Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands.
Center for Special Care in Dentistry, Department of Maxillofacial Prosthodontics, Stichting Bijzondere Tandheelkunde, 1081 LA Amsterdam, The Netherlands.
Int J Environ Res Public Health. 2021 Oct 28;18(21):11349. doi: 10.3390/ijerph182111349.
This systematic review was aimed at gathering technical and clinical applications of CAD/CAM technology for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic search was executed. Human studies that utilized digital planning systems for the prosthetic rehabilitation of orbital defects were included. A total of 16 studies of 30 clinical cases, which were virtually planned through various digital planning and designing software, were included. The most common preoperative data required for digital planning were CT scans in 15 cases, the 3DSS-STD-II scanning system in 5 cases, an Artec Color 3D scanner in 3 cases and a NextEngine Desktop 3D laser scanner in 2 cases. Meanwhile, the digital designing software were Ease Orbital Implant Planning EOIPlan software in eight cases, Geomagic software in eight cases, Simplant software in four cases and Artec Studio 12 Professional in three cases. Surgical templates were fabricated for 12 cases to place 41 craniofacial implants in the orbital defect area. An image-guided surgical navigation system was utilized for the placement of five orbital implants in two cases. Digital designing and printing systems were reported for the preoperative planning of craniofacial implants placement, designing of molds and substructures and fabrication of orbital prostheses. The studies concluded that the digital planning, designing and fabrication of orbital prostheses reduce the clinical and laboratory times, reduces patient visits and provide a satisfactory outcome; however, technical skills and equipment costs are posing limitations on the use of these digital systems.
本系统评价旨在收集 CAD/CAM 技术在颅面植入物术前规划、模具和子结构设计以及眼眶假体制作方面的技术和临床应用。按照系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）指南进行了电子检索。纳入了利用数字规划系统进行眼眶缺损修复的人体研究。共纳入了 16 项研究中的 30 个临床病例，这些病例通过各种数字规划和设计软件进行了虚拟规划。数字规划最常需要的术前数据是 15 例 CT 扫描，5 例 3DSS-STD-II 扫描系统，3 例 Artec Color 3D 扫描仪和 2 例 NextEngine Desktop 3D 激光扫描仪。同时，数字设计软件包括 8 例 Ease Orbital Implant Planning EOIPlan 软件、8 例 Geomagic 软件、4 例 Simplant 软件和 3 例 Artec Studio 12 Professional 软件。为 12 例患者制作了手术模板，以在眼眶缺损区域植入 41 个颅面植入物。在 2 例病例中使用了图像引导手术导航系统来放置 5 个眼眶植入物。报告了数字设计和打印系统在颅面植入物术前规划、模具和子结构设计以及眼眶假体制作中的应用。研究结论认为，眼眶假体的数字化规划、设计和制作减少了临床和实验室的时间，减少了患者就诊次数，提供了满意的结果；然而，技术技能和设备成本对这些数字系统的使用构成了限制。
