Weihe S, Wehmöller M, Schliephake H, Hassfeld S, Tschakaloff A, Raczkowsky J, Eufinger H
Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery, Ruhr-University Bochum, Germany.
Int J Oral Maxillofac Surg. 2000 Oct;29(5):384-8.
The preoperative manufacturing of individual skull implants, developed by an interdisciplinary research group at Ruhr-University Bochum, is based on the use of titanium as the most common material for implants at present. Using the existing technology for materials that can be milled or moulded, customized implants may be manufactured as well. The goal of the study was to examine biodegradable materials and to evaluate the practicability of intraoperative instrument navigation and robotics. Data acquisition of an adult sheep's head was performed with helical computer tomography (CT). The data were transferred onto a computer aided design/computer aided manufacturing system (CAD/CAM system), and two complex defects in the frontotemporal skull were designed. Standard individual titanium implants were milled for both of the defects. Additionally, for one of the defects a resection template, as well as a mould for the biodegradable poly(D,L-lactide) (PDLLA) implant, were fabricated by the CAD/CAM system. A surgeon carried out the first bone resection (#1) for the prefabricated titanium implant using the resection template and an oscillating saw. The robot system Stäubli RX90CR, modified for clinical use, carried out the other resection (#2). Both titanium implants and the PDLLA implant were inserted in their respective defects to compare the precision of their fit. A critical comparison of both implant materials and both resection types shows that fabrication of a PDLLA implant and robot resection are already possible. At present, the titanium implant and resection using a template are more convincing due to the higher precision and practicability.
由波鸿鲁尔大学的一个跨学科研究小组开发的个性化颅骨植入物的术前制造，目前基于使用钛作为植入物最常用的材料。利用现有的可铣削或模塑材料的技术，也可以制造定制的植入物。该研究的目的是研究可生物降解材料，并评估术中器械导航和机器人技术的实用性。使用螺旋计算机断层扫描（CT）对一只成年绵羊的头部进行数据采集。数据被传输到计算机辅助设计/计算机辅助制造系统（CAD/CAM系统）上，并设计了额颞颅骨的两个复杂缺损。针对这两个缺损分别铣削了标准的个性化钛植入物。此外，对于其中一个缺损，通过CAD/CAM系统制作了一个切除模板以及一个用于可生物降解聚（D，L-丙交酯）（PDLLA）植入物的模具。一名外科医生使用切除模板和摆动锯对预制钛植入物进行了第一次骨切除（#1）。经过临床改装的史陶比尔RX90CR机器人系统进行了另一次切除（#2）。将钛植入物和PDLLA植入物分别插入各自的缺损中，以比较它们的贴合精度。对两种植入材料和两种切除方式的关键比较表明，制造PDLLA植入物和机器人切除已经是可行的。目前，由于更高的精度和实用性，使用模板的钛植入物和切除方式更具说服力。
