3D-printed Models Research Articles

Effect of Lateral Pressure on the Stability of Inclined Layered Rock Tunnel: A 3D-printed Model Investigation by Cement-based Materials

The inclined layered rock tunnel engineering in the alpine canyon area subject to tectonic stress will be influenced by high lateral stress. Currently, there are scarce reports on the impact of the lateral pressure coefficient on the stability of inclined layered rock tunnels. Hence, the mechanical response of the inclined layered tunnel model was investigated based on the 3D-printed model test, supplemented by acoustic emission (AE) and digital image correlation (DIC) monitoring methods under three cases of lateral pressure coefficients of 1.2, 1.5 and 1.8. The results reveal that for the tunnel model with a 60° bedding inclination, the bearing capacity is negatively correlated with the lateral pressure coefficient. The normal deformation of the bedding of the tunnel model is prominent, exhibiting significant asymmetric deformation characteristics. When the lateral pressure coefficient k increases from 1.2 to 1.5, the failure of the tunnel model changes from shear-slip failure along the layer to bedding cracking and buckling failure of the sidewall. The test results have enlightenment significance for the stability evaluation of inclined layered surrounding rock tunnels in the alpine canyon area.

Design and development of knee rehabilitation robot

This research presents a comprehensive design and analysis of a knee rehabilitation platform aimed at aiding individuals with knee dysfunction. Dysfunction in the knee joint can lead to an imbalance in gait and posture during activities of daily living (ADLs) such as standing, walking, and running. This study focuses on developing a 2-degree-of-freedom (2-DoF) knee rehabilitation device capable of mimicking linear and angular movements. A slider mechanism-based knee rehabilitation device is developed and simulated alongside various other mechanisms. The proposed mechanism achieves 32.5° of flexion for a linear movement of 0.45 m within 6 seconds, outperforming other mechanisms. To validate simulation results, a 3D-printed model is fabricated, and experimental studies are conducted under no-load conditions, showing close alignment with simulation outcomes with a deviation of ±5%. The device’s key features include portability, compliance, compactness, and enhanced stiffness. Future research will involve conducting pilot studies to further evaluate the practical efficacy and potential enhancements of the proposed knee rehabilitation platform.

Estimating Cognitive Workload Using Task-Related Pupillary Responses in Simulated Drilling in Cochlear Implantation.

Training of temporal bone drilling requires more than mastering technical skills with the drill. Skills such as visual imagery, bimanual dexterity, and stress management need to be mastered along with precise knowledge of anatomy. In otorhinolaryngology, these psychomotor skills underlie performance in the drilling of the temporal bone for access to the inner ear in cochlear implant surgery. However, little is known about how psychomotor skills and workload management impact the practitioners' continuous and overall performance. To understand how the practitioner's workload and performance unfolds over time, we examine task-evoked pupillary responses (TEPR) of 22 medical students who performed transmastoid-posterior tympanotomy (TMPT) and removal of the bony overhang of the round window niche in a 3D-printed model of the temporal bone. We investigate how students' TEPR metrics (Average Pupil Size [APS], Index of Pupil Activity [IPA], and Low/High Index of Pupillary Activity [LHIPA]) and time spent in drilling phases correspond to the performance in key drilling phases. All TEPR measures revealed significant differences between key drilling phases that corresponded to the anticipated workload. Enlarging the facial recess lasted significantly longer than other phases. IPA captured significant increase of workload in thinning of the posterior canal wall, while APS revealed increased workload during the drilling of the bony overhang. Our findings contribute to the contemporary competency-based medical residency programs where objective and continuous monitoring of participants' progress allows to track progress in expertise acquisition. Laryngoscope, 134:5087-5095, 2024.

Evaluation and Acceptance of Open-Source 3D-Printed Tracheobronchial Tree Models for Improving Pediatric Lung Isolation Techniques Training

Evaluation and Acceptance of Open-Source 3D-Printed Tracheobronchial Tree Models for Improving Pediatric Lung Isolation Techniques Training

Evolving Methods and Application of a 3D Printed Model in the Current Deep Inferior Epigastric Perforator Flap Elevation.

The choice of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction has increased. Three-dimensional (3D) models of DIEP flaps have been introduced with advances in 3D technology to assist the tedious intramuscular dissection of the pedicle. This study presents the process of creating an ideal 3D model for a DIEP flap. Collaboration among various professionals, including surgeons, radiologists, and 3D-printing model makers, is essential for manufacturing suitable 3D-printing DIEP models. Our team facilitated the collaboration process by sharing the virtual 3D model via a uniform resource locator (URL) using an online platform accessible on mobile devices. During collaboration in 3D DIEP model-making, we continuously upgraded the model to a better version. The model was modified according to the surgeon's preference from a 1:1 ratio size to a handheld size. Additionally, we achieved significant advancements over conventional methods, including improved visualization of detailed vessel pathways with separation of arteries and veins, tissue transparency, and superficial inferior epigastric vein (SIEV). Through 3D model-making collaborations, our team successfully developed a 3D DIEP model with translucency and visualized arteries and veins separately with accentuation of the perforators, including SIEV tracing, which is more accurate. This ideal 3D model for the DIEP flap enables the selection of a perforator vessel that is safe and easy to dissect to lower complications and procedure time and will be of great help to less experienced surgeons.

A neurosurgical nursing training system based on 3D printing models: practice and exploration of precision medicine.

In recent years, the concept of precision medicine has gradually permeated the field of nursing, presenting new challenges for neurosurgical nursing staff. Traditional teaching methods often struggle to adequately convey complex anatomical knowledge and nursing skills, thereby affecting the learning outcomes and clinical decision-making abilities of nurses. As an innovative educational tool, three-dimensional (3D) printing technology has demonstrated significant potential in medical education in recent years. Therefore, this project aims to explore the advantages and feasibility of using 3D printed models as a novel teaching tool in neurosurgical nursing. The study involved 80 nursing personnel who participated in the neurosurgical rotation training at Shaoxing People's Hospital from 2022 to 2023. The control group (40 individuals) used only traditional teaching tools such as textbooks, multimedia courseware, and laboratory equipment for theoretical and practical training based on the curriculum. The experimental group (40 individuals) incorporated a 3D printing model database as an innovative teaching tool on the basis of traditional teaching methods, and used patient-specific 3D printed models for precise nursing training. After the training, both groups were assessed for theoretical and practical abilities, professional values, job satisfaction, and the prognosis of intracranial aneurysm patients they cared for. The experimental group demonstrated superior scores in theoretical and practical abilities, professional values, and job satisfaction compared to the control group. During the training period, patients with intracranial aneurysms receiving precision nursing care from the experimental group showed better quality of life and neurological functional outcomes compared to the control group. The nursing training system based on 3D printing models can enhance the learning efficiency and nursing work satisfaction of nursing personnel. It may have a positive impact on the professional values of nursing personnel, thereby laying a solid foundation for providing high-quality, precise nursing services in the field of neurosurgery in the future.

Content Validity for a 3D-Printed Model for Simulation-Based Training of Basic Epistaxis Management

Introduction Hands-on training of basic epistaxis management is often minimal during pregraduate medical training. The objective was to develop and gather structured content validity evidence for a 3D-printed model for simulation-based training and assessment of technical skills in basic epistaxis management. Methods A simulator for epistaxis management training was built based on publicly available 3D-print files with addition of tubing to mimic anterior bleeding. Ten otorhinolaryngologists evaluated the model after performing nasal cavity inspection and insertion and insufflation of a nasal tamponade device. Content validity evidence was collected following Messick's framework. Results Two content experts contributed to define features in the iterative building process. In the structured evaluation of the model, experienced clinicians found the appearance of the outer nose and the resistance when insufflating a nasal tamponade device into the nasal cavity satisfying (mean score of 3.9 and 4.7 out of 5, respectively), whereas the nasal cavity was found to be a bit too spacious compared with typical real-life conditions. Conclusions A 3D-printed simulator for simulation-based training of basic epistaxis management was successfully built. Content validity was gathered, and overall, content experts found the model to adequately represent the technical skills challenges for training novices such as medical students and junior doctors.

Challenges and Solutions for Cost-Effective and Practical Dental Cast Fabrication With a Desktop Fused Deposition Modeling (FDM) 3D Printer

Challenges and Solutions for Cost-Effective and Practical Dental Cast Fabrication With a Desktop Fused Deposition Modeling (FDM) 3D Printer

Three-dimensional printed apical barrier model technology for pre-clinical dental education.

Clinically, apical barrier procedure can be adopted to create an immediate artificial barrier for tooth with an open apex. Given that the quality of the barrier is crucial, the apical barrier procedure is known for its high technical sensitivity, posing significant learning challenges for dental students. Therefore, a new dental teaching model not only effectively enhances the future clinical skills of dental students but also benefits a wider range of patients. A new dental model for simulating apical barrier procedure in vitro, is helpful for dental students to practice apical barrier procedure. This study aims to design, assess, and evaluate the feasibility of a three-dimensional (3D) printed apical barrier model for pre-clinical dental education. A novel 3D-printed apical barrier model was developed, consisting of a tooth model and a matching blind box. Total 200 3D-printed apical barrier models were used to train dental students, and fifty fifth-year dental students participated in this voluntary hands-on course. Each student performed apical barrier procedures on four 3D-printed models. The outcome of the first model served as the representative result for the "direct barrier group", whereas the outcome of the fourth model represented the result of the "post-training barrier group". The quality of the apical barrier procedure was assessed through X-ray examination, and a questionnaire was used to evaluate the 3D-printed model's benefits, with scores ranging from 1 (strongly agree) to 5 (strongly disagree). The overall rating for the 3D-printed model was 2.0 ± 0.6. The model was noted for its high degree of realism, ease of use, and practical applicability. Post-training assessments showed significant improvements in the density of apical barrier fillings (P< 0.05), reduction in underfilling rates (P< 0.05), and decrease in overfilling distances (P< 0.05). Students overwhelmingly agreed that the model was beneficial for training in apical barrier procedures (1.06 ± 0.24), helped identify their shortcomings (1.62 ± 0.53), and improved their operational skills (1.90 ± 0.51). Both the questionnaire feedback and the quality of the fillings confirmed the feasibility and efficacy of the 3D-printed apical barrier model for dental education. The students had the possibility to learn the correct apical barrier procedure on printed dental models.

Comparison of the safety of flexible ureteroscopy with the different irrigation methods in a 3D print kidney model.

To compare intrarenal pressure (IRP) and irrigation flow by varying suspended water heights and hand-held pressure pumping during flexible ureteroscopy using an in vitro 3D printed kidney model. A 3D-printed silicone model was used to simulate the kidney. The ureteral access sheath(UAS) was connected to the kidney model and positioned at the ureteropelvic junction. Central venous pressure tubing was used to monitor the pressure in the renal pelvis under different conditions. Sheath sizes of 12Fr and 14Fr were tested with flexible ureteroscope (fURS) sizes of 7.5, 8.5, and 9.5Fr, respectively. The irrigation was gravity-based, with suspended water heights set at 60, 90, 120, 150, and 180cm. The manual pumping as another set of measurement is used to measure the maximum intrarenal pressure. Using a 12Fr sheath with a 9.5Fr fURS loading without additional accessories resulted in IRP ranging from 8.4 to 17.5 cmH2O, while manual pumping perfusion pressure exceeded 60 cmH2O. Loading a 200-um laser fiber reduced the pressure to 6.4-10.5 cmH2O, and using a stone basket decreased it to 4.0-5.0 cmH2O. Using a 14Fr sheath with a 9.5Fr fURS resulted in an IRP of 2.5-6.0 cmH2O, compared to 17 cmH2O with manual pumping. With a 12Fr sheath and a 7.5Fr fURS, the IRP ranged from 5.4 to 8.2 cmH2O, while manual pumping resulted in 25.5 cmH2O. With a 14Fr sheath and a 7.5Fr fURS, the IRP ranged from 1.5 to 4.3 cmH2O, and manual pumping resulted in 9.0 cmH2O. When using a UAS in a flexible ureteroscopy, the IRP can be maintained within a safe range with different fURS/UAS combos with a suspended water height of less than 180cm. However, with specific fURS/UAS(9.5Fr/12Fr) combos, the IRP exceeded the safe limit when using manual pumping. Gravity irrigation with a suspended water height of less than 180cm is safe in this simulated clinical environment.

The accuracy and efficiency of design and development of 3D printed integral anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip

Objective: To compare the accuracy and efficiency between the model development method and the software development method, which design and develop 3D printed integral anatomical acetabular prosthesis to be used in total hip arthroplasty(THA) for patients with Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH). Methods: Fifteen patients with end-stage hip osteoarthritis due to Crowe type Ⅱ and Ⅲ DDH who underwent THA in the Orthopedics Department of the First Affiliated Hospital of Bengbu Medical College between January 2015 and June 2023 were selected in this study retrospectively. There were 1 male (1 hip) and 14 females (17 hips) with a mean age of (55.1±9.1) years. There were 12 hips with Crowe type Ⅱ, 6 hips with Crowe type Ⅲ. The preoperative pelvis three-dimensional CT data in those patients were used to design integral anatomical acetabular prosthesis. The model development group used 3D printing technology to print life-size pelvis models. The acetabulum was reamed and the acetabulum cup was inserted into the socket according to conventional THA procedures. The bone defect above the acetabulum cup was filled with bone wax. The Mimics and 3-matic software were used to simulate the THA procedures, design and install the integrated anatomical acetabular prosthesis in the software development group. The operation time, the size of the acetabular cup, the volume and surface area of the acetabulum bone defect, the acetabular cup's inclination and anteversion, the horizontal distance and the vertical distance of hip rotation center were compared between the two methods. Results: The study in the two groups were all based on the data of 18 hips in the 15 patients. The horizontal and vertical distances of rotation center in the model development group and software development group was (32.08±1.80) mm, (32.17±2.40) mm and (14.36±1.53) mm, (15.11±1.45) mm, respectively (both P>0.05). The cup size in model development group was (48.56±1.15)mm, and it was (48.77±1.22) mm in the software group (P=0.160). The anteversion and inclination of the acetabular cup in the model and software groups were 23.79°±6.31°, 30.49°±11.03° and 15.17°±0.52°, 40.24°±0.58°, respectively (both P<0.01). The volume and surface area of the acetabulum bone defect in the model development group was (5.06±2.86) mm3 and (8.31±2.21) mm2, respectively, while it was (4.01±2.56)mm3 and (6.83±2.71) mm2, respectively, in the software development group (both P<0.05). The work time in the model development group was (24.43±0.68) h and (0.47±0.12) h in the software development group, respectively (P<0.001). Conclusion: Compared with the 3D printing model development method, the application of Mimics and 3-matic software to design and develop integrated anatomical acetabular prosthesis in total hip arthroplasty for Crowe type Ⅱ and Ⅲ DDH show advantages of convenience, high efficiency and more accuracy.

Pilot Study on Integrating 3D-Printed Models into Undergraduate Medical Education for Congenital Heart Disease

BackgroundThis study aimed to assess the feasibility and effectiveness of implementing 3D-printed heart models in the education of medical students in a Canadian Medical School. MethodsThree types of 3D-printed models – normal, unrepaired Tetralogy of Fallot (TOF) and surgically repaired adult TOF – were provided for medical students in their 2nd year of training after a 30-minute lecture. The repaired TOF model depicted a transannular patch, ventricular septal defect closure, and right ventricular outflow tract resection. Knowledge acquisition was measured by comparing pre-and post-session tests consisting of 5 questions. Learner satisfaction ratings were measured with questionnaires completed after the session. A statistical analysis was performed using the t-test. ResultsTwenty-two medical students participated in the study with 20 students submitting complete data for analysis. The students’ score on 5 questions improved after the 3D-printed model session. The average number of correct answers in the test was 2.1 ± 1.0 pre-session and 4.3 ± 0.9 post-session (P < 0.001) out of the possible total of 5. Participants reported a high level of satisfaction (86.4%), understanding (86.4%), and usefulness (90.9%) with the incorporation of 3D-printed models in the educational session. ConclusionsAn educational session which integrated 3D-printed anatomic models to teach congenital heart disease anatomy significantly enhanced knowledge outcomes. Learner assessment of the impact of the use of the 3D models was highly favourable.

Analysis and Visualization of Inter-/Intra-surgeon Variability Using Surgical Simulation for Partial Anomalous Pulmonary Venous Connection Repair.

There may be inter-/intra-surgeon variability in the repair of congenital heart defects. The objective was to analyze and visualize inter-/intra-surgeon variability in the level of patch suture lines and in the shape and size of patches developed through surgical simulation for partial anomalous pulmonary venous connection (PAPVC) repair using a patient-specific 3D-printed heart model. A patient with PAPVC and preoperative computed tomography data were selected, and a patient-specific heart model was obtained. Two different exposures on the model were tested. Two surgeons were enrolled. Both surgeons performed a single-patch repair on four heart models with one exposure and four models with the other. On the potential suture line, 20 points common in each model were allocated. The level of patch suture lines was represented as a deviation from the 20 points. The shape and size of the patches were analyzed and visualized using geometric morphometrics approaches, using the 20 points as landmarks to represent the patches. There was inter-surgeon variability in the level of patch suture lines, and the variability was higher in particular locations. There was inter-surgeon variability in the shape and size of patches, which was not affected by the exposures. The inter-surgeon variability in the shape of patches was higher in particular locations. There was intra-surgeon variability in the shape of patches. Inter-/intra-surgeon variability was analyzed and visualized by the surgical simulation using geometric morphometrics approaches. Further studies are needed to scrutinize whether the variability affects postoperative hemodynamics in actual surgery.

Effect of Metal Artifacts in Cone-beam Computed Tomography on Accuracy of Implant Placement by Static and Dynamic Computer- Assisted Implant Surgery: An In Vitro Study.

This study evaluates the impact of metal artifacts in cone-beam computed tomography (CBCT) on the accuracy of static and dynamic computer-assisted implant surgery (CAIS) techniques. An implant was placed on each of thirty 3D-printed models embedded with Cobalt-Chrome strips to simulate metal artifacts by Porcelain-fused-to-metal (PFM), utilizing these CAIS techniques: radiographic template (RT) (n=10), radiographic markers (RM) (n=10), and dynamic navigation (DN) (n=10). Trueness and precision were analyzed by comparing 3D global deviation and the difference in implant positions at the neck, apex, depth, and angle in initial planned and final placed scans. DN exhibited significantly lower 3D global trueness deviation to RT (p = 0.022) and lower angular deviation compared to both RT (p = 0.003) and RM (p = 0.002). RM showed greater trueness at the implant neck compared to DN (p = 0.005) and better depth trueness than RT (p = 0.001) and DN (p = 0.027). DN demonstrated higher precision in implant angulation than RM (p = 0.011) and RT (p = 0.041). In the presence of metal artifacts, both DN and RM techniques offered greater trueness in specific implant positions compared to RT. However, DN proved to be the most precise method for implant placement.

Evaluating the efficacy of a cost-effective, fully three-dimensional-printed vertebra model for endoscopic spine surgery training for neurosurgical residents.

A fused deposition modeling three-dimensional (3D)-printed model of the L4-5 vertebra for lumbar discectomy was designed. The model included separately printed dura mater, spinal cord, ligamentum flavum, intervertebral disc (from thermoplastic polyurethane), and bony structures (from polylactic acid), and the material cost approximately US$ 1 per model. A simple plumbing endoscope was used for visualization. Dura mater injury was assessed by painting two layers on the dura mater, which peeled off with trauma. Endoscopic spine surgery is a subject of high interest in neurosurgery given its minimally invasive nature; however, it has a steep learning curve. This study evaluated the effectiveness of a cost-efficient 3D-printed model when teaching this technique to neurosurgery residents. Only a few studies have investigated the efficacy of such a model. Eight residents with >2 years of training participated. Residents performed the procedure bilaterally and twice at 1-week intervals. From the 32 surgeries, four were excluded because of facet removal (as it widened the surgical corridor), leaving 28 surgeries for analysis. Initial surgeries demonstrated a mean operation time of 21 minutes 18 seconds (standard deviation [SD], 2 minutes 32 seconds), which improved to a mean of 6 minutes 45 seconds (SD, 37 seconds) in the fourth surgery (F(3, 17)=19.18, p <0.0001), demonstrating a significant reduction in surgical time over successive surgeries. The median area with the paint removed decreased, from 161.80 (85.55-217.83) to 95.13 mm2 (12.62-160.54), (F(2.072, Inf)=2.04, p =0.128); however, this was not significant. Resident feedback indicated high satisfaction with the educational value of the model. The developed fully 3D-printed model provides a viable and scalable option for neurosurgical training programs, enhancing the learning experience while maintaining low costs. This model may be an excellent stepping stone for learning lumbar spine endoscopy, acclimating to the two-dimensional view, progressing to cadaver models, and, eventually, independent surgery.

Feasibility of augmented reality using dental arch-based registration applied to navigation in mandibular distraction osteogenesis: a phantom experiment

ObjectiveDistraction osteogenesis is a primary treatment for severe mandibular hypoplasia. Achieving the ideal mandible movement direction through precise distraction vector control is still a challenge in this surgery. Therefore, the aim of this study was to apply Optical See-Through (OST) Augmented Reality (AR) technology for intraoperative navigation during mandibular distractor installation and analyze the feasibility to evaluate the effectiveness of AR in a phantom experiment.MethodsPhantom was made of 3D-printed mandibular models based on preoperative CT scans and dental arch scans of real patients. Ten sets of 3D-printed mandible models were included in this study, with each set consisting of two identical mandible models assigned to the AR group and free-hand group. 10 sets of mandibular distraction osteogenesis surgical plans were designed using software, and the same set of plans was shared between the AR and free-hand groups. Surgeons performed bilateral mandibular distraction osteogenesis tasks under the guidance of AR navigation, or the reference of the preoperative surgical plan displayed on the computer screen. The differences in angular errors of distraction vectors and the distance errors of distractor positions under the guidance of the two methods were analyzed and compared.Results40 distractors were implanted in both groups, with 20 cases in each. In intra-group comparisons between the left and right sides, the AR group exhibited a three-dimensional spatial angle error of 1.88 (0.59, 2.48) on the left and 2.71 (1.33, 3.55) on the right, with P = 0.085, indicating no significant bias in guiding surgery on both sides of the mandible. In comparisons between the AR group and the traditional free-hand (FH) group, the average angle error was 1.94 (1.30, 2.93) in the AR group and 5.06 (3.61, 9.22) in the free-hand group, with P < 0.0001, resulting in a 61.6% improvement in accuracy. The average displacement error was 1.53 ± 0.54 mm in the AR group and 3.56 ± 1.89 mm in the free-hand group, with P < 0.0001, indicating a 57% improvement in accuracy.ConclusionAugmented Reality technology for intraoperative navigation in mandibular distraction osteogenesis is accurate and feasible. A large randomized controlled trial with long-term follow-up is needed to confirm these findings.Trial RegistrationThe project has been registered with the Chinese Clinical Trial Registry, with registration number ChiCTR2300068417. Date of Registration: 17 February 2023.

Comparative Micro-CT Analysis of Minimally Invasive Endodontic Systems Using 3D-Printed Replicas and Natural Teeth.

(1) Background: This study aimed to compare the shaping abilities of modern minimally invasive endodontic systems using natural teeth and 3D-printed resin replicas. These replicas offer a standardized approach for studying root canal preparation while eliminating the variability and scarcity of natural teeth. (2) Methods: Eleven mandibular molars with Vertucci class IV anatomy and their 3D-printed replicas (n = 132 canals) were scanned using micro-CT before and after preparation with six rotary systems. Shaping abilities were assessed by comparing volume, surface area, and unprepared areas between natural teeth and their 3D replicas, focusing on the apical third. Statistical analysis included the Shapiro-Wilk test to assess data normality and ANOVA and t-tests to compare different endodontic systems. (3) Results: Both qualitative and quantitative analyses revealed high similarity between natural teeth and 3D replicas. No significant differences in volume or surface area were found except in the apical third, where 3D replicas showed slightly larger increases in volume. (4) Conclusions: 3D resin replicas closely mimic natural teeth and provide a practical tool for assessing the shaping abilities of endodontic systems. This study demonstrates that 3D-printed models are suitable for endodontic research, offering a standardized and accessible alternative to natural teeth.

Pre-Surgical Planning Using Virtual And 3D Printing Model as Guidance for SECONDARY Mandible Reconstruction with Bone Graft: A Case Report

Reconstruction of mandibular defects due to trauma or tumor resection is a significant challenge for surgeons, given the unique and variable shape of the mandible in terms of curvature, length, and height. Numerous techniques have been developed to achieve both aesthetic and functional outcomes. This case report presents a 28-year-old patient with mandibular irregularity following ameloblastoma dissection, which was reconstructed with non-vascularized bone grafts (NBGs) from the left iliac crest approximately 10 years ago. Prior to our procedure, virtual planning and 3D modeling were employed to accurately assess the bone defect. After debridement, a 5 cm defect was identified, and NBGs were harvested from the right iliac crest for reconstruction. NBGs are commonly used for small mandibular defects (&lt;6 cm), non-continuity defects, and benign pathologies, and they can be performed in centers without microsurgical expertise. The use of virtual planning and 3D printing enables the surgical team to thoroughly study the case, anticipate potential issues, and improve precision, resulting in better outcomes and reduced operative time. NBGs, guided by virtual planning and 3D modeling, prove to be an effective technique in reducing surgical time and minimizing the risk of failure during the postoperative recovery period.

Simulation training for invasive cardiovascular procedures: the Heart-SIMS-1 study

Abstract Introduction Interventional cardiology training has a long learning curve and exposes patients and clinicians to undesirable procedural risks. We aim to assess whether mentored simulation-based training with three dimensional (3D) printed models can improve the procedural skills and safety performance of beginners in coronary diagnostic procedures. Methods Twenty-nine final-year medical students from a single centre were lectured in the basic principles of invasive coronary angiography (ICA) for one-hour, and then randomized to conventional training or simulation training. Conventional training (n=15) consisted in watching a 20-minute video demonstrating all ICA steps in a 3D-printed coronary simulator. Simulation training (n=14) offered the same explanations in a hands-on training session with the 3D-printed model, in pairs, for 20 minutes. The co-primary endpoint was efficacy and safety of performing a simulated ICA in the 3D-printed simulator, installed under sterile drapes, in a conventional angiography suite. Efficacy and safety were graded by a blinded investigator using a pre-specified performance checklist, including the identification of procedural "red flags", graded 0-100%. The secondary endpoint was theoretical knowledge, assessed in a 25-question multiple-choice quiz, graded 0-100%. Results All participants completed the training and evaluation phases. Both elements of the co-primary endpoint were superior in the simulation group: efficacy score of 91.5 ± 3.8 vs 64.6 ± 8.3% and safety score 100.0 (100.0-100.0) vs 62.5 (20.8-79.2) %, p&amp;lt;0.001. The median number of "red flags" were 2 (1-4) in conventional and 0 (0-0) in simulation training recipients (p&amp;lt;0.001). Secondary endpoint was higher in simulation training: 85.7 ± 9.0 vs 76.8 ± 12.7% (p=0.039). Conclusion Mentored simulation-based training of medical students in ICA with 3D-printed models resulted in improved performance regarding efficacy, procedural safety, and theoretical knowledge.ResultsSimulation and evaluation setup

A promising pullulan/PLA composite: Influence of pullulan in the scaffolds morphology constructed by 3D printing

AbstractManufacturing three‐dimensional scaffolds with significant rough and porous structures is advantageous in tissue regeneration approaches influencing cell growth. Thus, this work aims to study the effect of using different Pullulan contents (PULL) in the poly(lactic) acid (PLA) matrix for 3D printing scaffolds. PLA composites filler with PULL (5 and 10% wt.) were prepared in a thermokinetic mixer, extruded in a machine, and then used to print samples using a fused deposition modeling (FDM) 3D printer. The prepared filaments and scaffolds were characterized using Field emission scanning electron microscopy (FESEM), Fourier‐transform infrared spectroscopy (FTIR), thermogravimetry analyses (TGA), water contact angle (WCA), differential scanning calorimetry (DSC), and hardness techniques. The insertion of PULL into the PLA matrix influenced the increase in diameter and roughness, and density reduction of the composite filaments compared to pristine PLA. Furthermore, the filler promoted an increase in thermal stability, shore hardness, and the development of promising morphological characteristics for cell growth because the walls of the scaffolds are more robust and have more regular‐sized holes. The scaffold fabrication reinforced with 10% PULL presented high surface roughness (up to 1022% if compared with pristine PLA), and open pores can be confirmed successfully compared to pristine PLA. Thus, the use of PULL as a filler in a PLA matrix guarantees the development of composite scaffolds with improved morphological and hardness properties, which could allow the possibility of future research into the application of the proposed material (10% wt. PULL) as an ecologically correct and biocompatible alternative for application in tissue engineering.