Korn Philippe, Jehn Philipp, Nejati-Rad Narin, Winterboer Jan, Gellrich Nils-Claudius, Spalthoff Simon
Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
J Oral Maxillofac Surg. 2022 Apr;80(4):676-681. doi: 10.1016/j.joms.2021.12.003. Epub 2021 Dec 15.
The use of patient-specific implants for reconstruction of complex orbital floor defects is increasing and requires communication with an industry partner, which warrants investigation. Therefore, the aim of this study was to evaluate the effects of in-house training of engineers on such communication as well as to identify frequent sources of problems and their solutions for improvement of the implant-planning workflow.
We conducted a retrospective cross-sectional study and enrolled a sample of patients who had undergone orbital reconstruction with patient-specific implants between 2017 and 2020. The predictor variables were in-house training (additional training completed in hospital or not) and implant complexity (complex [multiwalled implants] vs less complex [isolated orbital floor reconstructions]). The outcome variables were duration of communication, message length, and need for synchronous communication or modifications to the original design. Descriptive, univariate, and multivariate statistics were computed, and statistical significance was set at a P value of < 0.05.
This study included the data of 66 patients (48 men and 18 women, average age: 42.27 years). The complexity of the implant statistically significantly increased the duration of the communication (8.76 vs 16.03 days; P = .004). In 72.73%, the initial design had to be changed. Engineers trained in house required less communication to plan less-complex implants and generally needed fewer corrections to the original design (P = .020 and P = .036, respectively). Problems during planning were observed in 25.76% of the cases, with an insufficient diagnostic 3-dimensional data set being the most common (15.15%).
In-house training of engineers is time-saving while planning the workflow for patient-specific implants, especially in less-complex cases, given that design changes are not needed often. The high rate of data sets that were insufficient for planning patient-specific implants suggests that diagnostic 3-dimensional data sets should already meet the requirements for such planning.
使用定制化植入物修复复杂眶底缺损的情况日益增多，这需要与行业合作伙伴进行沟通，值得深入研究。因此，本研究旨在评估对工程师进行内部培训对这种沟通的影响，并找出常见问题来源及其解决方案，以改进植入物规划工作流程。
我们进行了一项回顾性横断面研究，纳入了2017年至2020年间接受定制化植入物眶部重建的患者样本。预测变量为内部培训（是否在医院完成额外培训）和植入物复杂性（复杂[多壁植入物]与不太复杂[单纯眶底重建]）。结果变量为沟通时长、信息长度以及同步沟通需求或对原始设计的修改需求。计算了描述性、单变量和多变量统计数据，设定统计学显著性为P值<0.05。
本研究纳入了66例患者的数据（48例男性和18例女性，平均年龄：42.27岁）。植入物的复杂性在统计学上显著增加了沟通时长（8.76天对16.03天；P = 0.004）。在72.73%的情况下，初始设计必须更改。接受内部培训的工程师在规划不太复杂的植入物时所需沟通较少，并且通常对原始设计的修正需求也较少（分别为P = 0.020和P = 0.036）。在25.76%的病例中观察到规划过程中存在问题，其中诊断性三维数据集不足最为常见（15.15%）。
对工程师进行内部培训在为定制化植入物规划工作流程时可节省时间，尤其是在不太复杂的病例中，因为通常不需要进行设计更改。用于规划定制化植入物的数据集不足率较高，这表明诊断性三维数据集应已满足此类规划的要求。
