Godinho Miguel R, Mestrinho Lisa A
Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal.
Front Vet Sci. 2024 Feb 6;11:1347107. doi: 10.3389/fvets.2024.1347107. eCollection 2024.
Three-dimensional (3D) printed models can improve the understanding of the structural anatomic changes in cases of temporomandibular joint ankylosis and pseudoankylosis leading to closed jaw locking. Their use in pre-surgical planning and intraoperative guidance has been reported, contributing to the predictability and success of these surgery procedures, which can be quite complex, especially in small animal patients. The use and production of 3D tools and models remain challenging and are so far limited to institutions with high (economical and human) resources. This study aims to propose simplified workflows using open-source software to facilitate an in-house 3D printing process. To illustrate this, three cases of temporomandibular joint ankylosis and one of pseudoankylosis were reviewed, where in-house 3D printed models were used for client communication and surgical management. The 3D models were segmented from computed tomography and printed via stereolithography. They were used to support discussion with clients ( = 4), to allow surgeons to pre-surgical plan and practice ( = 4) and for intraoperative guidance during surgery ( = 2). Surgical cutting guides were produced in one case to improve precision and define more accurately osteotomy lines. It is essential to consider the initial time and financial investment required for establishing an in-house 3D printing production, particularly when there is a need to produce biocompatible tools, such as surgical cutting guides. However, efficient and streamlined workflows encourage the integration of this technology, by accelerating the printing process and reducing the steep learning curves, while open-source software enhances accessibility to these resources.
三维(3D)打印模型可以增进对颞下颌关节强直和假性强直导致牙关紧闭病例中结构解剖变化的理解。已有报道称其用于术前规划和术中引导,有助于提高这些手术的可预测性和成功率,这些手术可能相当复杂,尤其是在小动物患者中。3D工具和模型的使用与制作仍然具有挑战性,目前仅限于拥有丰富(经济和人力)资源的机构。本研究旨在提出使用开源软件的简化工作流程,以促进内部3D打印过程。为说明这一点,回顾了三例颞下颌关节强直和一例假性强直病例,其中内部3D打印模型用于与客户沟通和手术管理。3D模型从计算机断层扫描中分割出来,并通过立体光刻法打印。它们被用于支持与客户的讨论(n = 4),让外科医生进行术前规划和练习(n = 4),以及在手术期间进行术中引导(n = 2)。在一个病例中制作了手术切割导板,以提高精度并更准确地确定截骨线。必须考虑建立内部3D打印生产所需的初始时间和资金投入,特别是在需要生产生物相容性工具(如手术切割导板)时。然而,高效且简化的工作流程通过加快打印过程和减少陡峭的学习曲线来鼓励这项技术的整合,而开源软件则提高了获取这些资源的便利性。