Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-11T09:12:14.636Z Has data issue: false hasContentIssue false
  • English
  • Français

Design of a Custom-Made Cranial Implant in Patients Suffering from Apert Syndrome

Part of: Design for Additive Manufacturing

Published online by Cambridge University Press:  26 July 2019

Marco Mandolini ,
Agnese Brunzini ,
Eleonora Brandoni Serrani ,
Mario Pagnoni ,
Alida Mazzoli  and
Michele Germani
Marco Mandolini*
Affiliation:
Università Politecnica delle Marche;
Agnese Brunzini
Affiliation:
Università Politecnica delle Marche;
Eleonora Brandoni Serrani
Affiliation:
Università Politecnica delle Marche;
Mario Pagnoni
Affiliation:
Università degli Studi di ROMA La Sapienza
Alida Mazzoli
Affiliation:
Università Politecnica delle Marche;
Michele Germani
Affiliation:
Università Politecnica delle Marche;
*
Contact: Mandolini, Marco, Università Politecnica delle Marche, Department of Industrial Engineering and Mathematical Sciences, Italy, m.mandolini@univpm.it

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

This study defines a methodological procedure for the design and manufacturing of a prosthetic implant for the reconstruction of a midsagittal bony-deficiency of the skull due to the Apert congenital disorder. Conventional techniques for craniofacial defects reconstruction rely on the mirrored-image technique. When the cranial lesion extends over the midline or in case of bilateral defects, other approaches based on thin plate spline interpolation or constrained anatomical deformation are applied.

The proposed method uses the anthropometric theory of cranial landmarks identification for the retrieval of a template healthy skull, useful as a guide in the successive implant design. Then, anatomical deformation of the region of interest and free-form modelling allow to get the customized shape of the implant. A full bulk and a porous implant have been provided according to the surgeon advises.

The models have been 3D printed for a pre-surgical analysis and further treatment plan. They fulfilled the expectancies of the surgeon thus positive results are predictable.

This methodology results to be reproducible to any other craniofacial defect spanning over the entire skull.

Keywords

Additive ManufacturingBiomedical designDesign processImplant designApert Syndrome
Type
Article
Information
Proceedings of the Design Society: International Conference on Engineering Design , Volume 1 , Issue 1 , July 2019 , pp. 709 - 718
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s) 2019

References

Benazzi, S. and Senck, S. (2011), “Comparing 3-Dimensional Virtual Methods for Reconstruction in Craniomaxillofacial Surgery”, Journal of Oral Maxillofacial Surgery, Vol. 69, pp. 1184–1194. http://doi.org/10.1016/j.joms.2010.02.028Google Scholar
Bhargava, D., Bartlett, P., Russell, J., Liddington, M., Tyagi, A. and Chumas, P. (2010), “Construction of titanium cranioplasty plate using craniectomy bone flap as template”, Acta Neurochirurgica, Vol. 152, pp. 173–176. http://doi.org/10.1007/s00701-009-0394-2Google Scholar
Bogu, V.P., Kumar, Y.R., Kumar, and Khanara, A. (2017), “Modelling and structural analysis of skull/cranial implant: beyond mid-line deformities”, Acta of Bioengineering and Biomechanics Original paper, Vol. 19 No. 1, pp. 125–131. http://doi.org/10.5277/ABB-00547-2016-04Google Scholar
Breik, O., Mahindu, A., Moore, M.H., Molloy, C.J., Santoreneos, S. and David, D.J. (2016), “Apert syndrome: Surgical outcomes and perspectives”, Journal of Cranio-Maxillo-Facial Surgery, Vol. 44, pp. 1238–1245. http://doi.org/10.1016/j.jcms.2016.06.001Google Scholar
Brunzini, A., Mandolini, M., Manieri, S., Germani, M., Mazzoli, A., Pagnoni, M., Iannetti, G. and Modugno, A. (2017), “Orbital wall reconstruction by selective laser sintered mould”, Proceedings of the IASTED International Conference in Biomedical Engineering (BioMed 2017), February 20–21, 2017, Innsbruck, Austria, pp. 260–264. http://doi.org/10.2316/P.2017.852-045Google Scholar
Carr, J.C., Fright, W.R. and Beatson, R.K. (1997), “Surface interpolation with radial basis functions for medical imaging”, IEEE Transactions on Medical Imaging, Vol. 16, pp. 96–107. http://doi.org/10.1109/42.552059Google Scholar
Dean, D. and Min, K.J. (2003), “Deformable templates for preoperative computer-aided design and fabrication of large cranial implants”, International Congress Series, pp. 710–715. https://doi.org/10.1016/S0531-5131(03)00514-4Google Scholar
Driessen, C., van Veelen, M. L. C., Joosten, K. F. M., Versnel, S. L., van Nieuwenhoven, C. A. E., Wolvius, B., Bredero-Boelhouwer, H. H., Arnaud, E. and Mathijssen, I. M. J. (2017), “Apert syndrome: the Paris and Rotterdam philosophy”, Expert Opinion on Orphan Drugs, Vol. 5 No. 7, pp. 599–605. http://doi.org/10.1080/21678707.2017.1335195Google Scholar
Drstvensek, I., Hren, N.I., Strojnik, T., Brajlih, T., Valentan, B., Pogacar, V. and Hartner, T.Z. (2008), “Applications of Rapid Prototyping in Cranio-Maxilofacial Surgery Procedures”, International Journal of Biology and Biomedical Engineering, Vol. 2 No. 1, pp. 29–38.Google Scholar
Dumbrigue, H.B., Arcuri, M.R., LaVelle, W.E. and Ceynar, K.J. (1998), “Fabrication procedure for cranial prostheses”, Journal of Prosthetic Dentistry, Vol. 79 No. 2, pp. 229–231. https://doi.org/10.1016/S0022-3913(98)70222-7Google Scholar
Farkas, (1994), “Anthropometry of the head and face”, Raven, second edition.Google Scholar
Gunz, P. and Mitteroecker, P. (2013), “Semilandmarks: a method for quantifying curves and surfaces”, Hystrix, the Italian Journal of Mammalogy, Vol. 24 No. 1, pp. 103–109. https://doi.org/10.4404/hystrix-24.1-6292Google Scholar
Kai, C.C. Meng, C.S., Ching, L.S., Teik, L.S. and Aung, S.C. (2000), “Facial prosthetic model fabrication using rapid prototyping tools”, Integrated Manufacturing Systems, Vol. 11 No. 1, pp. 42–53. https://doi.org/10.1108/09576060010303668Google Scholar
Karageorgiou, V. and Kaplan, D. (2005), “Porosity of 3D biomaterial scaffolds and osteogenesis”, Biomaterials, Vol. 26, pp. 5474–5491. http://doi.org/10.1016/j.biomaterials.2005.02.002Google Scholar
Milovanović, J. and Trajanović, M. (2007), “Medical applications of rapid prototyping”, Mechanical Engineering Vol. 5 No. 1, pp. 79–85Google Scholar
Mandolini, M., Brunzini, A., Germani, M., Manieri, S., Mazzoli, A. and Pagnoni, M. (2019), “Selective laser sintered mould for orbital cavity reconstruction”, Rapid Prototyping Journal, Vol. 25 No. 1, pp. 95–103. http://doi.org/10.1108/RPJ-05-2017-0098Google Scholar
Moiduddin, K., Al-Ahmari, A., Abouel Nasr, E.S., Al Kindi, M., Ramalingam, S. and Kamrani, A. (2016), “Comparing 3-Dimensional Virtual Reconstruction methods in Customized Implants”, International Journal of Advanced Biotechnology and Research, Vol. 7 No. 1, pp. 323–331.Google Scholar
Muschler, G. F., Nakamoto, C. and Griffith, L. G. (2004), “Engineering Principles of Clinical Cell-Based Tissue Engineering”, The Journal of Bone and Joint Surger, Vol. 86, pp. 1541–1558.Google Scholar
Park, D.K., Song, I., Lee, J.H. and You, Y.J. (2013), “Forehead Augmentation with a Methyl Methacrylate Onlay Implant Using an Injection-Molding Technique”, Archives of Plastic Surgery, Vol. 40 No. 5, pp. 597–602. https://doi.org/10.5999/aps.2013.40.5.597Google Scholar
Shah, A.M., Jung, H. and Skirboll, S. (2014), “Materials used in cranioplasty: a history and analysis”, Neurosurg Focus, Vol. 36 No. 4, pp. 1–7. http://doi.org/10.3171/2014.2.FOCUS13561.Google Scholar
Wung, T., Engelhardt, M., Fieten, L., Popovic, A. and Radermacher, K. (2006), “Anatomically Constrained Deformation for Design of Cranial Implant: Methodology and Validation”, Medical Image Computing and Computer-Assisted Intervention, Vol. 9 No. 1, pp. 9–16. https://doi.org/10.1007/11866565_2Google Scholar