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The Emergence ofAdvance Technologies andIndustrial Revolutions
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CAD systems, being produced following the third industrial revolution and the
advancement of computer models in medical science, enable object modeling before
design and analysis. To perform modeling, the object must be photographed with a
3D scanner or 3D imaging systems. Today, many intraoral and extraoral scanners
are commercially available for 3D modeling, shaping, and imaging. In addition to
3D modeling, a software is needed to manipulate the 3D objects. In order for the
photographed object to be manipulated by the software, it must be converted into an
STL le format. In this format, regardless of its color, the object will have points in
a three-dimensional space, providing the system with spatial object topographies.
Thereafter, the STL formatted-le is rendered in the software to shape and assess it.
In the eld of oral and maxillofacial surgery, CAD has also led to emergence of
virtual surgical planning (VSP) and designing of surgical guides, splints, and
implants. Virtual-based learning (VBL) is another CAD-based technology that is
the new branch in dental education.
CAM system, which was created after the third and fourth industrial revolutions,
is the result of combined use of software and computer-controlled machinery, without any manual intervention, aiming to provide a fully automated manufacturing
process [13, 14]. CAM includes two subbranches: additive manufacturing (AM)
and subtractive manufacturing (SM) [15]. AM is dened as quantiable layer-bylayer deposition of working materials to directly obtain CAD-based 3D objects [16,
17]. In this light, CAD/CAM benets fabrication of geometrically complex assem-
blies from a exible selection of materials [16, 18]. AM, also known as 3D printing,
includes techniques such as binder jetting (inkjet printing), stereolithography
(SLA)/digital light processing (DLP), fused deposition modeling (FDM), and selective laser sintering (SLS)/selective laser melting (SLM) [15]. On the contrary, the
controlled process of material removal and machining, drilling, and milling solid
blocks is categorized as subtractive manufacturing technologies (SM).
Following the advancement of CAD/CAM systems, robotic surgeries were also
evolved. Facilitated performing of these surgeries is among the many goals of integrating CAD/CAM technologies with medical sciences. Robotic surgery or navigation surgery aims to employ a minimally invasive approach to access
not-easily-accessible anatomical areas, for instance, posterior of the oral cavity,
such as oropharynx, larynx, and hypopharynx, or even the skull base [19–21].
Combining VSP with robotic surgeries has been demonstrated to cut down on operative durations and improve patient outcomes, rather than sole robotic surgery [20,
22]. In trans-oral robotic surgery (TORS), the robot is xated within the oral cavity
while surgeon views the surgical eld on the monitor. This method can benet educational purpose through providing better visualization of the surgical environment
for all students and residents.
Today, medicine has evolved from replacement therapies toward regenerative
therapies. Therefore, tissue engineering products have gained attention of many
researchers and clinicians. Contemporary tissue engineering-based approaches
often employ a cocktail of stem cells, growth factors, scaffolds, and bioreactors,
aiming to initiate and support regeneration aptitudes of host body [23]. The aforementioned technologies can be used to make these products.
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H. Nokhbatolfoghahaei and A. Khojasteh
The eld of regenerative dentistry has made great strides in this eld using
advanced technologies. Two of the most important applications of new technologies
that are desired in this eld are bioprinting and bioreactors.
In order to produce engineered tissue, it is necessary to examine and bio-design
the micro- and macro-environments of tissues. This is done with the purpose of
imitation of physiological and mechanical tissue conditions, outside the body [24,
25]. Bioreactors are used to somewhat mimic the body’s physiological and mechan-
ical characteristics [24]. There are different types of systems for the bioreactor’s
design, including (1) hydrodynamic shear stress, (2) direct mechanical stress, and
(3) electromagnetic eld (EMF)-based bioreactors [24–26].
Bioprinting refers to additive manufacturing technologies in which the scaffold
is fabricated from a blend of cells and biocompatible materials, the so-called bioink, in a layer-by-layer manner [27]. Categorization of the commonly used bioprinting technologies were extrusion-based methods, laser-based methods, and inkjet
bioprinting [28].
All elds of applied modern technologies in the eld of oral and maxillofacial
surgery are furtherly discussed in the following chapters.
The applications of CAD/CAM in the eld of oral and maxillofacial surgery are
bone reconstruction surgeries, orthognathic surgeries, implant dentistry, and transoral robotic surgery (Fig.2) [8, 11, 29–34].
The reconstruction procedure aims to reestablish the form and the function of the
defectious areas. Donor site morbidity, limited donor tissue, incompatible features
among recipient versus donor tissue, unpredictable resorption, and varying longterm results are the main disadvantages of the traditional reconstructive methods
[35]. Therefore, CAD/CAM-based methods have gained an increased attention in
terms of overcoming these drawbacks. In bone reconstruction, CAD/CAM can be
used for virtual defect design, i.e., virtual surgical planning (VSP) [8, 36]. It can
also be used for prototyping or creating a defect model, which involves thorough
defect modeling and visualization preoperatively [37]. Of note, it can highly contribute to making patient-specic implants (PSI) [8, 38]. In orthognathic surgeries,
CAD/CAM can be used for VSP [39, 40]. It is also used in fabrication of surgical
Reconstruction
Surgery
PSI VSP
Fig. 2 Flowchart of applications of CAD/CAM in oral and maxillofacial surgery (OMFS). PSI
patient-specic implants, VSP patient-specic implants
Prototyping
CAD/CAM in OMFS
Orthognathic
Surgery
VSP Surgical Stent
Dental Implant
Surgery
Navigation Surgical Stent
Robotic Surgery
Soft Palate Surgery
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guides, mainly facilitating and benetting the surgical trajectory time-wise [11]. In
the eld of dental implants, CAD/CAM is also used in surgical stents [41].
Navigational surgery is also one of their applications in implantology [42]. Finally,
in robotic surgeries, trans-oral robotic (cleft palate) surgery (TORCS) is chiey
implemented in soft tissue surgeries of the posterior portion of pharynx, such as the
soft palate [43].
In OMFS reconstructions, entire condition and three-dimensional topography of
tumor or defect can be evaluated and investigated on the computer monitor, preoperatively [8, 36]. This allows a relaxed and laid-back approach to be achieved for
thorough assessments. In prototyping, the defect model or tumor model may be
consisted of a polymeric content, modeling the jaws. This furtherly contributes to
comprehensive evaluations in terms of tumor/defect expansive specics, etc., to be
performed not only preoperatively but also even prior to meeting the patient and
viewing the two-dimensional radiographies. In prototyping or model design, mainly
curable polymers with lower temperatures can be employed [44]. For example,
FDM systems are very suitable for fabricating CAD models [44]. Therefore, CAD/
CAM in bone reconstruction and bone grafting can assist fabrication of patientspecic bone implants and preserving the protected healing space for in situ bone
regeneration (Fig.3).
Bone contouring, functional bone replacement, and functional bone regeneration
(FBR) can be achieved through application of bone implants [45–47].
Bone contouring refers to the usage of patient-specic products to restore the
standard and anatomical contour of the bone. The individualized products are
implanted in areas with nonspecic masticatory role and are not prone to undergoing jaw movement or functional or loadbearing incidents [48]. In bone contouring,
there is mainly a need for prosthesis, meaning that the implanted substance will
remain in place. In this eld, polymers such as polymethyl methacrylate (PMMA)
are mainly used [49]. In this case, FDM printer can be used. High-density polyethylenes (HDPE), such as polytetrauoroethylene (PTFE) or polyether ether ketone
(PEEK), are employed for fabrication of bone contouring prostheses, and chin or
cheek prostheses as well [50, 51]. Upon application of these materials, the selective
laser sintering (SLS) method of AM is required [52].
On the other hand, aiming for functional bone replacement, implants must restore
the functional behaviors of the resected tissue, including both mastication and jaw
movement. In functional bone replacement, the resected region is replaced by a
prosthesis that not only plays a functional role but can also generate and feasibly
withstand the masticatory forces. While for functional bone replacement, the applied
material has to tolerate the external forces and provide proper contour. Nowadays,
the most commonly employed materials for fabrication of functional bone replacement prosthesis are titanium in the bones and tantalum in the spine area [53, 54]. In
the past, stainless steels were used with this regard, but due to corrosive reactions
and numerous postoperative complications, leading to screw loosening and macrophage inammatory reactions, their application has minimized considerably [55,
56]. The use of titanium and tantalum in CAD/CAM is due to their high melting
point, making them usable with AM methods, such as selective laser melting (SLM).
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H. Nokhbatolfoghahaei and A. Khojasteh
CAD/CAM in Reconstruction
FDM PMMA
SLS HDPE
SLS PTFE
SLS PEEK
FDM Gelatin
FDM Collagen
FDM Chitosan
FDM Fibrin
FDM GelMA
FDM PEG
Bone
Contouring
Patient Specific
Bone Implants
Functional
Replacement
Ti
SLM
Bone
Ta
SLMSSSLM
Natural
Synthetic
ECM Like
(Hydrogel)
Functional
Bone
Regeneration
Scaffoldprosthesisprosthesis
Mineral Like
Healing Space
Insitu Bone
Regeneration
TCP
HA
PDLLA
PCL
Composite
Protected
Ti
SLM
FDM Alginate
Fig. 3 Flowchart of applications of CAD/CAM in bone reconstruction surgery. PMMA poly-
methyl methacrylate, HDPE high-density polyethylenes, PTFE polytetrauoroethylene, PEEK
polyether ether ketone, GelMA gelatin and methacrylate, PEG polyethylene glycol, Ti titanium, Ta
tantalum, SS stainless steel, ECM extracellular matrix, TCP tricalcium phosphate, HA hydroxyapatite, PDLLA poly (,-lactic acid), PCL polycaprolactone, FDM fused deposition modeling, SLS
selective laser sintering, SLM selective laser melting
In functional bone regeneration, a three-dimensional scaffold is fabricated. The
implanted scaffolds tend to induce bone formation, in order to replace the lost tissue
and restore both function and form of the defected area using host body’s regenerative abilities. Tissue engineering scaffolds have been used to provide spatial support
The Emergence ofAdvance Technologies andIndustrial Revolutions
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to enable new bone formation in defected sites. In the other words, scaffolds should
optimally imitate the native properties of extracellular matrix (ECM), both the mineral and organic portions of the native bone tissue ECM [26]. Upon placement, the
scaffold will undergo degradation and be replaced over a period of 6–18months
with natural bone tissue of normal anatomical features [57]. In functional bone
regeneration, materials that take the shape similar to bone at a lower temperature are
needed. In order to imitate ECM, there are materials of natural and synthetic origin.
Gelatin, collagen, chitosan, and brin are natural polymers or hydrogels used with
the FDM method to reconstruct a bone-imitating scaffold [58, 59]. Organic scaffolds that exist in synthetic form usually include a mixture of gelatin and methacrylate (GelMA), polyethylene glycol (PEG), and alginate, which are also mainly
prepared by the FDM method [60, 61]. Bone-like mineral tissue is mainly composed of tricalcium phosphate (TCP), hydroxyapatite (HA), or composite of a polymer along with TCP or HA [62, 63].
As mentioned above, another category of CAD/CAM application in bone reconstruction surgery is in situ bone regeneration through preserving a protected healing
space. In this method, there is a need to preserve a protected healing space, so that
the body can generate bone in that space. To make this guided or protected healing
space in the CAD-CAM method, the material of the membrane is usually titanium,
and the method of choice, SLM [64, 65].
All elds of applied modern technologies and application of CAD/CAM in the
eld of oral and maxillofacial surgery are furtherly discussed in the following
chapters.
References
1. Watanabe Y, Dasher RB.On the progress of industrial revolutions: a model to account for the
spread of articial intelligence innovations across industry. Kindai Manag Rev. 2020;8:113–23.
2. Xu M, David JM, Kim SH.The fourth industrial revolution: opportunities and challenges. Int
J Finance Res. 2018;9(2):90–5.
3. Prisecaru P.Challenges of the fourth industrial revolution. Knowl Horiz Econ. 2016;8(1):57.
4. Abdulla MA, Ali H, Jamel RS.CAD-CAM technology: a literature review. Al-Radain Dent
J. 2020;20(1):95–113.
5. Vyas K, Gibreel W, Mardini S.Virtual surgical planning (VSP) in craniomaxillofacial reconstruction. Facial Plast Surg Clin North Am. 2022;30(2):239–53.
6. Shenaq DS, Matros E.Virtual planning and navigational technology in reconstructive surgery.
J Surg Oncol. 2018;118(5):845–52.
7. Pucci R, Priore P, Manganiello L, Cassoni A, Valentini V.Accuracy evaluation of virtual surgical planning (VSP) in orthognathic surgery: comparison between CAD/CAM fabricated surgical splint and CAD/CAM cutting guides with PSI.J Oral Maxillofac Surg. 2019;77(9):e4–5.
8. Farajpour H, Bastami F, Bohlouli M, Khojasteh A.Reconstruction of bilateral ramus-condyle
unit defect using custom titanium prosthesis with preservation of both condyles. J Mech Behav
Biomed Mater. 2021;124:104765.
9. Unsal G-S, Turkyilmaz I, Lakhia S.Advantages and limitations of implant surgery with CAD/
CAM surgical guides: a literature review. J Clin Exp Dent. 2020;12(4):e409.
10. Cassetta M, Altieri F, Di Giorgio R, Barbato E. Palatal orthodontic miniscrew insertion
using a CAD-CAM surgical guide: description of a technique. Int J Oral Maxillofac Surg.
2018;47(9):1195–8.
8
https://t.me/medicina_free
11. Khojasteh A, Bastami F, Alikhasi M.Implant-assisted orthognathic surgery. In: Integrated procedures in facial cosmetic surgery. Cham: Springer; 2021. p.687–702.
12. Nokhbatolfoghahaei H, Bastami F, Farzad-Mohajeri S, Rezai Rad M, Dehghan MM, Bohlouli
M, etal. Prefabrication technique by preserving a muscular pedicle from masseter muscle as
an invivo bioreactor for reconstruction of mandibular critical-sized bone defects in canine
models. J Biomed Mater Res B Appl Biomater. 2022;110(7):1675–86.
13. Baldaniya L, Patel B.Computer-assisted manufacturing of medicines. Computer aided pharmaceutics and drug delivery. Cham: Springer; 2022. p.153–87.
14. Chlebus E, Kozera M, Trześniowski T.CAD/CAM systems integration. Zesz Nauk Politech
Śl Mech. (117):87–92.
15. Kumar V, Isanaka BR, Gupta S, Kushvaha V.Future trends and technologies in additive and
subtractive manufacturing. Additive and subtractive manufacturing of composites. Cham:
Springer; 2021. p.227–47.
16. Praveena B, Lokesh N, Buradi A, Santhosh N, Praveena B, Vignesh R.A comprehensive
review of emerging additive manufacturing (3D printing technology): methods, materials,
applications, challenges, trends and future potential, vol. 52. Mater Today; 2021. p.1309–13.
17. Gibson I, Rosen DW, Stucker B, Khorasani M, Rosen D, Stucker B, etal. Additive manufacturing technologies. Cham: Springer; 2021.
18. Guo N, Leu MC.Additive manufacturing: technology, applications and research needs. Front
Mech Eng. 2013;8(3):215–43.
19. Yee S.Transoral robotic surgery. AORN J. 2017;105(1):73–84.
20. Dutta SR, Passi D, Sharma S, Singh P.Transoral robotic surgery: a contemporary cure for
future maxillofacial surgery. J Oral Maxillofac Surg Med Pathol. 2016;28(4):290–303.
21. Liu H-H, Li L-J, Shi B, Xu C-W, Luo E.Robotic surgical systems in maxillofacial surgery: a
review. Int J Oral Sci. 2017;9(2):63–73.
22. Peacock ZS, Aghaloo T, Bouloux GF, Cillo JE Jr, Hale RG, Le AD, etal. Proceedings from
the 2013 American Association of Oral and Maxillofacial Surgeons Research Summit. J Oral
Maxillofac Surg. 2014;72(2):241–53.
23. de Peppo G, Thomsen P, Karlsson C, Strehl R, Lindahl A, Hyllner J.Human progenitor cells
for bone engineering applications. Curr Mol Med. 2013;13(5):723–34.
24. Nokhbatolfoghahaei H, Rad MR, Khani M-M, Nadjmi N, Khojasteh A.Application of bioreactors to improve functionality of bone tissue engineering constructs: a systematic review.
Curr Stem Cell Res Ther. 2017;12(7):564–99.
25. Nokhbatolfoghahaei H, Bohlouli M, Paknejad Z, Rad RM, Amirabad ML, Salehi-Nik N,
etal. Bioreactor cultivation condition for engineered bone tissue: effect of various bioreactor designs on extra cellular matrix synthesis. J Biomed Mater Res A. 2020;108(8):1662–72.
26. Nokhbatolfoghahaei H, Paknejad Z, Bohlouli M, Rezai Rad M, Aminishakib P, Derakhshan
S, etal. Fabrication of decellularized engineered extracellular matrix through bioreactor-based
environment for bone tissue engineering. ACS Omega. 2020;5(49):31943–56.
27. Somasekharan TL, Kasoju N, Raju R, Bhatt A.Formulation and characterization of alginate dialdehyde, gelatin, and platelet-rich plasma-based bioink for bioprinting applications.
Bioengineering (Basel). 2020;7(3):108.
28. Murphy SV, Atala A. 3D bioprinting of tissues and organs. Nat Biotechnol. 2014;32(8):
773–85.
29. Kothai P, Subudhi SK, Padhiary S, Lenka S, Pal KS, Choudhury BK.Application of CADCAM in Oral and maxillofacial surgery: a literature review. Indian J Public Health Res Devel.
2019;10(11):1287.
30. Jamali J, Kolokythas A, Miloro M.Clinical applications of digital dental Technology in Oral
and Maxillofacial Surgery. Clinical applications of digital dental technology. Hoboken, NJ:
Wiley; 2015. p.207.
31. Markiewicz MR, Farrell B, Shanti RM.Technology in oral and maxillofacial reconstruction.
In: Peterson’s principles of oral and maxillofacial surgery. Cham: Springer; 2022. p.1455–532.
32. Sukegawa S, Kanno T. Computer-assisted navigation surgery in Oral and maxillofacial surgery. In: Oral and maxillofacial surgery for the clinician. Cham: Springer; 2021. p.841–62.
H. Nokhbatolfoghahaei and A. Khojasteh
The Emergence ofAdvance Technologies andIndustrial Revolutions
https://t.me/medicina_free
33. Rad MR, Fahimipour F, Dashtimoghadam E, Nokhbatolfoghahaei H, Tayebi L, Khojasteh
A.Osteogenic differentiation of adipose-derived mesenchymal stem cells using 3D-printed
PDLLA/β-TCP nanocomposite scaffolds. Bioprinting. 2021;21:e00117.
34. Khojasteh A, Nadjmi N.Future trends in alveolar cleft osteoplasty. Integrated procedures in
facial cosmetic surgery. Cham: Springer; 2021. p.525–33.
35. Nyberg EL, Farris AL, Hung BP, Dias M, Garcia JR, Dorafshar AH, etal. 3D-printing technologies for craniofacial rehabilitation, reconstruction, and regeneration. Ann Biomed Eng.
2017;45(1):45–57.
36. Myers PL, Nelson JA, Rosen EB, Allen RJ Jr, Disa JJ, Matros E.Virtual surgical planning
for oncologic mandibular and maxillary reconstruction. Plast Reconstr Surg Glob Open.
2021;9(9):e3672.
37. Dreizin D, Nam AJ, Hirsch J, Bernstein MP. New and emerging patient-centered CT imaging and image-guided treatment paradigms for maxillofacial trauma. Emerg Radiol.
2018;25(5):533–45.
38. Ismail MB, Darwich K.Reconstruction of large mandibular bone defects extended to the condyle using patient-specic implants based on CAD-CAM technology and 3D printing. Adv
Oral Maxillofac Surg. 2022;5:100229.
39. Schneider D, Kämmerer PW, Hennig M, Schön G, Thiem DG, Bschorer R.Customized virtual
surgical planning in bimaxillary orthognathic surgery: a prospective randomized trial. Clin
Oral Investig. 2019;23(7):3115–22.
40. Jaisinghani S, Adams NS, Mann RJ, Polley JW, Girotto JA.Virtual surgical planning in orthognathic surgery. Eplasty. 2017;17:ic17.
41. Kalman L. 3D printing in dentistry: fundamentals, workows and clinical applications. In:
Advances in dental implantology using nanomaterials and allied technology applications.
Cham: Springer; 2021. p.325–51.
42. D’Souza KM, Aras MA.Applications of CAD/CAM technology in dental implant planning
and implant surgery. In: Advances in dental implantology using nanomaterials and allied technology applications. Cham: Springer; 2021. p.247–86.
43. Bansal A, Bansal V, Popli G, Keshri N, Khare G, Goel S.Robots in head and neck surgery. J
Appl Dent Med Sci. 2016;2:168–75.
44. Jockusch J, Özcan M.Additive manufacturing of dental polymers: an overview on processes,
materials and applications. Dent Mater J. 2020;2019-123:345.
45. Nyirjesy SC, Heller M, von Windheim N, Gingras A, Kang SY, Ozer E, et al. The role of
computer aided design/computer assisted manufacturing (CAD/CAM) and 3-dimensional
printing in head and neck oncologic surgery: a review and future directions. Oral Oncol.
2022;132:105976.
46. Tarsitano A, Battaglia S, Ramieri V, Cascone P, Ciocca L, Scotti R, etal. Short-term outcomes
of mandibular reconstruction in oncological patients using a CAD/CAM prosthesis including a
condyle supporting a bular free ap. J Cranio-Maxillofac Surg. 2017;45(2):330–7.
47. Helal MH, Hendawy HD, Gaber RA, Helal NR, Aboushelib MN. Osteogenesis ability
of CAD-CAM biodegradable polylactic acid scaffolds for reconstruction of jaw defects. J
Prosthet Dent. 2019;121(1):118–23.
48. Cucchi A, Bianchi A, Calamai P, Rinaldi L, Mangano F, Vignudelli E, etal. Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computeraided manufacturing (CAD/CAM) customized titanium meshes: a pilot study. BMC Oral
Health. 2020;20(1):1–11.
49. Tan ET, Ling JM, Dinesh SK.The feasibility of producing patient-specic acrylic cranioplasty
implants with a low-cost 3D printer. J Neurosurg. 2016;124(5):1531–7.
50. Haleem A, Javaid M. Polyether ether ketone (PEEK) and its manufacturing of customised
3D printed dentistry parts using additive manufacturing. Clin Epidemiology Glob Health.
2019;7(4):654–60.
51. Honigmann P, Sharma N, Okolo B, Popp U, Msallem B, Thieringer FM.Patient-specic surgical implants made of 3D printed PEEK: material, technology, and scope of surgical application. Biomed Res Int. 2018;2018:1.
9
10
https://t.me/medicina_free
52. Mazzoli A. Selective laser sintering in biomedical engineering. Med Biol Eng Comput.
2013;51(3):245–56.
53. Dang RR, Mehra P.Alloplastic reconstruction of the temporomandibular joint. J Istanb Univ
Fac Dent. 2017;51(3 Suppl 1):S31.
54. Fernandes N, Van den Heever J, Hoogendijk C, Botha S, Booysen G, Els J.Reconstruction
of an extensive midfacial defect using additive manufacturing techniques. J Prosthodont.
2016;25(7):589–94.
55. Pacici L, De Angelis F, Oreci A, Cielo A. Metals used in maxillofacial surgery. Oral
Implantol. 2016;9(Suppl 1/2016 to N 4/2016):107.
56. Attarilar S, Ebrahimi M, Djavanroodi F, Fu Y, Wang L, Yang J. 3D printing technologies
in metallic implants: a thematic review on the techniques and procedures. Int J Bioprint.
2021;7(1):306.
57. Maroulakos M, Kamperos G, Tayebi L, Halazonetis D, Ren Y.Applications of 3D printing on
craniofacial bone repair: a systematic review. J Dent. 2019;80:1–14.
58. Polo-Corrales L, Latorre-Esteves M, Ramirez-Vick JE.Scaffold design for bone regeneration.
J Nanosci Nanotechnol. 2014;14(1):15–56.
59. Kim HD, Amirthalingam S, Kim SL, Lee SS, Rangasamy J, Hwang NS. Biomimetic
materials and fabrication approaches for bone tissue engineering. Adv Healthc Mater.
2017;6(23):1700612.
60. Chen Y, Li W, Zhang C, Wu Z, Liu J.Recent developments of biomaterials for additive manufacturing of bone scaffolds. Adv Healthc Mater. 2020;9(23):2000724.
61. Qu M, Wang C, Zhou X, Libanori A, Jiang X, Xu W, etal. Multi-dimensional printing for bone
tissue engineering. Adv Healthc Mater. 2021;10(11):2001986.
62. Zhao L, Liang L.Materials comparison of 3D printed scaffolds for bone tissue engineering
applications.
63. Sansha S, Ali MM.Composite scaffolds in tissue engineering. Mater Today. 2020;24:2318–29.
64. Ciocca L, Fantini M, De Crescenzio F, Corinaldesi G, Scotti R.Direct metal laser sintering
(DMLS) of a customized titanium mesh for prosthetically guided bone regeneration of atrophic maxillary arches. Med Biol Eng Comput. 2011;49(11):1347–52.
65. Sumida T, Otawa N, Kamata Y, Kamakura S, Mtsushita T, Kitagaki H, etal. Custom-made
titanium devices as membranes for bone augmentation in implant treatment: clinical application and the comparison with conventional titanium mesh. J Cranio-Maxillofac Surg.
2015;43(10):2183–8.
H. Nokhbatolfoghahaei and A. Khojasteh
CBCT andMRI Data Acquisition
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asaBasis forComputer-Assisted
Maxillofacial Treatments
MitraGhazizadeh Ahsaie
1 Introduction
The invention of advanced imaging such as computed tomography (CT) and magnetic resonance imaging (MRI) has revolutionized the medical and dental treatments. The oral and maxillofacial region has a complex anatomy due to the presence
of various critical organs, such as the nerves, vessels, teeth, eye, and brain. Serving
as the third eye, three-dimensional imaging modalities provide accurate details on
hard and soft tissue, anatomic land marks, variations, abnormalities, and pathologies of the maxillofacial region [1].
Since the development of the rst medical CT scanners in 1960s, various generations have been introduced, each producing higher impact in the diagnosis and treatment plans. The fundamental principles of CT, whether applied to multidetector
computed tomography (MDCT) or CBCT, are the same: a collimated x-ray source
and detector, mounted in a xed or rotating gantry, turn around the patient’ head [2].
During this rotation, the X-ray beam is attenuated, the remnant photons are captured
by the detector, and further reconstruction algorithms mathematically and spatially
process this attenuated data into a 3D map (Fig.1).
The initial CTs, also known as the rst-generation CT scanners, used a pencilshaped X-ray beam and a single-array detector, with a translate rotate function, and
required a 5-min scan time. Subsequently, the CT scanner design evolved through
four generations, decreasing scan time to 1–2s. In the late 1990s, MDCT or multislice CT (MSCT) was introduced, having 64–640 detector rows; this technology
has now become the most widely used CT scanner design. This technology has
considerably reduced scan times, which is an important factor in reducing motion
artifacts especially in pediatric, trauma, or elderly patients [3].
M. Ghazizadeh Ahsaie (*)
Department of Oral and Maxillofacial Radiology, School of Dentistry,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
e-mail: mitraghazizadeh@sbmu.ac.ir
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023
A. Khojasteh et al. (eds.), Emerging Technologies in Oral and Maxillofacial
Surgery, https://doi.org/10.1007/978-981-19-8602-4_2
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X-ray
source
Detector
Fig. 1 Cone beam imaging geometry. A divergent cone beam X-ray is projected from the tube
head and is directed to the detector. The machine continues evolving around the object for the
entire 360° or along a reduced or partial trajectory
M. Ghazizadeh Ahsaie
In 1980s, CBCT was originally developed in angiography, and in the early 2000s,
this modality was introduced in dental and maxillofacial 3D imaging. While CBCT
is used for many purposes including routine oral and maxillofacial surgical treatments, like extraction of the mandibular third molars and removal of impacted teeth
and placement of dental implants, with expanding availability of a third-party application software capable of importing data in Digital Imaging and Communications
in Medicine (DICOM) format, the role of maxillofacial CBCT has now expanded in
a broad range of 3D printing procedures of models and surgical guides for jaw or
facial reconstruction.
In the 1980s, MRI was developed and entered practical clinical diagnosis. In this
noninvasive technique, the patient is placed in a large magnet. Radiofrequency (RF)
pulse is directed to the tissue, and the volumetric data is produced based on a map
of the distribution of hydrogen and local tissue properties that inuence the strength
of the magnetic resonance signal. To accurately assess maxillofacial soft tissues,
MRI can provide three-dimensional views and even provide soft tissue prosthesis
using additive manufacturing techniques [4].
CBCT and MRI data acquisition as a basis for computer-assisted maxillofacial
treatments is further discussed in this chapter, focusing on their operating principles
and clinical applications.
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