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Objective:To compare 3D-printing-assisted surgery and conventional surgery in the treatment of Schazker type Ⅵ tibial plateau fractures.Methods:A retrospective study was conducted to analyze the clinical data of 50 patients with type Ⅵ tibial plateau fracture who had been treated from January 2019 to December 2021 at the 5 Departments of Orthopedics in The First Affiliated Hospital of Nanchang University, The First People's Hospital of Jiujiang, Pingkuang General Hospital, Ganzhou People's Hospital, and Nanchang Hongdu Hospital of Traditional Chinese Medicine. The patients were divided into 2 groups according to their different treatment methods. In the 3D printing group of 25 cases treated by 3D-printing-assisted surgery, there were 14 males and 11 females, with an age of (42.5±9.1) years; in the conventional group of 25 cases treated by conventional surgery, there were 13 males and 12 females with an age of (42.2±9.3) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, fracture healing time, postoperative complications, the Rasmussen radiological scores and the American Hospital for Special Surgery (HSS) knee function scores at 6 and 12 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The operation time [(125.4±10.6) min], intraoperative blood loss [(206.2±16.3) mL], intraoperative fluoroscopy frequency [(9.2±2.7) times] and fracture healing time [(3.0±0.7) months] in the 3D printing group were all significantly less than those in the conventional group [(168.2±14.1) min, (303.2±20.4) mL, (15.5±3.5) times and (4.1±0.8) months] while the Rasmussen radiological scores (17.6±1.2 and 17.9±0.6) and HSS knee scores (90.8±6.4 and 91.5±5.6) at 6 and 12 months after operation in the 3D printing group were all significantly higher than those in the conventional group (16.2±2.6 and 16.7±2.2; 84.5±9.2 and 87.6±8.0) (all P<0.05). In the 3D printing group, there were 1 case of wound infection and 1 case of wound dehiscence after operation. In the conventional group, there were 2 cases of wound skin necrosis, 3 cases of wound dehiscence, 1 case of traumatic arthritis, 2 cases of wound infection, and 1 case of screw loosening. The incidence of complications in the 3D printing group (8.0%, 2/28) was significantly lower than that in the conventional group (36.0%, 9/25) ( P<0.05). Conclusion:In the treatment of Schatzker type VI tibial plateau fractures, compared with conventional surgery, 3D-printing-assisted surgery can lead to better curative outcomes, because it is conducive to lowering surgical difficulty, reducing postoperative complications, and promoting fracture union and functional recovery of the knee.
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Objective:To explore the short-term efficacy of fixation with a 3D printed individualized custom-made plate in the treatment of elderly patients with periprosthetic femoral fracture.Methods:Retrospectively analyzed were the 5 elderly patients with periprosthetic femoral fracture who had been treated by fixation with a 3D printed individualized custom-made plate from January 2022 to July 2022 at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital. There were 3 males and 2 females, aged 81, 86, 77, 91 and 87 years, respectively. One left and 4 right limbs were affected. Vancouver classification: type B1 ( n=3), type B2 ( n=1), and type C ( n=1). The time from operation to injury was 5, 6, 10, 5 and 7 days, respectively. Preoperatively, the femur affected, prosthesis and individualized plate with a greater trochanteric hook, loop cable channel and bone-like trabecular microporous structure were custom-made by 3D printing according to 1:1 models. Virtual operations were simulated to formulate surgical protocols. The operation time, length of surgical incision, intraoperative blood loss and transfusion, hospital stay, hip function and complications at the last follow-up were recorded. Results:The 5 patients were followed up for 12, 7, 10, 3 and 6 months, respectively. There were no events of superficial incision or deep prosthesis infection. Respectively, the operation time was 1.8, 1.7, 2.3, 2.0 and 3.3 h; the length of surgical incision 31, 30, 38, 27 and 30 cm; the intraoperative bleeding volume 400, 300, 300, 500 and 600 mL; the length of hospital stay 8, 9, 15, 14 and 11 d. Four patients received intraoperative blood transfusion of 300, 900, 150 and 1, 050 mL, respectively. One patient died of a heart attack 3 months after discharge; another patient developed dyskinesia at the contralateral limb 3 months after discharge due to cerebral infarction and died of recurrent cerebral infarction 7 months after discharge. At the last follow-up, the Harris hip scores of 3 patients were 86, 77 and 69 points, respectively. None of the patients had complications like breakage or loosening of implants.Conclusion:In the treatment of elderly patients with periprosthetic femoral fracture, fixation with a 3D printed individualized custom-made plate may lead to fine limb function and good short-term curative efficacy.
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Objective:To explore the application effect of case-based learning (CBL), teaching mode combined with 3D printing in clinical teaching of sacral tumors.Methods:A total of 108 undergraduate interns and standardized residency training students who studied in our hospital from 2017 to 2018 were divided into the CBL teaching group ( n = 53) and the CBL combined with 3D printing teaching group ( n = 55) according to their study time. The combined teaching group used computer tomography (CT) data to reconstruct and print out a 3D model of sacral tumors based on CBL, and performed preoperative teaching on the invasion of the surrounding tissues of the tumor. The scores of the students in the two groups were evaluated respectively, and the students were surveyed by self-identification questionnaire (learning interest, self-learning ability, teamwork ability, comprehensive analysis ability and clinical thinking ability). The t-test (one-sided) was used for comparison between groups using stata 14.0. Results:The score of CBL teaching group (75.90±6.70) was lower than that of CBL combined with 3D printing teaching group (83.60±7.40). In terms of critical thinking ability evaluation, self-learning ability, learning interest, comprehensive analysis ability and clinical thinking ability, the CBL combined 3D printing teaching group was superior to the CBL teaching group, and the difference was statistically significant ( P<0.001). In terms of teamwork ability, there was no statistical difference between the two groups. Conclusion:The CBL teaching mode combined with 3D printing can improve academic performance, students' learning interest and clinical thinking ability of sacral tumors in the teaching of undergraduate interns and standardized residency training students.
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Objective @#To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). @*Methods @# This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P<0.05 indicating a statistically significant difference. @*Results @#The experimental group was significantly better than the control group in terms of the success rate of the first puncture (χ2 = 21.51, P<0.001), puncture time (Z = -5.51, P<0.001), operative time (t = 9.37, P<0.001), and the number of C-arm scans (Z = -4.59, P<0.001). Postoperative BNI scores of the experimental group included 21 cases of grade Ⅰ (91.5%) and 1 case of grade Ⅱ, while the control group included 17 cases of grade Ⅰ (85.0%), 2 cases of grade Ⅱ (10.0%) and 1 case of grade Ⅲ (5.0%), with no statistical significance (P>0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. @* Conclusions @#3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.
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@#With the rapid advancement of science and technology, the application of 3D printing technology for personalized drug manufacturing is becoming increasingly sophisticated.Compared to traditional manufacturing technology, 3D printing can easily customize preparations with specific sizes, shapes and release behaviors for personalized drug use.This review summarizes the principles of several 3D printing technologies commonly used in drug manufacturing, lists the unique advantages and application examples of 3D printing technology for pharmaceutical preparation, analyses the current research status and development trends of the global industry of drug 3D printing, and summarizes the current problems and challenges facing drug 3D printing, aiming to provide some guidance for researchers of 3D printed drugs.
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OBJECTIVES@#Renal cancer is a common malignancy of the urinary system, and the partial nephrectomy is a common surgical modality for early renal cancer. 3D printing technology can create a visual three-dimensional model by using 3D digital models of the patient's imaging data. With this model, surgeons can perform preoperative assessment to clarify the location, depth, and blood supply of the tumor, which helps to develop preoperative plans and achieve better surgical outcomes. In this study, the R.E.N.A.L scoring system was used to stratify patients with renal tumors and to explore the clinical application value of 3D printing technology in laparoscopic partial nephrectomy.@*METHODS@#A total of 114 renal cancer patients who received laparoscopic partial nephrectomy in Xiangya Hospital from June 2019 to December 2020 were enrolled. The patients were assigned into an experimental group (n=52) and a control group (n=62) according to whether 3D printing technology was performed, and the differences in perioperative parameters between the 2 groups were compared. Thirty-nine patients were assigned into a low-complexity group (4-6 points), 32 into a moderate-complexity group (7-9 points), and 43 into a high-complexity group (10-12 points) according to R.E.N.A.L score, and the differences in perioperative parameters between the experimental group and the control group in each score group were compared.@*RESULTS@#The experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (all P<0.05), less intraoperative blood loss (P=0.047), and smaller postoperative blood creatinine change (P=0.032) compared with the control group. In the low-complexity group, there were no statistically significant differences between the experimental group and the control group in operation time, renal ischemia time, intraoperative blood loss, postoperative blood creatinine changes, and postoperative hospital stay (all P>0.05). In the moderate- and high- complexity groups, the experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (P<0.05 or P<0.001), less intraoperative blood loss (P=0.022 and P<0.001, respectively), and smaller postoperative blood creatinine changes (P<0.05 and P<0.001, respectively) compared with the control group.@*CONCLUSIONS@#Compared with renal tumor patients with R.E.N.A.L score<7, renal cancer patients with R.E.N.A.L score≥7 may benefit more from 3D printing assessment before undergoing partial nephrectomy.
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Female , Humans , Male , Blood Loss, Surgical , Creatinine , Ischemia , Kidney Neoplasms/surgery , Laparoscopy/methods , Nephrectomy/methods , Printing, Three-Dimensional , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To compare minimally invasive treatment with versus without a 3D printed guide plate for Sanders type Ⅱ calcaneal fractures.Methods:A retrospective analysis was done of the 74 patients with Sanders type Ⅱ displaced intra-articular calcaneal fracture who had been treated at Foot and Ankle Surgery Center, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2018 to January 2020. They were divided into 2 groups according to whether a 3D printed guide plate was used or not. In the 3D printing group of 38 patients treated by minimally invasive surgery assisted by a 3D printed guide plate, there were 22 males and 16 females with an age of (41.5±3.5) years; in the control group of 36 patients treated by traditional minimally invasive surgery, there were 24 males and 12 females with an age of (40.3±7.2) years. The 2 groups were compared in terms of operation time, intraoperative fluoroscopy, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), Short Form 36 (SF-36), B?hler angle, Gissane angle, calcaneal length, width and height and postoperative complications.Results:There was no significant difference in the preoperative demographic data between the 2 groups, indicating comparability between groups ( P>0.05). All patients were available for a follow-up of (12.6±3.6) months (from 6 to 24 months) after surgery. The operation time [(55.3±7.1) min] and intraoperative fluoroscopy [(8.1±2.6) times] in the 3D printing group were significantly less than those in the control group [(71.2±8.7) min and (21.2±8.7) times] ( P<0.01) while the AOFAS score in the former group (81.4±6.3) was significantly higher than that in the latter (77.9±6.2) ( P<0.01). There were no statistically significant differences between the 2 groups in VAS, SF-36, B?hler angle, Gissane angle, calcaneal length, calcaneal width or calcaneus height ( P>0.05). In the control group, 4 screws were found to be too long with possible impingement on the medial structures of the foot, and 3 screws to penetrate the subtalar joint; in the 3D printing group, there were no too long or off-target screws in the sustentaculum tali. Conclusion:The minimally invasive treatment of Sanders type Ⅱ calcaneal fractures assisted by a 3D printing guide plate can reduce operation time, intraoperative fluoroscopy and potential complications, improving the clinical efficacy.
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@#<b>Objective</b> To study the feasibility of clinical application of an individualized customized material. <b>Methods</b> Five batches of individualized customized materials were randomly selected, from which 10 cm × 11 cm samples were intercepted for experimental analysis. Among them, 10 cm × 10 cm materials were selected to perform dosimetric analysis and HU change analysis before and after irradiation with a radiotherapy dose for breast cancer of 50 Gy as the irradiation basis. The center Point 1 on the lower surface of the individualized material and the center Point 2 of the solid water volume were selected for dosimetric analysis before and after the sample is irradiated. After reaching a sufficient amount of irradiation, the 1 cm × 10 cm materials intercepted in the center position and the remaining 1 cm × 10 cm materials after the first sampling were sent to the material science laboratory for analysis of physical properties of density, viscosity, hardness, and tear strength. <b>Results</b> In the comparative analysis of HU values before and after exposure, after receiving 50 Gy dose irradiation, the difference rate of HU value was 5.252%, which was close to the expected 5% difference rate in clinical medicine. In the dosimetric analysis of Point 1 and Point 2, the dose in the irradiated samples was significantly higher than that in the unirradiated samples; the dose in Point 1 increased by 3.742%, and the dose in Point 2 increased by 2.039%. Before and after irradiation, except for the physical density which showed a significant difference, there was no significant difference in viscosity, hardness, and tear strength. <b>Conclusion</b> The individualized customized material can meet the requirements of routine clinical medicine.
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Free vascularised fibular flap has many advantages in repair of mandibular defects, and it has become the main method in the mandibular reconstruction. However, the traditional free fibular flap used to repair the mandibular defect is lack of individualised design and precise surgical guidance, and it is difficult to achieve accurate repair and the effect of reconstruction. The concept of personalised and accurate functional reconstruction and the clinically application of digital medical technology provides a new approach to solve the problems. The application of digital medical technology in the repair of mandibular defects with fibular flap is one of the hotspots of current research. This article introduces the application characteristics of digital medical technology, such as 3-dimensional reconstruction technology, virtual surgery planning (VSP) technology and 3D printing technology, in the repair of mandibular defects with fibular flap transfer.
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Objective:To investigate the clinical efficacy of a new 3D printed guide plate in the minimally invasive treatment of fresh closed Achilles tendon rupture.Methods:From January 2019 to January 2020, 14 fresh closed Achilles tendon ruptures were treated by minimally invasive surgery at Department of Foot and Ankle Surgery, Xuzhou Renci Hospital. There were 13 males and one female, with an average age of 39.1 years (from 18 to 63 years). The rupture of the Achilles tendon body, 3 cm in length on average, was located 2 to 6 cm above the attachment of the calcaneal tuberosity. The ruptured Achilles tendon was repaired by suture with the aid of the new 3D printed guide plate. After operation, in cooperation of the Rehabilitation Department, we performed rehabilitation exercise under the guidance of the concept of Enhanced Recovery After Surgery (ERAS). The length of incision, operation time, intraoperative blood loss, ankle function at the last follow-up and follow-up complications were recorded.Results:In this cohort, incision length averaged 2.5 cm (from 2.0 to 3.5 cm), operation time 45 min (from 30 to 60 min), and intraoperative blood loss 15 mL (from 10 to 20 mL). The 14 patients were followed up for 13 to 16 months (average, 14 months) after operation. In one patient, the epidermis at the incision edge became black and necrotic, which was healed after dressing change. Follow-ups observed no such complications as suture rejection, sural nerve injury, or Achilles tendon re-rupture. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores at the last follow-up averaged 98 points (from 93 to 99 points), yielding 13 excellent cases and one good case; according to the Arner-Lindholm evaluation, the efficacy was excellent in 12 cases, good in one and poor in one.Conclusion:The minimally invasive treatment of fresh closed Achilles tendon rupture with our new 3D printed guide plate has exhibited advantages of minimally invasive incision, limited complications, simple manipulation, good functional recovery of the ankle joint and strong reproducibility of surgical operations.
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Objective:To explore the application value of 3D printing technology in the precise resection of pediatric retroperitoneal neuroblastoma(NB).Methods:Eleven patients with retroperitoneal NB admitted to the Department of Pediatric Surgery of Henan Provincial People′s Hospital from March 2017 to December 2019 were selected in this study, and all of them received preoperative plain and enhanced computed tomography (CT) scanning of whole abdomen.The original data were imported into the mimics 20 software for processing.The tumor and important peripheral blood vessels were reconstructed with such commands as multi-layer edition, threshold adjustment, regional growth and 3D edition to output the standardized 3D printing stl format file and print out the tumor model by 3D printer.Based on the 3D reconstruction results, the precise surgical planning was performed to determine the optimal operative scheme.The data of all cases were analyzed retrospectively.The parents of these children were investigated by questionnaire and the results were statistically analyzed.Results:All 11 patients successfully underwent the operation under the planning of 3D printing technology.Nine of them had complete tumor resection and 2 cases had palliative resection.The operation time ranged from 140 min to 750 min, with an average of 210 min; the bleeding volume ranged from 100 mL to 1 500 mL, with an average of 240 mL; the postoperative pathological reports revealed that 9 children had NB and 2 cases had ganglioneuroblastoma.There was no case of perioperative death.There were 2 cases of postoperative complications, including 1 case of severe diarrhea with chylous leakage, which was relieved after the treatment of parenteral nutrition and somatostatin, and 1 case of left lower extremity weight-bearing difficulty after left iliac artery anastomosis, which was improved after rehabilitation physical therapy.The follow-up time ranged from 1 month to 30 months.There were 2 cases recurred in the original operation area.One patient received reoperation after chemotherapy; the other continued chemotherapy in progress.As for the 2 cases of palliative resection, they received chemotherapy and survived with tumor.After using 3D model to communicate with children′s parents, their awareness rate of disease, operation mode and postoperative complications were significantly higher than that of CT.Conclusions:3D printing technology can accurately evaluate the structural relationship between retroperitoneal NB and important peripheral blood vessels in children, which contributes to improving the parents′ cognition of the operation mode, and is conducive to selecting the optimal operation scheme and achieving precise tumor resection.
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@#Objective To evaluate the clinical value of three-dimensional (3D) printing model in accurate and minimally invasive treatment of double outlet right ventricle (DORV). Methods From August 2018 to August 2019, 35 patients (22 males and 13 females) with DORV aged from 5 months to 17 years were included in the study. Their mean weight was 21.35±8.48 kg. Ten patients who received operations guided by 3D printing model were allocated to a 3D printing model group, and the other 25 patients who received operations without guidance by 3D printing model were allocated to a non-3D printing model group. Preoperative transthoracic echocardiography and CT angiography were performed to observe the location and diameter of ventricular septal defect (VSD), and to confirm the relationship between VSD and double arteries. Results The McGoon index of patients in the 3D printing model group was 1.91±0.70. There was no statistical difference in the size of VSD (13.20±4.57 mm vs. 13.40±5.04 mm, t=−0.612, P=0.555), diameter of the ascending aorta (17.10±2.92 mm vs. 16.90±3.51 mm, t=0.514, P=0.619) or diameter of pulmonary trunk (12.50± 5.23 mm vs. 12.90±4.63 mm, t=−1.246, P=0.244) between CT and 3D printing model measurements. The Pearson correlation coefficients were 0.982, 0.943 and 0.975, respectively. The operation time, endotracheal intubation time, ICU stay time and hospital stay time in the 3D printing model group were all shorter than those in the non-3D printing model group (P<0.05). Conclusion The relationship between VSD and aorta and pulmonary artery can be observed from a 3D perspective by 3D printing technology, which can guide the preoperative surgical plans, assist physicians to make reasonable and effective decisions, shorten intraoperative exploration time and operation time, and decrease the surgery-related risks.
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@#Objective To discuss the operation skill and clinical effects of using domestic balloon-expandable Prizvalve® transcatheter "valve-in-valve" to treat the degenerated bioprosthesis in the tricuspid position. Methods All the admitted surgical tricuspid valve bioprosthetic valve replacement patients were evaluated by computerized tomography angiography (CTA), ultrasound, and 3D printing technology, and 2 patients with a degenerated bioprosthesis were selected for tricuspid valve "valve-in-valve" operation. Under general anesthesia, the retro-preset Prizvalve® system was implanted into degenerated tricuspid bioprosthesis via the femoral vein approach under the guidance of transesophageal echocardiographic and fluoroscopic guidance. Results Transcatheter tricuspid valve implantation was successfully performed in both high-risk patients, and tricuspid regurgitation disappeared immediately. The operation time was 1.25 h and 2.43 h, respectively. There was no serious complication in both patients, and they were discharged from the hospital 7 days after the operation. Conclusion The clinical effect of the degenerated tricuspid bioprosthetic valve implantation with domestic balloon-expandable valve via femoral vein approach "valve-in-valve" is good. Multimodality imaging and 3D printing technology can safely and effectively guide the implementation of this innovative technique.
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OBJECTIVE@#To explore the application value of 3D printing technology in preoperative surgery plan and intraoperative auxiliary operation for adult kyphoscoliosis deformity.@*METHODS@#The clinical data of 12 adult patients with kyphoscoliosis deformity treated from September 2017 to January 2019 were retrospectively analyzed. There were 3 males and 9 females, aged from 21 to 63 years old with an average of (47.67±13.32) years old. Among them, 4 cases were congenital kyphoscoliosis, 2 cases were old tuberculosis thoracolumbar kyphosis ; 2 cases were idiopathic kyphoscoliosis, 4 cases were degenerative kyphoscoliosis. The CT scan data of the patient's spine was imported into Mimics17.0 software to establish the three dimensional model of the spine, and the spine model was produced by 3D printer. Using the spine model simulated operation, preoperative surgery program planning and formulated a precise surgery, and further analysed postoperative imaging parameters improvement. All the patients were followed up for more than 1 year. Before and after operation and at the last follow-up, the scoliosis Cobb angle, maximum kyphosis Cobb angle, and coronal plane balance (distance between C 7 plumbline and center sacral vertical line, CPL-CSVL), sagittal plane balance (sagittal vertical axis, SVA), pelvic parameters and other related imaging parameters were measured to further evaluate its orthopedic effect.@*RESULTS@#Twelve patients with spine deformity were treated with different osteotomy and internal fixation fusion methods under the guidance of a 1∶1 spine model (pedicle screw placement of 4 patients with severe deformity were assisted by pedicle screw guide plates), nail placement and osteotomy have good effects, no major tissue damage such as blood vessels, nerves and spinal cord during and after surgery, no complications such as cerebrospinal fluid leakage and infection. Preoperative Cobb angle of scoliosis was (56.5±22.5) °, Cobb angle of kyphosis was (65.2±19.5) °, C PL-CSVL was (45.8±16.9) mm, SVA was (48.7±25.4) mm. Postoperative at 4 weeks, Cobb angle of scoliosis was (20.8±11.5) °, and Cobb angle of kyphosis was (22.0±6.6) °, with correction rates of (65.1±9.7)% and (64.6± 10.6)%, respectively ; C PL-CSVL was (22.3±8.9) mm, and SVA was (23.3±13.1) mm, all of which were significantly improved compared with preoperative results. The mean follow-up time was (18.5±7.9) months in 12 patients. At the last follow-up, the Cobb angles of scoliosis and kyphosis were (22.2±10.8) ° and (23.6±7.7) °, respectively, C PL-CSVL was (23.5±10.8) mm, and SVA was (24.7±12.5) mm. The results were statistically significant compared preoperative (0.05).@*CONCLUSION@#The 3D print model can visually and clearly show the vertebral morphology and structure of adult kyphoscolisis and its spatial relationship with the adjacent vertebrae, blood vessels, and nerves, which provides a good and intuitive stereoscopic anatomical structure observation for the individualization of the surgical plan. Pre-simulation of operations to determine the internal fixation, fusion segment and osteotomy orthopedic way, may to provide a reference for actual clinical surgery, and can improve the accuracy and safety of surgery.
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3D printing technology has the advantages of accurate spatial distribution, accurate drug release and personalized drug dosage, which can make up for the shortcomings of traditional pharmaceutical technology. In recent years drop-on powder (DoP) 3D printing technology has been widely used in pharmaceutical preparation. Compared with other types of 3D printing technology, it is more simple, flexible and easy to operate. In 2015, Aprecia Pharmaceuticals announced that the US Food and Drug Administration (FDA) approves the launch of its first instant tablet Spritam® (levetiracetam) made with DoP 3D printing. After the first 3D printed medicine was launched, people also saw the unique advantages and broad prospects of DoP 3D printing technology platform in pharmaceutical preparation. This review focuses on the technical principles and key factors of DoP 3D printing, its application in the preparation field and its future development challenges.
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Objective@# To investigate the manufacturing procedures of personalized miniscrew-assisted rapid palatal expanders (pMARPE) using digital technologies and to evaluate the effect of the expanders when expanding the midpalatal suture of an adult. @*Methods@# Digital technologies were used to make pMARPE, which was used to treat a 21-year-old woman with maxillary transverse deficiency (MTD). The relevant literature on MARPE was reviewed.@* Results@#PMARPE could be manufactured using intraoral digital scanning, computer-aided design and computer-aided manufacturing(CAD/CAM ), and 3D printing technologies. After expansion, the width of the anterior midpalatal suture, posterior midpalatal suture and maxillary skeletal width increased by 3.9 mm, 3.2 mm and 4.7 mm, respectively. There was no significant change in the inclination of maxillary first molars, and the height of alveolar ridge decreased slightly. It could be seen that using digital technologies to manufacture personalized expanders was possible for MARPE , and the initial stability of miniscrews played an important role in the expansion success rate, the increase of molar inclination is composed of many parts, and the decrease of alveolar ridge height may be overestimated due to the measurement method, as shown by a literature review. @*Conclusion@#The midpalatal suture of an adult patient with MTD could be expanded by pMARPE. However, the effect of this expander on the inclination of the first molar and alveolar bone height needs to be further studied with a larger sample size.
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BACKGROUND: In the case of tooth defect or missing, the treatment should be achieved by making a personalized prosthesis. Traditional manufacturing process is time-consuming, costly and accurate. After the introduction of 3D printing technology into dental manufacture, the manufacturing efficiency and quality can be improved to a certain extent. OBJECTIVE: To introduce the application of 3D printing technology in dental manufacture, discuss the bottleneck in recent application, and guide the development of 3D printing technology in dental manufacture. METHODS: The authors used the search times "3D printing, metal implant, dental manufacturing, dental restorations” to search Web of Science, Wanfang, CNKI databases in English and Chinese separately to search papers published during 1980-2019. 261 papers were preliminarily retrieved and 60 of them were included in the final analysis. RESULTS AND CONCLUSION: 3D printing dental mold, digital implant guide plate and wax pattern have been widely used in dental manufacture. 3D printing technology has been widely used in dental manufacture. The most widely used six processes are stereo lithography appearance, laminated object manufacturing, fused deposition modeling, selective laser sintering, selective laser melting, and inkjet printing. There are some technical bottlenecks in the application of 3D printing technology in the field of dental manufacturing. After breaking through technology bottlenecks, 3D printing will be more useful in the field of dental manufacturing in the future.
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BACKGROUND: 3D printed bone model was widely used in clinical teaching and simulated surgery training, but it did not pay enough attention to the construction of soft tissue, and the simulation was poor, which cannot reflect the soft tissue exposure process. OBJECTIVE: To explore the feasibility of constructing a simulated lumbar spine surgery model based on 3D printing technology for the training of lumbar pedicle screw placement in junior orthopedic surgeons. METHODS: The solid model of the lumbar spine was printed at the same proportion based on 3D printing technology, and the model of simulated lumbar spine surgery was constructed with plasticine and cloth. Thirty orthopedic residents performed lumbar pedicle screw placement alone on the simulated model, and performed once a day for 10 consecutive days. They recorded the operation time, and evaluated the accuracy of screw placement by postoperative CT scan. By comparing the operation time and screw placement accuracy of the operators in the early stage (the first 5 times) and the later stage (the last 5 times), all above parameters were statistically analyzed. This study was approved by the Ethics Committee of Zigong Fourth People's Hospital. RESULTS AND CONCLUSION: (1) In the early stage (the first 5 times), the average operation time was (100. 00+12. 67) minutes. In the later stage (the last 5 times), the average operation time was (83. 50+10. 14) minutes, and the difference was statistically significant (f=20. 67, P=0. 00). (2) The success rate of former screw placement (including grade I and II screw placement) was 88. 53%, and the failure rate (grade III screw placement) was 11. 47%. The success rate and failure rate of latter screw placement were 97. 47% and 2. 53%, respectively, with statistically significant difference (x2-20. 68, P=0. 00). (3) The simulated model of lumbar spine surgery based on 3D printing technology has high simulation and feasibility, and can be used for the training of lumbar pedicle screw placement in junior orthopedic surgeons.
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BACKGROUND: Polyetheretherketone (PEEK) and Its composites have a unique set of properties, and 3D printing technology can customize personalized Implants according to the patient's condition, and the effective combination of the two plays a significant role In the field of bone repair. OBJECTIVE: To summarize the application status of PEEK and Its composite combined with 3D printing technology In the field of bone repair, and to further predict the application prospects of the effective combination of the two. METHODS: CNKI, PubMed, and Web of Science databases were retrieved with the search terms “PEEK, PEEK composites, bone defect repair, PEEK Implants, PEEK 3D printing, prosthodontlcs” in English and Chinese, respectively, for the articles published from April 1995 to April 2019. Totally 147 articles were searched, and finally 51 eligible articles were enrolled for review in accordance with the inclusion and exclusion criteria. RESULTS AND CONCLUSION: Biologically active materials and the particles or fibers with Improved mechanical properties were Introduced Into the PEEK matrix to prepare its composite. 3D printing technology was used to precisely customize Implants that are highly matched to the patient's defect. The Implants with good biocompatibility, bioactlvity, and mechanical properties exhibited good therapeutic effects In the repair of skull, jaw, spine, lumbar vertebra, artificial joint and oral defects. They Improved patient satisfaction after treatment. This article summarized the application of PEEK, its composite and 3D printing technology In the repair of various bone defects, and expressed its views on the application and prospect of personalized PEEK implants or prostheses prepared with 3D printing technology.
ABSTRACT
BACKGROUND: With the constant development of current society, traumatic bone injury caused by the traffic and other accidents becomes more and more common. Bone defect scope is increasingly extend, and the treatment results in the long cycle, the high cost, and the uncontrolled effect, accompanied with infections, bone nonunion and other complications, which not only causes the painfulness of the patient physically and mentally, but also is a difficult problem and challenge for orthopedic surgeons at the same time. OBJECTIVE: To analyze the advantages and disadvantages of traditional treatments and their latest progress, and focus on the research progress and advantages of tissue engineering technology in treating bone defect. METHODS: The author took “bone defect, bone transplantation, tissue engineering, induced membrane technology, bone transfer technology, endothelial progenitor cells, 3 D printing technology” as the key words, and data were summarized by searching CNKI, Wanfang and Pub Med databases. Totally 120 related literatures were retrieved. Through reading the title, abstract and part of the literature content, the outdated, ambiguous and repetitive literatures were excluded. Finally, 49 literatures meeting the inclusion criteria were selected for review. RESULTS AND CONCLUSION:(1) Traditional bone defect treatment has certain defects. The emergence of bone tissue engineering technology is expected to become one of the most effective ways for bone defect.(2) Seed cells have good osteogenic properties and can secrete some important factors.(3) Scaffold material can provide mechanical strength for patients in early stage, and has advantages of good biocompatibility, bone induction, and controllable degradation.(4) The urgent problem of vascularization is also being solved gradually, which can bring good news to the patients with bone defect.