models.

Three-dimensional (3D) printed models can improve the understanding of the structural anatomic changes in cases of temporomandibular joint ankylosis and pseudoankylosis leading to closed jaw locking. Their use in pre-surgical planning and intraoperative guidance has been reported, contributing to the predictability and success of these surgery procedures, which can be quite complex, especially in small animal patients. The use and production of 3D tools and models remain challenging and are so far limited to institutions with high (economical and human) resources. This study aims to propose simplified workflows using open-source software to facilitate an in-house 3D printing process. To illustrate this, three cases of temporomandibular joint ankylosis and one of pseudoankylosis were reviewed, where in-house 3D printed models were used for client communication and surgical management. The 3D models were segmented from computed tomography and printed via stereolithography. They were used to support discussion with clients (n = 4), to allow surgeons to pre-surgical plan and practice (n = 4) and for intraoperative guidance during surgery (n = 2). Surgical cutting guides were produced in one case to improve precision and define more accurately osteotomy lines. It is essential to consider the initial time and financial investment required for establishing an in-house 3D printing production, particularly when there is a need to produce biocompatible tools, such as surgical cutting guides. However, efficient and streamlined workflows encourage the integration of this technology, by accelerating the printing process and reducing the steep learning curves, while open-source software enhances accessibility to these resources.

Three-dimensional (3D) printing has emerged as a promising new technology for the development of surgical prosthetics. Research in orthopedic surgery has demonstrated that using 3D printed customized prosthetics results in more precise implant placements and better patient outcomes. However, there has been little research on implementing customized 3D printed prosthetics in otolaryngology. The program sought to determine whether computed tomography (CT) serves as feasible templates to construct 3D printed palatal obturator prosthetics for defects in patients who have been treated for head and neck cancers. A retrospective review of patients with palatal defects was conducted and identified 1 patient with high quality CTs compatible with 3D modeling. CTs of the patient's craniofacial anatomy were used to develop a 3D model and a Formlabs 3B+ printer printed the palatal prosthetic. We successfully developed and produced an individualized prosthetic using CTs from a veteran with head and neck deformities caused by cancer treatment who was previously treated at the Veterans Affairs Palo Alto Health Care System. This project was successful in printing patient-specific implants using CT reproductions of the patient's craniofacial anatomy, particularly of the palate. The program was a proof of concept and the implant we created was not used on the patient. Customized 3D printed implants may allow otolaryngologists to enhance the performance and efficiency of surgeries and better rehabilitate and reconstruct craniofacial deformities to restore appearance and function to patients. Additional research will strive to enhance the therapeutic potential of these prosthetics to serve as low-cost, patient-specific implants.

Background and aim:Osseous and medullar anomalies constitute a hard challenge for interpretation of complex vertebral deformities anatomy. To better frame these deformities three-Dimensional (3D) printing represents a new frontier in this field. The aim of this brief report is describing the use of 3D printed models for surgical planning in four complex vertebral deformity cases treatment.Methods:Four cases of severe scoliosis were treated between December 2017 and January 2019; patients’ mean age was 12,25 years. Two patients underwent neurosurgical intervention for myelomeningocele at the time of birth. Standard and dynamics X-Ray, Computed Tomography (CT) and Magnetic Resonance (MR) of the column were performed pre-operatively. CT files were implemented to build the 3D model of each spine and selected ribs. The models were 3D printed in thermoplastic material, then used to study the deformities and for surgical planning. A survey proposal about 3D models’ utility and accuracy has been made to 15 residents and 6 main surgeons.Results:Preparation of each 3D models required about 316.5 minutes and printing time was about 108 hours each. The average cost was 183.16 € to produce one 3D printed model, which resulted useful in surgical planning and educational.Conclusions:The manufacture of 3D models requires time, resources and multidisciplinary approach, it must be justified by complexity of the case. In this study 3D Printing allowed surgeons to carefully plan and simulate the surgery, ensuring for a better sizing of the implant. (www.actabiomedica.it)

Objective To explore the application of the renal calculus 3D model based on CT in percutameous nephrolithotomg (PCNL). Methods From July 2016 to September 2016, twelve patients were diagnosed with renal calculus and underwent PCNL in Shenzhen Baoan District People's Hospital. The mean age was 39 (range: 28-46) years old. Among them, there were 5 patients with left renal calculus and 7 patients with right renal calculus. The maximum diameter of the renal calculus was between 2.3 to 4.2 cm, and the mean diameter was 3.2 cm according to the CT scan. The CT image data collected from these patients would be divided and rebuilt its 3D model by using the 3D rebuilding software MIMICS 17.0, to build a personalized 3D model of the renal calculus. Before the surgery, 4 surgeons would design a specific surgery strategy according to the 3D model of the renal calculus and combine it with the iconography materials. During the surgery, they would record the practical operating data, and fill the appraisal questionnaire of the 3D models after the surgery to appraise the availability of the 3D model. As for the patients and their families, the 3D renal calculus model was used as a tool for communication before the surgery, and they were invited to fill the appraisal questionnaire. Results The 3D renal calculus models of these 12 patients were successfully constructed. The models clearly showed the size and location of the renal calculus, the inner renal collecting system, renal pelvis, vein and the interrelationship with the adjacent anatomical structures. The virtual puncture point and the renal calyx of puncture were basically corresponded to the actual operation. The puncture depth of virtual operations was (6.6±0.8) cm, while the puncture depth of actual operations was (7.1±0.7) cm, and there was no significant difference (P>0.05). The mean evaluation score of the models given by surgeons was (8.5±0.6). And the mean score of the doctor-patient conversation before operation given by the patients or their family members was (8.4±0.7). Conclusions The 3D renal calculus models based on CT can clearly reflect not only the size and location of renal calculus, but also the relationship between the kidney and adjacent anatomical structures.The models also play a very important role in preoperative planning and operative process. Meanwhile, the models could be useful in the doctor-patient consultation. Key words: Renal calculi; 3D technology; Percutaneous nephrostomy; Preoperative planning

Introduction and backgroundThree dimensional (3D) printing has gained popularity in the medical field because of increased research in the field of haptic 3D modeling. We review the role of 3D printing with specific reference to liver directed applications.MethodsA literature search was performed using the scientific databases Medline and PubMed. We performed this in-line with the PRISMA [20] statement. We only included articles in English, available in full text, published about adults, about liver surgery and published between 2005 and 2015. The 3D model of a patient's liver venous vasculature and metastasis was prepared from a CT scan using Osirix software (Pixmeo, Gineva, Switzerland) and printed using our 3D printer (MakerBot Replicator Z18, US). To validate the model, measurements from the inferior vena cava (IVC) were compared between the CT scan and the 3D printed model.ResultsA total of six studies were retrieved on 3D printing directly related to a liver application. While stereolithography (STL) remains the gold standard in medical additive manufacturing, Fused Filament Fabrication (FFF), is cheaper and may be more applicable. We found our liver 3D model made by FFF had a 0.1 ± 0.06 mm margin of error (mean ± standard deviation) compared with the CT scans.Conclusion3D printing in general surgery is yet to be thoroughly exploited. The most relevant feature of interest with regard to liver surgery is the ability to view the 3D dimensional relationship of the various hepatic and portal veins with respect to tumor deposits when planning hepatic resection.Systematic review registration number: researchregistry1348.

Three-dimensional (3D) printing has been increasingly used in medical applications with the creation of accurate patient-specific 3D printed models in medical imaging data. This study has been planned based on the fact that research on 3D printing in pancreaticobiliary disease is limited due to lack of studies on validation of model accuracy. This is an innovative study where general surgery residents are presented 5 distinct hepatopancreatobiliary disease scenarios to generate a perception and required to compare their perception level of these cases with magnetic resonance cholangiopancreatography (MRCP), 3D images and 1:1 solid models that the pathology, diverse diagnosis and presurgery diagnosis stages can be observed. This study is single-centered. The dilated pancreaticobiliary intervention based on scenarios for general surgery residency was more original since there was no prior study that includes both model building and the evaluation of the perception created by the model. Five scenarios provided qualitative assessment with results showing the usefulness of 3D models when used as clinical tools in preoperative planning, simulation of interventional procedures, surgical education, and training. The perception level in the 3D model, MRCP (Z: 3.854, p: 0.000) and the 3D image (Z: 2.865, p: 0.004) was higher; likewise, the 3D-STL image was higher compared to the MRCP image (Z: 3.779, p: 0.000). All subspecialists agree that 3D models provided better understanding of dilated pancreaticobiliary pathoanatomy and improved surgical planning. A thoroughly outlined genuine patient situation layout aimed for general surgery training can be installed and monitored with the support of 3D printing technology of this study. This can be utilized to develop the comprehension of pathoanatomical variations of complex pancreaticobiliary illness and to adopt a surgical approach.

The aim of study was to evaluate the efficacy of the use of three-dimensional (3D) printing model for preoperative planning in treatment of tibial plateau fracture. Besides, we also investigated the effect of 3D printing technology on the communication between doctors and patients. Thirty-three patients with tibial plateau fractures were enrolled in the study from March 2022 to July 2023. A 3D digital model of each tibial plateau fracture was constructed, and the individual model was exported to a 3D printer for the construction of a full solid model. This 3D-printing model, along with the Three-Column classification, was utilized to plan the operation. During each operation, the operative time and amount of blood loss were recorded as primary outcome measures. Patients were followed to evaluate surgical outcomes using Rasmussen scores and radiological evaluation, which served as secondary outcome measures. Additionally, satisfaction for patients was assessed using questionnaires developed by Yiting Lou. Two-column fractures accounted for the highest proportion at 45.5%. Isolated posterior column fractures constituted 9.1%. The average 3D printing time was 7.1 ± 0.9 h; a material cost of 1 USD per model. Complex fracture cases had significantly longer 3D printing times (p = 0.001) and provided more information to the surgical team than simple fractures. Patient satisfaction with 3D models was rated at 7.4 ± 0.7 out of 10 points. Malalignment and gap width were not correlated with surgical time (p = 0.3 and 0.2). The infection rate was 3%, and the rate of secondary loss of reduction at six months was 25%, with no correlation with Rasmussen scores (P > 0.05, Fisher’s test). Our study revealed that 3D printing models effectively assist the surgeons in planning operations, especially in complex cases, and may enhances communication between surgeons and patients. Follow-up 6 months after surgery showed good knee function.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-30475-7.

Three-dimensional (3D)-printed anatomical models of the bones play a key role in complex surgical procedures. These subject-specific physical models are valuable in pre-operative planning and may also offer assistance during surgery by improving the visibility of inaccessible anatomical structures, particularly in spine surgery. Starting from medical imaging, virtual 3D bone models are reconstructed, and these can also be used for quantifying original, planned, and achieved bone-to-bone alignments. The purpose of this study is to report on an original exploitation of these techniques on a patient with a severe cervical deformity to undergo corrective and stabilizing surgery. A virtual anatomical model of the cervical spine before surgery was obtained from computer tomography to assess the original deformity and for surgical planning. The corresponding 3D model was printed in acrylonitrile-butadiene-styrene and used to simulate the surgery by performing bone cuts, implanting the screws, and placing and shaping the fixation elements. During surgery, this physical 3D-printed model was used as a reference for each surgical action. The comparisons between pre- and post-operative virtual models confirmed that the planned correction was achieved. Virtual and 3D-printed anatomical models of the cervical spine offer advantages in the planning and execution of personalized complex surgeries, in addition to improving surgical safety.

This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use. The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included. The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility‐specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed. 3D printing applications using high‐resolution radiology‐based imaging data will be presented. This data is used to 3D print individualized physical models of patient's unique anatomy for aid in planning complex and challenging surgical procedures. Methods, techniques and imaging requirements for 3D printing anatomic models from imaging data will be discussed. Specific applications currently being used in the radiology clinic will be detailed. Standardized phantoms for radiation therapy are abundant. However, custom phantom designs can be advantageous for both clinical tasks and research. 3D printing is a useful method of custom fabrication that allows one to construct custom objects relatively quickly. Possibilities for custom radiotherapy phantoms range from 3D printing a hollow shell and filling the shell with tissue equivalent materials to fully printing the entire phantom with materials that are tissue equivalent as well as suitable for 3D printing. A range of materials available for use in radiotherapy phantoms and in the case of phantoms for dosimetric measurements, this choice is critical. The necessary steps required will be discussed including: modalities of 3D model generation, 3D model requirements for 3D printing, generation of machine instructions from the 3D model, and 3D printing techniques, choice of phantoms material, and troubleshooting techniques for each step in the process. Case examples of 3D printed phantoms will be shown. Learning Objectives: Understand the types of 3D modeling software required to design your device, the file formats required for data transfer from design software to 3D printer, and general troubleshooting techniques for each step of the process. Learn the differences between materials and design for photons vs. electrons vs. protons. Understand the importance of material choice and design geometries for your custom phantoms. Learn specific steps of quality assurance and quality control for 3D printed beam filters and compensators for proton therapy. Learn of special 3D printing applications for imaging. Cunha: Research support from Phillips Healthcare.

This study aimed to introduce 3D printing in a municipal hospital to improve the treatment of craniomaxillofacial patients and optimize costs and operating time. Thus we describe the implementation of low-cost in-house 3D printing to facilitate orbital- and mandible reconstruction in CMF surgery. Moreover, we address legal requirements, safety at work, fire- and data protection. Finally, we want to share our experiences using 3D printing and point out its advantages in providing better patient care. We outline the setup of in-house 3D printing and focus on obeying German health care regulations. We based our approach on a fused deposition modeling 3D printer and free software. As proof of concept, we treated 4 cases of severe orbital trauma and 1 case of mandibular reconstruction. We printed a 3D patient-specific model for each case and adapted a titanium mesh implant, respectively, a titanium reconstruction plate before performing the surgery. Our approach reduced costs, duration of anesthesia, operating time, recovery time, and postoperative swelling and increased the revenue. Functional outcome in orbital reconstruction like eye movement and double vision, was improved compared to the conventional technique. No severe complications like loss-of-vision or surgical revision occurred. Likewise, mandibular reconstruction showed no plate loosening or plate fracture. The implementation of cost-efficient 3D printing resulted in successful patient treatment with excellent outcomes. Our practice guide offers a 3D printing workflow and could be adapted to fit the needs of other specialties like neurosurgery, orthopedic surgery as well.

Heritage structures are important for tourism and for learning about nations’ history. Historical sites around the world are in damaged conditions due to various factors from the environment, man-made activities or natural calamities. To ensure safety and avoid further deterioration, digital re- construction of heritage sites can be used to create 3D virtual models of these structures for archiving and for inspection purpose. This paper presents a technique to reconstruct a high-quality image-based 3D model of a heritage structure. An exemplar-based inpainting algorithm was used for removing deformable obstacles such as trees in 2D images since such obstacles are unwanted in a final 3D model. They also create noise in the 3D modeling process, which makes the final 3D model less accurate. In this paper, an inpainting algorithm is applied to generate implied texture to fill holes that occurred from removing objects so that the generated 3D model does not contain any hole and becomes watertight. The modified exemplar-based inpainting algorithm was implemented on 2D images to remove unwanted objects, and then the image-based 3D modeling technique was applied to create a 3D model that did not contain any unwanted objects. The results show that the final 3D model is more accurate when applied the object removal process and the model provides better visualization for heritage structures.

Introduction: Three-dimensional (3D) printing (additive manufacturing, rapid prototyping) is a technology that has attracted the attention of craniofacial surgeons to gain perfection in analysis, planning and execution of complex surgical challenges. Rapid prototyping technology was introduced to surgery via computer-aided design/computer-aided manufacturing, which enabled two-dimensional planning. The purpose of this article is to demonstrate the application of 3D printing (3DP) technology in craniofacial surgery, with a specific intention of addressing the planning of complex 3D deformities. Materials and Methods: This was a retrospective analysis of our surgical cases where we have used 3DP technology in 10 cases from 2014 to 2016 at a tertiary care hospital in India. 3D models were used in planning the correction of hypertelorism, craniosynostosis - open and endoscopic techniques, hemifacial microsomia, skull bone defects, and secondary orbital floor defects. The process of preparing a 3DP implant from a locally based company to suit the economic constraints of the patient has also been addressed in this article. Results: Each of the 10 patients are discussed, where this technology was used for planning, execution and training in craniofacial surgery. With the experience gained through these cases, the authors discuss the advantages of using 3DP technology in assessment of the true defect, accurate planning of the procedure, performance of model surgery, patient education, resident training, preparation of custom made implants, and more importantly providing all of these in an economical price using a locally based company for production of 3D models. Conclusion: 3DP models will revolutionize the way plastic and craniofacial surgeons think and plan surgical simulation. The authors recommend a wider application of such a technology to orthognathic surgery and any surgery that requires bony osteotomies with movement.

Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models.

Background:To fabricate three-dimensional (3D) models of brain arteriovenous malformation (bAVM) and report our experience with customized 3D printed models of patients with bAVM as an educational and clinical tool for patients, doctors, and surgical residents.Methods:Using computerized tomography angiography (CTA) or digital subtraction angiography (DSA) images, the rapid prototyping process was completed with specialized software and “in-house” 3D printing service. Intraoperative validation of model fidelity was performed by comparing to DSA images of the same patient during the endovascular treatment process. 3D bAVM models were used for preoperative patient education and consultation, surgical planning, and resident training.Results:3D printed bAVM models were successful made. By neurosurgeons’ evaluation, the printed models precisely replicated the actual bAVM structure of the same patients (n = 7, 97% concordance, range 95%–99% with average of < 2 mm variation). The use of 3D models was associated shorter time for preoperative patient education and consultation, higher acceptable of the procedure for patients and relatives, shorter time between obtaining intraoperative DSA data and the start of endovascular treatment. Thirty surgical residents from residency programs tested the bAVM models and provided feedback on their resemblance to real bAVM structures and the usefulness of printed solid model as an educational tool.Conclusions:Patient-specific 3D printed models of bAVM can be constructed with high fidelity. 3D printed bAVM models were proven to be helpful in preoperative patient consultation, surgical planning, and resident training.

Objective To investigate the effect of calculus model made by preoperative 3D printing technique on the puncture accuracy and postoperative complications of percutaneous nephrolithotomy (PCNL). Methods Thirteen patients with kidney calculi who underwent PCNL in our hospital between June 2014 and August 2016 were selected as study subjects, and all patients underwent ultrasound and 64 slice spiral CT examination before operation. The DICOM formatted files of CT were processed by the 3D medical image data processing platform. The thermoplastic plastics were used for 3D print, and the 3D kidney calculus models were obtained. 3D stone kidney model was obtained and simulated puncture in vitro. Analysis the function of 3D model of PCNL instructed to establish percutaneous renal access.The operation time, intraoperative blood loss, stone clearance rate, postoperative hospital stay and postoperative complications were observed. Results The 3D calculus models of 13 patients were successfully printed, There were no significant differences in the renal length, transverse diameterand the longest diameter [(11.89±0.46) cm, (6.87±0.25) cm, (4.10±0.27) cm] under 3D models and the the actual values (P>0.05). The accuracy of 3D model guided PCNL was 100%, and there was no significant differences between the estimated puncture depth [(5.76±0.65) cm] and the actual puncture depth [(6.14±0.34) cm, P>0.05]. The total score of the 3D model was (30.13±1.55), and the scores of patients and their family members on the 3D models was (31.45±0.99). Operation time(55±24) min, and intraoperative blood loss was(62.2±12.7)mL, postoperative hospitalization was(5.5±1.2)d. There were no complications such as peripheral organ injury, bleeding and infection in 13 patients. Conclusions The 3D printing models can better reflect the relationship between the stones and the surrounding tissues, guide the accurate puncture of PCNL and communication between doctors and patients, and reduce postoperative complications, which is worthy of clinical application. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Postoperative Complications