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Objective: To get a feedback from students participating in a skill enhancement course where a combination of a 3D-printed mandible with a natural tooth in place of the impacted tooth for surgical training is used and to compare it to an animal jaw model used for the same purpose. Methods: 41 participants were enrolled for the study, and extraction procedure was performed on both the bovine jaw and the 3D-printed mandible. Participants evaluated both models using a validated questionnaire to assess the anatomical and operative simulation and to compare its cost effectiveness. Results: Overall significant differences between the two models were found in the student assessment. Whilst the animal jaw models achieved better results in the haptic feedback of the soft tissue, the 3D-printed models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. Conclusion: The 3D-printed models presented a realistic alternative to cadaveric jaw models in the training of operational skills of dental surgeons. Whilst the 3D-printed models received positive feedback from students in a hands-on course, some aspects of the model leave room for improvement. [ABSTRACT FROM AUTHOR]

Introduction: The treatment of carious lesions is one of the most fundamental competencies in daily dental practice. However, many commercially available training models lack in reality regarding the simulation of pathologies such as carious lesions. 3D printed models could provide a more realistic simulation. This study provides an exemplary description of the fabrication of 3D printed dental models with carious lesions and assesses their educational value compared to commercially available models in conservative dentistry. Materials and Methods: A single‐stage, controlled cohort study was conducted within the context of a curricular course. A stereolithographic model was obtained from an intraoral scan and then printed using fused deposition modelling. These models were first piloted by experts and then implemented and compared against commercial models in a conservative dentistry course. Experts and students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. Results: Thirteen dentists and twenty‐seven 5th year dental students participated in the study. The 3D printed models were rated significantly more realistic in many test areas. In particular, the different tactility and the distinction in colour was rated positively in the 3D printed models. At 28.29€ (compared to 112.36€), the 3D printed models were exceptionally cost‐efficient. Conclusions: 3D printed dental models present a more realistic and cost‐efficient alternative to commercial models in the undergraduate training of conservative dentistry. [ABSTRACT FROM AUTHOR]

Polyhydroxyalkanoates (PHAs) are a class of structurally diverse natural biopolyesters, synthesized by various microbes under unbalanced culture conditions. PHAs as biomedical materials have been fabricated in various forms to apply to tissue engineering for the past years due to their excellent biodegradability, inherent biocompatibility, modifiable mechanical properties, and thermo-processability. However, there remain some bottlenecks in terms of PHA production on a large scale, the purification process, mechanical properties, and biodegradability of PHA, which need to be further resolved. Therefore, scientists are making great efforts via synthetic biology and metabolic engineering tools to improve the properties and the product yields of PHA at a lower cost for the development of various PHA-based scaffold fabrication technologies to widen biomedical applications, especially in bone tissue engineering. This review aims to outline the biosynthesis, structures, properties, and the bone tissue engineering applications of PHA scaffolds with different manufacturing technologies. The latest advances will provide an insight into future outlooks in PHA-based scaffolds for bone tissue engineering.

Endovascular aortic repair (EVAR) is a minimal-invasive technique that prevents life-threatening rupture in patients with aortic pathologies by implantation of an endoluminal stent graft. During the endovascular procedure, device navigation is currently performed by fluoroscopy in combination with digital subtraction angiography. This study presents the current iterative process of biomedical engineering within the disruptive interdisciplinary project Nav EVAR, which includes advanced navigation, image techniques and augmented reality with the aim of reducing side effects (namely radiation exposure and contrast agent administration) and optimising visualisation during EVAR procedures. This article describes the current prototype developed in this project and the experiments conducted to evaluate it.

Background: Recent advances in 3D printing technology have enabled the emergence of new educational and clinical tools for medical professionals. This study provides an exemplary description of the fabrication of 3D‐printed individualised patient models and assesses their educational value compared to cadaveric models in oral and maxillofacial surgery. Methods: A single‐stage, controlled cohort study was conducted within the context of a curricular course. A patient's CT scan was segmented into a stereolithographic model and then printed using a fused filament 3D printer. These individualised patient models were implemented and compared against cadaveric models in a curricular oral surgery hands‐on course. Students evaluated both models using a validated questionnaire. Additionally, a cost analysis for both models was carried out. P‐values were calculated using the Mann‐Whitney U test. Results: Thirty‐eight fourth‐year dental students participated in the study. Overall, significant differences between the two models were found in the student assessment. Whilst the cadaveric models achieved better results in the haptic feedback of the soft tissue, the 3D‐printed individualised patient models were regarded significantly more realistic with regard to the anatomical correctness, the degree of freedom of movement and the operative simulation. At 3.46 € (compared to 6.51 €), the 3D‐printed patient individualised models were exceptionally cost‐efficient. Conclusions: 3D‐printed patient individualised models presented a realistic alternative to cadaveric models in the undergraduate training of operational skills in oral and maxillofacial surgery. Whilst the 3D‐printed individualised patient models received positive feedback from students, some aspects of the model leave room for improvement. [ABSTRACT FROM AUTHOR]

During the last few years, the curriculum of many dentistry schools in Germany has been reorganised. Two key aspects of the applied changes are the integration of up-to-date teaching methods and the promotion of interdisciplinarity. To support these efforts, an approach to fabricating individualised simulation models for hands-on courses employing 3D printing is presented. The models are based on real patients, thus providing students a more realistic preparation for real clinical situations. As a wide variety of dental procedures can be implemented, the simulation models can also contribute to a more interdisciplinary dental education. The data used for the construction of the models were acquired by 3D surface scanning. The data were further processed with 3D modelling software. Afterwards, the models were fabricated by 3D printing with the PolyJet technique. Three models serve as examples: a prosthodontic model for training veneer preparation, a conservative model for practicing dental bonding and an interdisciplinary model featuring carious teeth and an insufficient crown. The third model was evaluated in a hands-on course with 22 fourth-year dental students. The students answered a questionnaire and gave their personal opinion. Whilst the concept of the model received very positive feedback, some aspects of the implementation were criticised. We discuss these observations and suggest ways for further improvement. [ABSTRACT FROM AUTHOR]

Endoscopic base of skull surgery has been growing in acceptance in the recent past due to improvements in visualisation and micro instrumentation as well as the surgical maturing of early endoscopic skull base practitioners. Unfortunately, these demanding procedures have a steep learning curve. A physical simulation that is able to reproduce the complex anatomy of the anterior skull base provides very useful means of learning the necessary skills in a safe and effective environment. This paper aims to assess the ease of learning endoscopic skull base exposure and drilling techniques using an anatomically accurate physical model with a pre-existing pathology (i.e., basilar invagination) created from actual patient data. Five models of a patient with platy-basia and basilar invagination were created from the original MRI and CT imaging data of a patient. The models were used as part of a training workshop for ENT surgeons with varying degrees of experience in endoscopic base of skull surgery, from trainees to experienced consultants. The surgeons were given a list of key steps to achieve in exposing and drilling the skull base using the simulation model. They were then asked to list the level of difficulty of learning these steps using the model. The participants found the models suitable for learning registration, navigation and skull base drilling techniques. All participants also found the deep structures to be accurately represented spatially as confirmed by the navigation system. These models allow structured simulation to be conducted in a workshop environment where surgeons and trainees can practice to perform complex procedures in a controlled fashion under the supervision of experts. [ABSTRACT FROM AUTHOR]

Abstract: Advances in 3D rapid-prototyping printers, 3D modeling software, and casting techniques allow for cost-effective fabrication of custom components in gamma-ray and X-ray imaging systems. Applications extend to new fabrication methods for custom collimators, pinholes, calibration and resolution phantoms, mounting and shielding components, and imaging apertures. Details of the fabrication process for these components, specifically the 3D printing process, cold casting with a tungsten epoxy, and lost-wax casting in platinum are presented. [Copyright &y& Elsevier]

Polyhydroxyalkanoates (PHAs) are a class of structurally diverse natural biopolyesters, synthesized by various microbes under unbalanced culture conditions. PHAs as biomedical materials have been fabricated in various forms to apply to tissue engineering for the past years due to their excellent biodegradability, inherent biocompatibility, modifiable mechanical properties, and thermo-processability. However, there remain some bottlenecks in terms of PHA production on a large scale, the purification process, mechanical properties, and biodegradability of PHA, which need to be further resolved. Therefore, scientists are making great efforts via synthetic biology and metabolic engineering tools to improve the properties and the product yields of PHA at a lower cost for the development of various PHA-based scaffold fabrication technologies to widen biomedical applications, especially in bone tissue engineering. This review aims to outline the biosynthesis, structures, properties, and the bone tissue engineering applications of PHA scaffolds with different manufacturing technologies. The latest advances will provide an insight into future outlooks in PHA-based scaffolds for bone tissue engineering., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Li, Zhang, Udduttula, Fan, Chen, Sun and Zhang.)

Background: Most simulation models used at university dental clinics are typodonts. Usually, models show idealized eugnathic situations, which are rarely encountered in everyday practice. The aim of this study was to use 3D printing technology to manufacture individualized surgical training models for root tip resection (apicoectomy) on the basis of real patient data and to compare their suitability for dental education against a commercial typodont model. Methods: The training model was designed using CAD/CAM (computer-aided design/computer-aided manufacturing) technology. The printer used to manufacture the models employed the PolyJet technique. Dental students, about one year before their final examinations, acted as test persons and evaluated the simulation models on a visual analogue scale (VAS) with four questions (Q1-Q4). Results: A training model for root tip resection was constructed and printed employing two different materials (hard and soft) to differentiate anatomical structures within the model. The exercise was rated by 35 participants for the typodont model and 33 students for the 3D-printed model. Wilcoxon rank sum tests were carried out to identify differences in the assessments of the two model types. The alternative hypothesis for each test was: "The rating for the typodont model is higher than that for the 3D-printed model". As the p-values reveal, the alternative hypothesis has to be rejected in all cases. For both models, the gingiva mask was criticized. Conclusions: Individual 3D-printed surgical training models based on real patient data offer a realistic alternative to industrially manufactured typodont models. However, there is still room for improvement with respect to the gingiva mask for learning surgical incision and flap formation.

Purpose: The construction of complex collimators with a high number of oblique pinholes is very labor intensive, expensive or is sometimes impossible with the current available techniques (drilling, milling or electric discharge machining). All these techniques are subtractive: one starts from solid plates and the material at the position of the pinholes is removed. The authors used a novel technique for collimator construction, called metal additive manufacturing. This process starts with a solid piece of tungsten on which a first layer of tungsten powder is melted. Each subsequent layer is then melted on the previous layer. This melting is done by selective laser melting at the locations where the CAD design file defines solid material. Methods: A complex collimator with 20 loftholes with 500 μm diameter pinhole opening was designed and produced (16 mm thick and 70 × 52 mm2 transverse size). The density was determined, the production accuracy was measured (GOM ATOS II Triple Scan, Nikon AZ100M microscope, Olympus IMT200 microscope). Point source measurements were done by mounting the collimator on a SPECT detector. Because there is increasing interest in dual-modality SPECT-MR imaging, the collimator was also positioned in a 7T MRI scanner (Bruker Pharmascan). A uniform phantom was acquired using T1, T2, and T2* sequences to check for artifacts or distortion of the phantom images due to the collimator presence. Additionally, three tungsten sample pieces (250, 500, and 750 μm thick) were produced. The density, attenuation (140 keV beam), and uniformity (GE eXplore Locus SP micro-CT) of these samples were measured. Results: The density of the collimator was equal to 17.31 ± 0.10 g/cm3 (89.92% of pure tungsten). The production accuracy ranges from -260 to +650 μm. The aperture positions have a mean deviation of 5 μm, the maximum deviation was 174 μm and the minimum deviation was -122 μm. The mean aperture diameter is 464 ± 19 μm. The calculated and measured sensitivity and resolution of point sources at different positions in the field-of-view agree well. The measured and expected attenuation of the three sample pieces are in a good agreement. There was no influence of the 7T magnetic field on the collimator (which is paramagnetic) and minimal distortion was noticed on the MR scan of the uniform phantom. Conclusions: Additive manufacturing is a very promising technique for the production of complex multipinhole collimators and may also be used for producing other complex collimators. The cost of this technique is only related to the amount of powder needed and the time it takes to have the collimator built. The timeframe from design to collimator production is significantly reduced. [ABSTRACT FROM AUTHOR]

Unlabelled: The traditionally accepted form of training is direct supervision by an expert; however, modern trends in medicine have made this progressively more difficult to achieve. A 3-dimensional printer makes it possible to convert patients imaging data into accurate models, thus allowing the possibility to reproduce models with pathology. This enables a large number of trainees to be trained simultaneously using realistic models simulating actual neurosurgical procedures. The aim of this study was to assess the usefulness of these models in training surgeons to perform standard procedures that require complex techniques and equipment., Methods: Multiple models of the head of a patient with a deep-seated small thalamic lesion were created based on his computed tomography and magnetic resonance imaging data. A workshop was conducted using these models of the head as a teaching tool. The surgical trainees were assessed for successful performance of the procedure as well as the duration of time and number of attempts taken to learn them., Findings: All surgical candidates were able to learn the basics of the surgical procedure taught in the workshop. The number of attempts and time taken reflected the seniority and previous experience of each candidate., Discussion: Surgical trainees need multiple attempts to learn essential procedures. The use of these models for surgical-training simulation allows trainees to practice these procedures repetitively in a safe environment until they can master it. This would theoretically shorten the learning curve while standardizing teaching and assessment techniques of these trainees., (© 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.)