Journal article
Can a Point-of-Care 3D Printing Workflow Produce Accurate and Successful Results for Craniomaxillofacial Trauma?
Journal of oral and maxillofacial surgery, Vol.82(2), pp.207-217
02/01/2024
DOI: 10.1016/j.joms.2023.11.006
PMID: 38012957
Abstract
Background: Computer-aided design and manufacturing (CAD/CAM) is having a profound impact on craniomaxillofacial surgery, and point-of-care (POC) solutions for repairing facial trauma are starting to emerge. Purpose: The purpose of this study was to demonstrate the success and accuracy of a POC 3D printing workflow for craniomaxillofacial trauma. Study Design, Setting, Sample: A retrospective cohort study was undertaken to analyze subjects presenting to a level 1 trauma center after sustaining facial trauma and were then treated using the POC 3D printing workflow. Subjects were excluded if they were not treated with the POC 3D printing workflow, were lost to follow-up, or if clinical data were incomplete. Predictor Variable: Predictor variables included the cause of trauma (mechanism), location of the mandibular fracture, type of fracture, mandibular severity score, and repair error (ie, root mean square error (RMSE) value for planned vs actual outcome). Main Outcome Variable(s): The primary outcome variables were case success and case error. Success was defined as clinical and radiographic evidence of bony stability at 3 months. Case accuracy was calculated overlaying preoperative plan data to postoperative data generating a numerical value (RMSE value, mm). Covariates: Covariates included age (years), gender (male/female), surgery time (mins), and CAD/CAM time (preoperative). Analyses: Descriptive statistics were calculated for each variable. Dependence between rates or counts was established using the Wilcoxon rank sum or Fisher's exact test. Linear regression model was computed to discern how predictor variables influence RMSE. AP value < .05 was considered statistically significant Results: The sample included 27 subjects (19 male/8 female). The average age of all subjects was 46.4 +/- 18.0 years. Common mechanisms of injury were assault (33%) and self-inflicted gunshots (SIGSW; 30%), and the average severity score for mandible injury was (13.5 +/- 3.3). Ninety-three percent of cases were deemed successful. The average repair accuracy (RMSE value) was 3.4 +/- 1.8 mm. A linear regression model indicated those injured by a fall (beta-coefficient 1.99; P = .010), motor vehicle collision (beta-coefficient 1.49; P = .043), or SIGSW (b-coefficient 2.82; P < .001) correlated with RMSE. Conclusion and Relevance: In-house CAD/CAM technologies can be utilized at the POC to repair com-plex facial trauma accurately and successfully.
Details
- Title: Subtitle
- Can a Point-of-Care 3D Printing Workflow Produce Accurate and Successful Results for Craniomaxillofacial Trauma?
- Creators
- Jeffrey S. Marschall - University of IowaMark A. Oppenheim - Temple CollegeGeorge M. Kushner - University of Louisville
- Resource Type
- Journal article
- Publication Details
- Journal of oral and maxillofacial surgery, Vol.82(2), pp.207-217
- DOI
- 10.1016/j.joms.2023.11.006
- PMID
- 38012957
- NLM abbreviation
- J Oral Maxillofac Surg
- ISSN
- 0278-2391
- eISSN
- 1531-5053
- Publisher
- Elsevier
- Number of pages
- 11
- Language
- English
- Date published
- 02/01/2024
- Academic Unit
- Craniofacial Anomalies Research Center; Oral and Maxillofacial Surgery
- Record Identifier
- 9984654469002771
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