Modified Impression Technique of a Custom Made Hand Painted Iris For an Ocular Prosthesis: A Case Report

@#The enucleation of the eye due to variety of causes such as trauma, tumor and severe eye disease or infection has resulted to permanent defect of sight and aesthetic. Defects of the eye may include removal of a part of or the entire orbit which has affected patient’s psychology. Restoring the defect with pre-fabricated or custom-made ocular prosthesis will restore aesthetics and improves patient’s social confidence. This is a case report of construction a custom-made; hand painted iris of ocular prosthesis on a patient with missing left eye due to trauma using modified impression method. The case describes the process of constructing the custom-made ocular prosthesis with modification of impression technique to improve accuracy and fitting. It is aim to highlight the importance of custom-made prosthesis as compared to pre-fabricated ocular prosthesis on its property, fitting to eye socket, hygiene and aesthetic satisfaction.

Custom-made finger splint versus prefabricated finger splint: finger flexion stabilization

SUMMARY OBJECTIVE: Finger splints are used as a treatment option in tendon, bone, and soft tissue injuries. For immobilization, custom-made splints and prefabricated finger splints are used. In splints made for immobilization, it is aimed to limit joint movement. The aim of our study is to reveal how much custom-made splints and prefabricated finger splints limit joint motion (flexion angle in proximal interphalangeal and distal interphalangeal joints). METHODS: Custom-made splints and prefabricated finger splints were applied to the second fingers of the dominant side in a total of 40 individuals, 20 women and 20 men, not having any health problems. Individuals were asked to flex and joint motion was measured with the iPhone compass application. RESULTS: The mean distal interphalangeal joint angle values of the participants measured by prefabricated finger splints were found to be 24.27±8.29, and the mean distal interphalangeal joint angle values measured by custom-made splints was 0.52±1.50. There was a difference between the participants' distal interphalangeal joint angle values measured by prefabricated finger splints and custom-made splints (p<0.001). distal interphalangeal joint angle values measured with custom-made splints were significantly smaller than those measured with prefabricated finger splint. The mean of the participants' proximal interphalangeal joint angle values measured by prefabricated finger splints was 16.55±7.90, and the proximal interphalangeal joint angle values measured by custom-made splints was "0" for all participants. There was a difference between the participants' proximal interphalangeal joint angle values measured by prefabricated finger splints and custom-made splints (p<0.001). Distal interphalangeal joint angle values measured with custom-made splints were significantly smaller than those measured with prefabricated finger splints. CONCLUSION: According to our study, custom-made splints can significantly reduce the flexion of the finger interphalangeal joints compared to prefabricated finger splints.

3D printing pre-operation assisted with custom-made plate for internal fixation of femoral shaft fractures after poliomyelitis / 中国组织工程研究

BACKGROUND: Patients with poliomyelitis often have abnormalities in the femur and the conventional plant matching degree of fracture is low. There are few reports on individualized treatment for severe deformity of femoral shaft fracture in poliomyelitis. OBJECTIVE: To summarize the clinical features of femoral shaft fracture in poliomyelitis and discuss the operative outcome of 3D printing pre-operation assisted with custom-made plate. METHODS: From May 2015 to May 2018, data of 19 patients with poliomyelitis surgically treated with 3D printing pre-operation assisted with custom-made plate were retrospectively analyzed. There were 11 males and 8 females with an average age of 52.5 years (range, 38-62 years). There were 7 cases on the left side, and 12 cases on the right side. According to AO/OTA classification of femoral shaft fracture, there were type A1 in 6 cases, type A2 in 3 cases, type A3 in 1 case, type B1 in 4 cases, type B2 in 4 cases and type C1 in 1 case. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The 3D printed 1:1 femur model and custom-made plate were designed. Operation was simulated in vitro in femoral model. The placement of the plate was identified. The direction and length of the screws were measured and recorded. The final internal fixation of fracture was performed according to the pre-operation results. Hip and knee functions in the affected limb were assessed based on Harris evaluation criterion and hospital for special surgery knee score evaluation criterion. RESULTS AND CONCLUSION: (1) All 19 patients were followed up for 12-18 months. Bone healing was obtained in all fractures, with a healing time of 5-12 months, averaging 6.6 months. (2) Harris score was (84.95±5.18) before injury, and (84.42±4.83) 1 year after operation. Hospital for special surgery knee score was (84.53±4.36) before injury, and (83.63±3.90) 1 year after operation. Statistical analysis showed no statistical difference between the two groups before and after the injury (P > 0.05). (3) All patients had no internal fixation loosening or fracture. One patient had delayed bone healing and healed after iliac bone grafting. One patient developed wound infection after surgery, and received adequate drainage. Wound was healed after intravenous application of sensitive antibiotics. (4) Patients with poliomyelitis often have abnormalities in the femur with varying degrees of osteoporosis. For femoral shaft fractures that cannot be fixed with conventional internal fixation, 3D printing pre-operation combined with custom-made steel plate provides a new choice for the treatment of femoral shaft fractures in poliomyelitis.

Effectiveness of AC custom-made Ortho-K lens / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the effectiveness of AC custom-made orthokeratology(Ortho-K)lens in overnight orthokeratology fitting.<p>METHODS: A prospective study was conducted for 84 patients(165 eyes)with myopia who wore overnight Ortho-K lens for the first time. All patients were randomly divided into two groups with 38 patients(76 eyes)in observation group wearing AC custom-made Ortho-K lens and 46 patients(89 eyes)in control group wearing standard Ortho-K lens. Three items including the uncorrected visual acuity(UCVA), corneal topography, and the complications of corneal epithelium were observed and quantized to be evaluated at 1mo after Ortho-K lens wearing. <p>RESULTS: The assessment of 156 eyes(94.5%, including 73 eyes in observation group and 83 eyes in control group)in Ortho-K lens fitting were fine or acceptable at 1mo. Only 9 eyes(5.5%, including 3 eyes in observation group and 6 eyes in control group)were not good or unacceptable at that time, so that their Ortho-K lens had to be followed-up ulteriorly or changed instead. In all examination of this study, the UCVA of 159 eyes(96.4%, including 74 eyes in observation group and 85 eyes in control group)could reach one line lower to the BVCA or better in standard logarithmic visual acuity chart. The assessment of 157 eyes(95.2%, including 73 eyes in observation group and 84 eyes in control group)in corneal topography were fine or acceptable and there were no patients that had any serious complications in corneal epithelium. The observation group wearing AC custom-made Ortho-K lens performed better than the control group wearing standard Ortho-K lens in the result of UCVA, corneal topography, and the complications in corneal epithelium(<i>P</i><0.05). <p>CONCLUSION: The overnight orthokeratology was effective and satisfying. AC custom-made Ortho-K lens performed better than standard Ortho-K lens in the assessment after wearing for 1mo.

Rehabilitation Of The Patient With Finger Prosthesis Along With Acrylic Resin Custom Made Nail- A Case Report

Hand is a body part which is of major significance for communication, body language and social contact along with its fundamental function of grasping and feeling. Finger and partial finger amputations are some of the most frequently encountered forms of partial hand loss in India which causes devastating physical, psychosocial and economic damage to an individual. Rehabilitation of amputed finger is of utmost importance and the first choice is micro vascular reconstruction. But when it is contraindicated, unavailable, unsuccessful or unaffordable, the prosthetic rehabilitation is an alternative for improving the psychological status of an individual. Silicone finger prosthesis with modern prosthetic designs, fabricated with immense care, can be life-like and can assist the amputee in returning to society socially as well as psychologically. This case report presents the fabrication of custom-made silicone finger prosthesis along with acrylic resin custom made nail in an attempt to avoid costly procedures and provide best possible esthetic results.

Effects of custom made fiber posts on the fracture resistance of young permanent teeth treated with calcium hydroxide / 上海交通大学学报（医学版）

Objective · To observe the effects of custom made fiber posts on the fracture resistance of young permanent teeth treated with calcium hydroxide for different time. Methods · Forty-five extracted human young permanent teeth (premolar) were selected and randomly assigned to 9 groups.One group was the control group and the rest 8 groups were treated with conventional root canal preparation. Of these 8 groups, 4 groups (F Ⅰ , F Ⅲ , F Ⅵ ,FⅨ ) were restored by custom made fiber posts after being treated with calcium hydroxide for 1, 3, 6, and 9 months respectively, and other 4 groups (C Ⅰ ,CⅢ , C Ⅵ , C Ⅸ ) were not restored by custom made fiber posts. All samples underwent fracture strength tests and their fracture modes were analyzed for the possibility of second repair. Results · The fracture load was decreased with the treatment time after being treated with calcium hydroxide for 1 month (P<0.01). The fracture loads in groups restored by custom made fiber posts were increased after being treated with calcium hydroxide for 6 and 9 months (P<0.05, P<0.01). After being treated with calcium hydroxide for 1 month, groups restored by custom made fiber posts were likely to have fracture modes that facilitate the second repair as compared with groups not restored by custom made fiber posts (P<0.05). Conclusion · The restoration by custom made fiber posts can increase the fracture resistance of young permanent teeth treated with calcium hydroxide for medium and long term ( ≥ 1 month).

Coronal microleakage of flared root canal teeth restored with CAD/CAM fiber post and core / 实用口腔医学杂志

Objective:To study the coronal microleakage of flared root canal teeth restored with computer aided design and computer aided manufacturing (CAD/CAM)fiber post and core.Methods:60 extracted human mandibular premolars with single canal were divided into 3 groups randomly(n =20).The roots of the teeth were restored with CAD/CAM glass fiber post and core(group A), prefabricated glass fiber post(group B)and gold alloy dowel-and-core(group C)respectively.The specimens were immersed in India ink for 4 weeks.Subsequently all teeth were demineralized,dehydrated and rendered transparent.Then coronal microleakage was ob-served with stereomicroscope.Nonparametric data were analyzed.After that,All the specimens was demineralized completely in nitric acid,Then the interface between the post,resin cement and canal wall was observed and recorded.Results:The microleakage was found in all the 3 groups,group A and C showed less microleakage than group B(P 0.05).Microleakage mostly appeared at the interface between post and resin cement in group A and C,while in group B,it appeared between resin cement and the wall of root canal totally.Conclusion:CAD/CAMfiber post and core demonstrates less coronal microleakage than prefabricated glass fiber post.

Selective laser melted titanium implants: a new technique for the reconstruction of extensive zygomatic complex defects / 대한악안면성형재건외과학회지

The restoration of extensive zygomatic complex defects is a surgical challenge owing to the difficulty of accurately restoring the normal anatomy, symmetry, proper facial projection and facial width. In the present study, an extensive post-traumatic zygomatic bone defect was reconstructed using a custom-made implant that was made with a selective laser melting (SLM) technique. The computer-designed implant had the proper geometry and fit perfectly into the defect without requiring any intraoperative adjustments. A one-year follow-up revealed a stable outcome with no complications.

Manufacture of custom-made cranial implants from DICOM® images using 3D printing, CAD/CAM technology and incremental sheet forming

INTRODUCTION: This work aims to pre-operatively manufacture custom-made low-cost implants and physical models (‘biomodels’) of fractured skulls. The pre-DOI: operative manufacturing of biomodels and implants allows physicians to study and plan surgery with a greater possibility of achieving the expected result. Customization contributes to both the esthetic and functional outcome of the implant because it considers the anatomy of each patient, while the low cost allows a greater number of people to potentially benefit. METHODS: From CT images of a fractured skull, a CAD model of the skull (biomodel) and a restorative implant were constructed digitally. The biomodel was then physically constructed with 3D Printing, and Incremental Sheet Forming (ISF) was used to manufacture the implant from a sheet of pure grade 2 titanium. Before cutting the implant’s final shape from a pre-formed sheet, heat treatment was performed to avoid deformations caused by residual stresses generated during the ISF process. RESULTS: A comparison of the dimensions of the implant and its respective CAD biomodel revealed geometric discrepancies that can affect both functional and aesthetic efficiency. Nevertheless, the final shape preserved symmetry between the right and left sides of the skull. Electron microscopy analysis did not indicate the presence of elements other than pure titanium. CONCLUSION: Dimensional variability can be decreased with changes in the manufacturing process (i.e., forming and cutting) and the heating ramp. Despite biomedical characteristics, there was no contamination of the implant by harmful chemical elements. 3D Printing was effective in making the biomodel, enabling pre-operative planning and improving physician-patient communication. Current results indicate that ISF is a process that can be used to obtain custom-made implants.

Surgeon Custom-Made Iliac Branch Device to Salvage Hypogastric Artery during Endovascular Aneurysm Repair

Endovascular salvage of the hypogastric artery using iliac branch device (IBD) during endovascular aortic aneurysm repair (EVAR), offers less invasive alternative solution to surgery to prevent pelvic ischemia. We have performed the first Korean surgeon custom-made IBD for this purpose to overcome the limitation of unavailability of the devices in Korea. Four patients with abdominal aortic aneurysm with bilateral common iliac artery aneurysm (CIAA) were treated using custom-made IBDs from October 2013 to December 2013. IBD was created in back table before EVAR operation using TFLE Zenith iliac limb stent graft (Cook Inc.). Three V12 (Atrium, Inc.) one Viabahn (Gore, Inc.) were used for bridging between IBD and target hypogastric artery. With this modification of IBD procedure, exteriorize the guide wire without snare device is possible which offers another benefit in terms of reducing medical costs comparing to commercial IBD. All operations were successful without any device related complications or postoperative endoleaks. During the mean follow up of 3 months, all IBD were patent without clinical complications. Surgeon custom made IBD is feasible and useful to preserve pelvic perfusion especially in the situation of limited commercial IBD availability in many countries. Long-term follow-up is needed to evaluate stent graft patency and IBD-related complications.

A simplified technique for custom made overdenture semi-precision attachments.

Context: Overdentures are the choice of treatment for most of them, but the only snag is its cost. In India, the rural areas are still deprived of quality treatment. This manuscript is showcasing a study, which is a cheaper, but effective way to provide the best to the patient. Aims: The aim of this study was to develop a custom made system, which can be used as an alternative treatment for the management of patients who need overdentures. The primary objective of this study was to provide a cost-effective attachment with the best functional efficacy. Materials and Methods: The semi-precision attachments were made by using the conventional technique of preparation of post space. The patterns were prepared by using the pattern resin material and the rest of the male and female attachments were fabricated by using innovative methods fulfilling the criteria. Results: The attachments were successfully used in patients with remarkably good function and comfort. Conclusion: It was a successful attempt to provide the specialized treatment in affordable cost. There is a need of innovative work to make the sophisticated systems more economical and readily available.

Custom Made Ocular Prosthesis at Optometry Clinic Universiti Kebangsaan Malaysia (UKM) / Jurnal Sains Kesihatan Malaysia

Patients who lost their eyes as results of accidents or diseases (e.g. retinoblastoma) usually underwent enucleation or evisceration. They were then fi tted with ocular prosthesis to prevent collapse of the globe and also for cosmetic effects. Custom made ocular prosthesis is almost unheard of in this country for most hospitals supply ready-made (stock) prosthesis. The cosmetic results of stock prosthesis are often unsatisfactory. Besides being uncomfortable, stock prosthesis may also induce allergic reaction that may lead to papillary conjunctivitis. The Optometry Clinic at UKM started its custom made prosthetic service in 2010. We described here two cases of patients who complained of discomfort with their old stock prosthesis and re-fi tted with custom made prosthesis. We also highlight the importance of proper hygiene and maintenance so that ocular prosthesis can be used for as long as possible. This article aims to create awareness among eye care practitioners and showcase the cosmetic benefi ts of custom made ocular prosthesis

A comparative study on the fit and screw joint stability of ready-made abutment and CAD-CAM custom-made abutment / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. MATERIALS AND METHODS: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (alpha=.05). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. RESULTS: The pre-loading reverse torque values were 26.0 +/- 0.30 Ncm (ready-made abutment; Transfer abutment) and 26.3 +/- 0.32 Ncm (CAD-CAM custom-made abutment; CustomFit abutment) and 24.7 +/- 0.67 Ncm (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. CONCLUSION: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

Comparative evaluation of the regional micro-push-out bond strength of custom-made resin post system with a prefabricated resin post: An in vitro study.

Aim : The purpose of the study is to compare the regional micro-push-out bond strength of custom-made resin post and a prefabricated resin post luted using self-etch adhesive and/or etch and rinse adhesive system at various regions. Materials and Methods : Forty freshly extracted human maxillary central incisors were selected for this study; 1.5-2-mm coronal to the cemento-enamel junction was removed with a diamond disk using a slow speed handpiece under cooling water. Working lengths were established, root canals were sequentially enlarged upto the apex until ISO size 50-K-file and obturated using gutta-percha and AH plus sealer by cold lateral compaction. Post spaces were prepared to a depth of 10 mm using paeso-reamer upto size #3. After preparation, each specimen was embedded in chemically cured acrylic resin. The roots were randomly assigned to four groups: Group I: Custom-made resin post+Self-etch adhesive, Group II: Glass FRC post+Self-etch adhesive, Group III: Custom-made resin post+Etch and Rinse adhesive, Group IV: Glass FRC post+Etch and Rinse adhesive. Fabrication of custom-made resin post was done. All the posts were cemented using a dual cure resin luting cement. Each root was sectioned perpendicular to the long axis using a microtome and subjected to micro-push-out bond strength. Results: The micro-push-out bond strength in the coronal region, in Group I 13.5±1.66 MPa, Group II 12.08±0.8 MPa, Group III 11.15±1.06 MPa, Group IV 11.81±1.11 MPa. In the middle third region: Group I 11.43±0.740 MPa, Group II 10.584±0.504 MPa, Group III 10.0582±0.830 MPa, Group IV 10.35±0772 MPa. In the apical third: Group I 10.38±0.878 MPa, Group II 9.59±1.06 MPa, Group III 9.34±0.73o MPa, Group IV 8.77±1.02 MPa. Conclusion : Within the limitations of the study, amongst all the four groups tested, custom-made resin post luted with self-etch system (CMPR-SE) showed higher micro-push-out bond strength values in all regions when compared to the other groups.

Evaluation of reverse torque value of abutment screws on CAD/CAM custom-made implant abutments / 대한치과보철학회지

PURPOSE: The purpose of this study was to compare the screw joint stability between the CADCAM custom-made implant abutment and the prefabricated implant abutment by measuring the reverse torque value after cyclic loading. MATERIALS AND METHODS: Twelve screw type implants (Implantium, Dentium Co., Seoul, Korea) were embedded in aluminum cylinder with acrylic resin. The implant specimens were equally divided into 3 groups, and connected to the prefabricated titanium abutments (Implantium, Dentium Co., Seoul, Korea), CADCAM custom-made titanium abutments (Myplant, Raphabio Co., Seoul, Korea) and CADCAM custom-made zirconia abutments (Zirconia Myplant, Raphabio Co., Seoul, Korea). The CAD-CAM milled titanium crown (Raphabio Co., Seoul, Korea) was cemented on each implant abutment by resin cement. Before cyclic loading, each abutment screw was tightened to 30 Ncm and the reverse torque value was measured about 30 minutes later. After the crown specimen was subjected to the sinusoidal cyclic loading (30 to 120 N, 500,000 cycles, 2 Hz), postloading reverse torque value was measured and the reverse torque loss ratio was calculated. Kruskal-Wallis test was used for statistical analysis of the reverse torque loss ratio. RESULTS: The CADCAM custom-made titanium abutments presented higher values in reverse torque loss ratio without statistically significant differences than the prefabricated titanium abutments (P>.05). Reverse torque loss ratio of the custom-made zirconia abutments was significantly higher compared to that of the prefabricated titanium abutments (P=.014). CONCLUSION: Within the limitation of the present in-vitro study, it was concluded that there was no significant difference in screw joint stability between the CADCAM custom-made titanium abutments and the prefabricated titanium abutments. On the other hand, the CADCAM custom-made zirconia abutments showed lower screw joint stability than prefabricated titanium abutments.

Prosthodontist contribution in treating post-burn hypertrophic facial scars.

The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

Customized artificial hemi-knee joint composite system based on rapid prototyping / 中国康复理论与实践

@# Objective Due to the problem of individual matching, exclusivity and loose with pure mechanical fixation for artificial hemi-knee joints made by traditional method, a new manufacturing process based on rapid prototyping technique and custom-made concept is presented.MethodsRapid prototyping was processed to rapidly and accurately shape the prototype of an artificial implant almost with the same shape as the hemi-knee joint of the patient, and the process based on Titanium alloy centrifugal casting technology and biomaterial sintering molding technology was used to fabricate the artificial hemi-knee joint and bioactive proximal tibia artificial bone, respectively.Results and ConclusionThe custom-made knee joint prosthesis has been fabricated and put into clinical use successfully. In comparison with the traditional implants, this system can realize the well matching movement between the artificial hemi-knee joint and its opposite. Meanwhile,the design of functional holes and tibial nails realizes the combination of biological fixation with mechanical fixation for the artificial implant,and the use of bioactive artificial bone promotes bone growth and minimizes the exclusive reaction.