• Journal of Korean Neurosurgical Society
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• v.62 no.4
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• pp.398-404
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• 2019

Objective : Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. Methods : Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-of-flight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. Results : The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). Conclusion : The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.429-438
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• 2021

Purpose: This study investigated the accuracy of laser-scanned models and 3-dimensional(3D) rendered cone-beam computed tomography (CBCT) compared to the gold standard (plaster casts) for linear measurements on dental arches. Materials and Methods: CBCT scans and plaster models from 30 patients were retrieved. Plaster models were scanned by an Emerald laser scanner (Planmeca, Helsinki, Finland). Sixteen different measurements, encompassing the mesiodistal width of teeth and both arches' length and width, were calculated using various landmarks. Linear measurements were made on laser-scanned models using Autodesk Meshmixer software v. 3.0 (Autodesk, Mill Valley, CA, USA), on 3D-rendered CBCT models using OnDemand 3D v. 1.0 (Cybermed, Seoul, Korea) and on plaster casts by a digital caliper. Descriptive statistics, the paired t-test, and intra- and inter-class correlation coefficients were used to analyze the data. Results: There were statistically significant differences between some measurements on plaster casts and laser-scanned or 3D-rendered CBCT models (P<0.05). Molar mesiodistal width and mandibular anterior arch width deviated significantly different from the gold standard in both methods. The largest mean differences of laser-scanned and 3D-rendered CBCT models compared to the gold standard were 0.12±0.23 mm and 0.42±0.53 mm, respectively. Most of the mean differences were not clinically significant. The intra- and inter-class correlation results were acceptable for all measurements(>0.830) and between observers(>0.801). Conclusion: The 3D-rendered CBCT images and laser-scanned models were useful and accurate alternatives to conventional plaster models. They could be used for clinical purposes in orthodontics and prostheses.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.295-303
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• 1999

Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

• The Journal of Advanced Prosthodontics
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• v.15 no.3
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• pp.145-154
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• 2023

PURPOSE. The objective of this study was to investigate how internal structures influence the overall and marginal accuracy of full arch preparations fabricated through additive manufacturing in different printing systems. MATERIALS AND METHODS. A full-arch preparation digital model was set up with three internal designs, including solid, hollow, and grid. These were printed using three different resin printers with nine models in each group. After scanning, each data was imported into the 3D data processing software together with the master cast, aligned and trimmed, and then put into the 3D data analysis software again to compare the overall and marginal deviation whose results are expressed using root mean square values and color maps. To evaluate the trueness of the resin model, the test data and reference data were compared, and the precision was evaluated by comparing the test data sets. Color maps were observed for qualitative analysis. Data were statistically analyzed by one-way analysis of variance and Bonferroni method was used for post hoc comparison (α = .05). RESULTS. The influence of different internal structures on the accuracy of 3D printed resin models varied significantly (P < .05). Solid and grid models showed better accuracy, while the hollow model exhibited poor accuracy. The color maps show that the resin models have a tendency to shrink inwards. CONCLUSION. The internal structure design influences the accuracy of the 3D printing model, and the effect varies in different printing systems. Irrespective of the kind of printing system, the printing accuracy of hollow model was observed to be worse than those of solid and grid models.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.489-498
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• 2022

Spatial insight into intracranial pathology and structure is important for neurosurgeons to perform safe and successful surgeries. Three-dimensional (3D) printing technology in the medical field has made it possible to produce intuitive models that can help with spatial perception. Recent advances in 3D-printed disease models have removed barriers to entering the clinical field and medical market, such as precision and texture reality, speed of production, and cost. The 3D-printed disease model is now ready to be actively applied to daily clinical practice in neurosurgical planning, simulation, and training. In this review, the development of 3D-printed neurosurgical disease models and their application are summarized and discussed.

• Imaging Science in Dentistry
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• v.51 no.1
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• pp.41-47
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• 2021

Purpose: This study aimed to compare the accuracy of 3-dimensional(3D) printed models derived from multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) systems with different fields of view (FOVs). Materials and Methods: Five human dry mandibles were used to assess the accuracy of reconstructions of anatomical landmarks, bone defects, and intra-socket dimensions by 3D printers. The measurements were made on dry mandibles using a digital caliper (gold standard). The mandibles then underwent MDCT imaging. In addition, CBCT images were obtained using Cranex 3D and NewTom 3G scanners with 2 different FOVs. The images were transferred to two 3D printers, and the digital light processing (DLP) and fused deposition modeling (FDM) techniques were used to fabricate the 3D models, respectively. The same measurements were also made on the fabricated prototypes. The values measured on the 3D models were compared with the actual values, and the differences were analyzed using the paired t-test. Results: The landmarks measured on prototypes fabricated using the FDM and DLP techniques based on all 4 imaging systems showed differences from the gold standard. No significant differences were noted between the FDM and DLP techniques. Conclusion: The 3D printers were reliable systems for maxillofacial reconstruction. In this study, scanners with smaller voxels had the highest precision, and the DLP printer showed higher accuracy in reconstructing the maxillofacial landmarks. It seemed that 3D reconstructions of the anterior region were overestimated, while the reconstructions of intra-socket dimensions and implant holes were slightly underestimated.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.44 no.5
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• pp.55-61
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• 2007

In this paper, we propose a three-dimensional(3D) active shape models for medical image segmentation. In order to build a 3D shape model, we need to generate a point distribution model(PDM) and select corresponding landmarks in all the training shapes. The manual determination method, two-dimensional(2D) method, and limited 3D method of landmark correspondences are time-consuming, tedious, and error-prone. In this paper, we generate a 3D statistical shape model using the 3D model generation method of a distance transform and a tetrahedron method for landmarking. After generating the 3D model, we extend the shape model training and gray-level model training of 2D active shape models(ASMs) and we use the integrated modeling process with scale and gray-level models for the appearance profile to represent the local structure. Experimental results are comparable to those of region-based, contour-based methods, and 2D ASMs.

• Imaging Science in Dentistry
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• v.34 no.1
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• pp.13-18
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• 2004

Purpose : This study was to evaluate the influence of slice thickness of computed tomography (CT) and rapid protyping (RP) type on the accuracy of 3-dimensional medical model. Materials and Methods: Transaxial CT data of human dry skull were taken from multi-detector spiral CT. Slice thickness were 1, 2, 3 and 4 mm respectively. Three-dimensional image model reconstruction using 3-D visualization medical software (V-works /sup TM/ 3.0) and RP model fabrications were followed. 2-RP models were 3D printing (Z402, Z Corp., Burlington, USA) and Stereolithographic Apparatus model. Linear measurements of anatomical landmarks on dry skull, 3-D image model, and 2-RP models were done and compared according to slice thickness and RP model type. Results: There were relative error percentage in absolute value of 0.97, 1.98,3.83 between linear measurements of dry skull and image models of 1, 2, 3 mm slice thickness respectively. There was relative error percentage in absolute value of 0.79 between linear measurements of dry skull and SLA model. There was relative error difference in absolute value of 2.52 between linear measurements of dry skull and 3D printing model. Conclusion: These results indicated that 3-dimensional image model of thin slice thickness and stereolithographic RP model showed relative high accuracy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.24.1-24.7
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• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.267-277
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• 2015

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.