• Journal of Korean Neurosurgical Society
• /
• v.52 no.6
• /
• pp.541-546
• /
• 2012

Objective : The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting. Methods : A total of 16 patients with large skull defects (>100 $cm^2$) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect. Results : The median operation time was $184.36{\pm}26.07$ minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously. Conclusion : Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.5
• /
• pp.382-387
• /
• 2021

Objectives: Zygomatic complex (ZMC) fractures comprise up to 40% of all facial fractures. Misaligned bone fragments and misplaced fixation hardware traditionally detected postoperatively on plain radiographs of the skull might require re-operation. The intraoperative O-Arm (Medtronic, USA) is a three-dimensional (3D) computed tomographic imaging system. Materials and Methods: This retrospective single-center study evaluated the utility of O-Arm scanning during corrective surgeries for ZMC and zygomatic arch (ZA) fractures from 2018 to 2020. Three females and 16 males (mean age, 31.52 years; range, 22-48 years) were included. Fracture instability (n=6) and facial deformity (n=15) were the most frequent indications for intraoperative 3D O-Arm scan. Results: The images demonstrated that all fracture lines were properly reduced and fixed. Another scan performed at the end of the fixation or reduction stage, however, revealed suboptimal results in five of the 19 cases, and further reduction and fixation of the fracture lines were required. Conclusion: Implementation of an intraoperative O-Arm system in ZMC and ZA fracture surgeries assists in obtaining predictable and accurate results and obviates the need for revision surgeries. The device should be considered for precise operations such as ZMC fracture repairs.

• Imaging Science in Dentistry
• /
• v.35 no.3
• /
• pp.167-173
• /
• 2005

Purpose : To investigate the relationship between three-dimensional (3D) bone imaging parameters and trabecular strength in the mandible. Materials and Methods : Bone specimens were obtained from the mandibles of five male pigs weighing around 110 kg each. Of those, 43 samples were selected for 3D analysis and measured by micro-computed tomography. The five morphometric parameters were trabecular thickness (Tb.Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI) and degree of anisotropy (DA). Through destructive mechanical testing, strength parameters were obtained. Results : BV/TV, SMI, BS/BV, and Tb.Th showed significant correlations with strength parameters. DA did not show any correlation with the other parameters. In multiple linear regression analysis, BV/TV alone explained $43\%$ of the variance in Young's modulus. By stepwise inclusion of SMI, the variance in the Young's modulus was better explained up to $52\%$. Conclusions : Predicting trabecular strength in the mandible through architectural analysis would be possible. Further study is needed to establish the tendency and variety of trabecular architecture and strength according to the locations within the mandible.

• Computers and Concrete
• /
• v.18 no.3
• /
• pp.319-336
• /
• 2016

In this study, both two- and three-dimensional (2D and 3D) finite-volume-based models were developed to analyze the heat transfer mechanisms through the porous structures of cellular concretes under steady-state heat transfer conditions and to investigate the differences between the 2D and 3D modeling results. The 2D and 3D reconstructed pore networks were generated from the microstructural information measured by 3D images captured by X-ray computerized tomography (X-CT). The computed effective thermal conductivities based on the 2D and 3D calculations performed on the reconstructed porous structures were found to be nearly identical to those evaluated from the 2D cross-sectional images and the 3D X-CT images, respectively. In addition, the 3D computed effective thermal conductivity was found to agree better with the measured values, in comparison with the 2D reconstruction and real cross-sectional images. Finally, the thermal conductivities computed for different reconstructed porous 3D structures of cellular concretes were compared with those obtained from 2D computations performed on 2D reconstructed structures. This comparison revealed the differences between 2D and 3D image-based modeling. A correlation was thus derived between the results of the 3D and 2D models.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.121-128
• /
• 2014

Purpose: The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning. Materials and Methods: One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image data-sets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs. Results: All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels. Conclusion: Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.

• The korean journal of orthodontics
• /
• v.42 no.2
• /
• pp.56-63
• /
• 2012

Objective: To identify the right and left difference of the facial soft tissue landmarks three-dimensionally from the subjects of normal occlusion individuals. Materials and Methods: Cone-beam computed tomography (CT) scans were obtained in 48 normal occlusion adults (24 men, 24 women), and reconstructed into 3-dimensional (3D) models by using a 3D image soft ware. 3D position of 27 soft tissue landmarks, 9 midline and 9 pairs of bilateral landmarks, were identified in 3D coordination system, and their right and left differences were calculated and analyzed. Results: The right and left difference values derived from the study ranged from 0.6 to 4.6 mm indicating a high variability according to the landmarks. In general, the values showed a tendency to increase according to the lower and lateral positioning of the landmarks in the face. Overall differences were determined not only by transverse differences but also by sagittal and vertical differences, indicating that 3D evaluation would be essential in the facial soft tissue analysis. Conclusions: Means and standard deviations of the right and left difference of facial soft tissue landmarks derived from this study can be used as the diagnostic standard values for the evaluation of facial asymmetry.

• Imaging Science in Dentistry
• /
• v.34 no.3
• /
• pp.151-157
• /
• 2004

Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0/sup TM/(Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons' two-sample test. Results: 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5mm, 10 in Helical 5mm, 5 in Conventional 7mm and 9 in Helical 7mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2mm in 19 line items of Conventional 3mm, 20 of Helical 3mm, 15 of Conventional 5mm, 18 of Helical 5mm, II of Conventional 7mm and 16 of Helical 7mm. Conclusion: Considering image quality and patient's exposure time, scanning protocol of Helical 5mm is recommended for 3D image analysis of the skull in CT.

• Archives of Craniofacial Surgery
• /
• v.16 no.1
• /
• pp.11-16
• /
• 2015

Background: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. Methods: From 2013 through 2014, three calvarial defects were repaired using custom-made 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. Results: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. Conclusion: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
• /
• v.9 no.2
• /
• pp.196-204
• /
• 2016

World Health Organization reported that heart-related diseases such as coronary artery stenoses show the highest occurrence rate which may cause heart attack. Using Computed Tomography angiography images will allow radiologists to detect and have intervention by creating 3D roadmapping of the vessels. However, it is often complex and difficult do reconstruct 3D vessel which causes very large amount of time and previous researches were studied to segment vessels more accurate automatically. Therefore, in this paper, Region Competition, Geodesic Active Contour (GAC), Multi-atlas based segmentation and Active Shape Model algorithms were applied to segment aortic root from CTA images and the results were analyzed by using mean Hausdorff distance, volume to volume measure, computational time, user-interaction and coronary ostium detection rate. As a result, Extracted 3D aortic model using GAC showed the highest accuracy but also showed highest user-interaction results. Therefore, it is important to improve automatic segmentation algorithm in future

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.40 no.1
• /
• pp.11-16
• /
• 2014

Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.