Trial fitting of a removable partial denture framework made using computer-aided design and rapid prototyping techniques.

Previous studies of CAD/CAM-produced sacrificial patterns for removable partial denture frameworks have been documented but to date, no such restorations have been test-fitted to a patient. This paper provides details of the first trial fitting to a patient of an RPD framework, the sacrificial pattern of which was produced by CAD/CAM and RP technologies. A cast of the patient was scanned and the normal procedures of dental surveying and pattern build were undertaken with reference to the scanned model using computer-aided design. A sacrificial pattern of the design was produced by rapid prototyping technology. After spruing the pattern, investment-casting and finishing techniques were carried out according to conventional principles. The framework was successfully trial-fitted to the patient and clinically judged to be acceptable for the next stage of denture fabrication, that of adding acrylic bases and artificial teeth.

A pilot study in the application of texture relief for digitally designed facial prostheses.

This pilot research aims to identify and assess suitable technologies that may be used to capture, create, and produce fine textures and wrinkles that may be incorporated into computer aided prosthesis design and production techniques. A range of suitable technologies is identified and two methods that may be used in different prosthetic rehabilitation situations are assessed: the creation of three-dimensional relief in a computer aided design environment and the capture of facial anatomy and texture using fringe-projection surface scanning. Patterns were produced using the suitable rapid prototyping processes identified, and these were assessed by a qualified and experienced prosthetist. The suitability of the technologies is commented upon, limitations discussed, and future directions identified.

The computer-aided design and rapid prototyping fabrication of removable partial denture frameworks.

This study explores the application of computer-aided design and manufacture (CAD/CAM) to the process of electronically surveying a scanned dental cast as a prior stage to producing a sacrificial pattern for a removable partial denture (RPD) metal alloy framework. These are designed to retain artificial replacement teeth in the oral cavity. A cast produced from an impression of a patient's mouth was digitally scanned and the data converted to a three-dimensional computer file that could be read by the computer-aided design (CAD) software. Analysis and preparation were carried out in the digital environment according to established dental principles. The CAD software was then used to design the framework and generate a standard triangulation language (STL) file in preparation for its manufacture using rapid prototyping (RP) methods. Several RP methods were subsequently used to produce sacrificial patterns, which were then cast in a chromium-cobalt alloy using conventional methods and assessed for accuracy of fit. This work demonstrates that CAD/CAM techniques can be used for electronic dental cast analysis, preparation, and design of RPD frameworks. It also demonstrates that RP-produced patterns may be successfully cast using conventional methods and that the resulting frameworks can provide a satisfactory fit.

The investigation of the changing facial appearance of identical twins employing a three-dimensional laser imaging system.

OBJECTIVE: An investigation to determine the changing facial appearance of identical twins. DESIGN: Clinical study. MATERIALS AND METHODS: Two Minolta Vivid 900 3D optical laser scanners were placed as a stereo pair to capture the soft tissues of a pair of identical twins. Each scan took approximately 2.5 s. The scanned whole faces were superimposed to determine changes in facial morphologies at different time intervals. OUTCOME MEASURES: The shell deviations between left and right scans of each patient were recorded and analysed for differences. Furthermore, final merged faces were overlaid to determine the changes in facial morphology over time. RESULTS: The results showed that changes in height and weight correlated with changes in facial morphology. CONCLUSION: The 3D laser scanning device is a clinically useful tool in the study of facial growth and facial morphology in a pair of twins.

The use of a reconstructed three-dimensional solid model from CT to aid the surgical management of a total knee arthroplasty: a case study.

The use of a rapid prototyping method was utilised to produce a pre-operative solid model of the proximal tibia in a patient with a massive defect of the medial tibial plateau. The solid model was reconstructed from aligned sequential CT images of the knee. This was then used to determine the level of bone resection of the proximal tibia for the optimum placement of the tibial component of a total knee replacement. This technique gives the surgeon both the three-dimensional anatomical information needed to ascertain whether there is adequate bony support after cutting for the prosthesis, as well as a solid model on which to carry out the proposed surgery, before undertaking the procedure on the patient.

Modelling soft tissue for kinematic analysis of multi-segment human body models.

Traditionally biomechanical models represent the musculoskeletal system by a series of rigid links connected by rigidly defined rotational joints. More recently though the mechanics of joints and the action of soft tissues has come under closer scrutiny: biomechanical models might now include a full range of physiological structures. However, soft tissue representation, within multi-segment human body models, presents significant problems; not least in computational speed. We present a method for representing soft tissue physiology which provides for soft tissue wrapping around multiple bony objects; while showing forces at the insertion points, as well as normal reactions due to contact between the soft and bony tissues. These soft tissue representations may therefore be used to constrain the joint, as ligaments would, or to generate motion, like a muscle, so that joints may be modelled which more accurately simulate musculoskeletal motion in all degrees of freedom--rotational and translational. This method produces soft tissues that do not need to be tied to a certain path or route between the bony structures, but may move with the motion of the model; demonstrating a more realistic analysis of soft tissue activity in the musculoskeletal system. The combination of solid geometry models of the skeletal structure, and these novel soft tissue representations, may also provide a useful approach to synthesised human motion.

The application of computer aided product development techniques in medical modelling topic: rehabilitation and prostheses.

When considering reconstructive surgery it is often difficult to ascertain the exact nature of affected internal anatomy. Although advances in Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) have enabled the generation of 3D reconstructions of internal anatomy, they are often only available as fixed 2D images. These may obscure important details or prove ambiguous depending upon the angle of view. Another problem is maintaining accuracy of reconstruction that may involve osteotomy, tissue grafts or implants. In such circumstances the ability to plan and rehearse complex procedures can prove invaluable, greatly improving surgical results whilst helping to eliminate potential errors and reducing theatre time. In this context 3D scan data can be treated as the equivalent of Computer Aided Design (CAD) data and can be applied to the production of accurate physical models. The approach undertaken by the DERC is based on close collaboration with surgical departments and enables the rapid and economic production of medical models based on CT/MRI data. This paper illustrates the transfer of product design technologies into a clinical context. Specifically, the use of 3D surface scanning and rapid prototyping technologies as an aid to post operative reconstruction is described. An evaluation of the application of product development tools within a clinical context is presented. The paper concludes with an assessment of likely future application in this area.

An investigation of three-dimensional scanning of human body surfaces and its use in the design and manufacture of prostheses.

The capture of highly accurate data describing the complex surfaces of the human body may prove extremely useful in many medical situations. The data provide a method of measuring and recording changes to the surface of a patient's soft tissue. The data may be applied to computer-controlled manufacturing techniques, such as rapid prototyping (RP). This enables accurate physical replicas of the patient topography to be produced. Such models may be used as an aid in the design and manufacture of prostheses. This paper describes an investigation aimed at identifying problems that may be encountered when scanning patients and describes the application of the resulting data in the design and manufacture of facial prostheses. The results of the experiment are presented together with a discussion of the accuracy and potential advantages afforded by this approach.