• International Journal of CAD/CAM
• /
• v.9 no.1
• /
• pp.121-128
• /
• 2010

The purpose of this study is to clarify the mechanical behavior of human lumbar vertebrae (L3/L4) with and without fusion bone under physiological axial compression. The author has developed the program code to build the patient specific three-dimensional geometric model from the computed tomography (CT) images. The developed three-dimensional model provides the necessary information to the physicians and surgeons to visually interact with the model and if needed, plan the way of surgery in advance. The processed data of the model is versatile and compatible with the commercial computer aided design (CAD), finite element analysis (FEA) software and rapid prototyping technology. The actual physical model is manufactured using rapid prototyping technique to confirm the executable competence of the processed data from the developed program code. The patient specific model of L3/L4 vertebrae is analyzed under compressive loading condition by the FEA approach. By varying the spacer position and fusion bone with and without pedicle instrumentation, simulations were carried out to find the increasing axial stiffness so as to ensure the success of fusion technique. The finding was helpful in positioning the fusion bone graft and to predict the mechanical stress and deformation of body organ indicating the critical section.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.41.1-41.6
• /
• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• Archives of Craniofacial Surgery
• /
• v.19 no.2
• /
• pp.152-156
• /
• 2018

Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.3
• /
• pp.207-213
• /
• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.28 no.4
• /
• pp.423-439
• /
• 2012

This case report described a technique utilizing a computer-aided design (CAD)/computer-aided machining (CAM) - guided surgical implant placement and prefabricated temporary fixed prosthesis for an immediately loaded restoration. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla received 8 implants in maxilla using CAD/CAM surgical templates. Prefabricated provisional maxillary implant supported fixed prosthesis were connected immediately after implant installation. Provisional prosthesis was evaluated for aesthetics, function during 6 months. Definitive implant supported fixed porcelain fused metal bridges were fabricated.

• The Journal of the Society of Korean Medicine Diagnostics
• /
• v.13 no.2
• /
• pp.140-148
• /
• 2009

The primary market of acupuncture treatment is concentrated on disorders of the musculoskeletal system. This study researches the clinical use of the musculoskeletal system evaluation with a computer simulation. Two fields are examined - patient evaluation and patient treatment. In the field of evaluation, the simulation is used to evaluates the prognosis of medical treatment. In the field of treatment, the simulation is used to decide the most suitable way to perform surgery using the quantitative evaluation about various cases of surgical results.

• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.456-466
• /
• 2019

As digital dentistry technology is being developed, it is being used in various ways. This case covers how digital dentistry technology is being applied on the treatment of patients with loss of vertical dimension due to worn dentition and multiple loss of teeth. The loss of vertical dimension was carefully assessed and recovered, and implants were placed with surgical guides, designed considering the final restoration. The movement of the mandibular was measured with the electronic instrument for recording mandibular movement. Wax-up process was done with Naturgemäße Aufwachs-Technik (N.A.T.) and Natural functional reconstruction (N.F.R.). It was scanned, and the provisional restoration was fabricated using Computer-Aided-Design/Computer-Aided-Manufacturing (CAD/CAM) technology, and the adjustment process was done at the clinic to meet with the satisfaction both functionally and esthetically, and then, using double scanning and CAD/CAM technology, it was carried out as a final restoration. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

• Proceedings of the KOSOMBE Conference
• /
• v.1998 no.11
• /
• pp.315-316
• /
• 1998

The purpose of this study is a potentiality examination of an infrared camera system for the 3D navigator which can be used in the field of neurosurgery. Nowadays, CAS(computer aided surgery) technique using 3D navigator is rapidly spread into the neurosurgeric operation such as brain and spine surgery. Several techniques which can detect 3D position of a probe have been proposed. These include mechnical arm, magnetic field, optical and ultrasonic sensing methods. In this study, we decided that using optical sensing method and tested a conventional CCD camera with a infrared filter and LEDs. Pulnix TM-300 camra has sufficient spectral response in the range of near infrared. Acquired image of infrared LEDs also sufficient quality.

• Journal of Institute of Control, Robotics and Systems
• /
• v.12 no.9
• /
• pp.918-925
• /
• 2006

Medical robotics and computer aided surgery in general, and robotic telesurgery in particular, are promising applications of robotics. In this paper, we shows a novel single-master (PHANTOM based single-master multi-slave telerobotic system) multi-slave system using two parallel mechanism micromanipulators as a slave device. After a general introduction to the systems structure and configuration of telerobotic system, a manipulation control strategy to build the system that human and both manipulators perform the cooperative manipulation, is introduced, followed by its kinematic analysis, mapping method, and experimental results.

• Journal of Institute of Control, Robotics and Systems
• /
• v.17 no.8
• /
• pp.807-813
• /
• 2011

High precision of planning in the preoperative phase can contribute to increase operational safety during computer-aided spinal fusion surgery, which requires extreme caution on the part of the surgeon, due to the complexity and delicacy of the procedure. In this paper, an advanced preoperative planning framework for spinal fusion is presented. The framework is based on spinal pedicle data obtained from CT (Computed Tomography) images, and provides optimal insertion trajectories and pedicle screw sizes. The proposed approach begins with safety margin estimation for each potential insertion trajectory that passes through the pedicle volume, followed by procedures to collect a set of insertion trajectories that satisfy operation safety objectives. The radius of a pedicle screw was chosen as 70% of the pedicle radius. This framework has been tested on 68 spinal pedicles of 8 patients requiring spinal fusion. It was successfully applied, resulting in an average success rate of 100% and a final safety margin of $2.44{\pm}0.51mm$.