Skip to main content

Advertisement

SpringerLink
Log in

Designing patient-specific 3D printed craniofacial implants using a novel topology optimization method

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

Large craniofacial defects require efficient bone replacements which should not only provide good aesthetics but also possess stable structural function. The proposed work uses a novel multiresolution topology optimization method to achieve the task. Using a compliance minimization objective, patient-specific bone replacement shapes can be designed for different clinical cases that ensure revival of efficient load transfer mechanisms in the mid-face. In this work, four clinical cases are introduced and their respective patient-specific designs are obtained using the proposed method. The optimized designs are then virtually inserted into the defect to visually inspect the viability of the design . Further, once the design is verified by the reconstructive surgeon, prototypes are fabricated using a 3D printer for validation. The robustness of the designs are mechanically tested by subjecting them to a physiological loading condition which mimics the masticatory activity. The full-field strain result through 3D image correlation and the finite element analysis implies that the solution can survive the maximum mastication of 120 lb. Also, the designs have the potential to restore the buttress system and provide the structural integrity. Using the topology optimization framework in designing the bone replacement shapes would deliver surgeons new alternatives for rather complicated mid-face reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Adachi T, Osako Y, Tanaka M, Hojo M, Hollister SJ (2006) Framework for optimal design of porous scaffold microstructure by computational simulation of bone regeneration. Biomaterials 27(21):3964–3972

    Article  CAS  PubMed  Google Scholar 

  2. Andrades P, Militsakh O, Hanasono MM, Rieger J, Rosenthal EL (2011) Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg 137(8):806–812

    Article  PubMed  PubMed Central  Google Scholar 

  3. Antony AK, Chen WF, Kolokythas A, Weimer KA, Cohen MN (2011) Use of virtual surgery and stereolithography-guided osteotomy for mandibular reconstruction with the free fibula. Plast Reconstr Surg 128(5):1080–1084

    Article  CAS  PubMed  Google Scholar 

  4. Bandyopadhyay A, Espana F, Balla VK, Bose S, Ohgami Y, Davies NM (2010) Influence of porosity on mechanical properties and in vivo response of ti6al4v implants. Acta Biomater 6(4):1640–1648

    Article  CAS  PubMed  Google Scholar 

  5. Bendsoe MP, Sigmund O (1999) Material interpolation schemes in topology optimization. Arch Appl Mech 69(9–10):635–654

    Google Scholar 

  6. Bendsoe MP, Sigmund O (2003) Topology optimization theory, methods and applications. Springer, Berlin

    Google Scholar 

  7. Bidra AS, Jacob RF, Taylor TD (2012) Classification of maxillectomy defects: a systematic review and criteria necessary for a universal description. J Prosthet Dent 107(4):261–270

    Article  PubMed  Google Scholar 

  8. Bluebond-Langner R, Rodriguez ED (2009) Application of skeletal buttress analogy in composite facial reconstruction. Craniomaxillofac Trauma Reconstr 2(1):19–25

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cordeiro PG, Chen CM (2012) A 15-year review of midface reconstruction after total and subtotal maxillectomy: part II. technical modifications to maximize aesthetic and functional outcomes. Plast Reconstr Surg 129(1):139–147

    Article  CAS  PubMed  Google Scholar 

  10. Cordeiro PG, Santamaria E (2000) A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg 105(7):2331–2346 (discussion 2347–8)

    Article  CAS  PubMed  Google Scholar 

  11. Cypher TJ, Grossman JP (1996) Biological principles of bone graft healing. J Foot Ankle Surg 35(5):413–417

    Article  CAS  PubMed  Google Scholar 

  12. Dalgorf D, Higgins K (2008) Reconstruction of the midface and maxilla. Curr Opin Otolaryngol Head Neck Surg 16(4):303–311

    Article  PubMed  Google Scholar 

  13. Derand P, Rannar LE, Hirsch JM (2012) Imaging, virtual planning, design, and production of patient-specific implants and clinical validation in craniomaxillofacial surgery. Craniomaxillofac Trauma Reconstr 5(3):137–144

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dobbe JGG, Vroemen JC, Strackee SD, Streekstra GJ (2013) Patient-tailored plate for bone fixation and accurate 3d positioning in corrective osteotomy. Med Biol Eng Comput 51(1–2):19–27

    Article  CAS  PubMed  Google Scholar 

  15. El-Hajje A, Kolos EC, Wang JK, Maleksaeedi S, He Z, Wiria FE, Choong C, Ruys AJ (2014) Physical and mechanical characterisation of 3d-printed porous titanium for biomedical applications. J Mater Sci Mater Med 25(11):2471–2480

    Article  CAS  PubMed  Google Scholar 

  16. Elsalanty ME, Genecov DG (2009) Bone grafts in craniofacial surgery. Craniomaxillofac Trauma Reconstr 2(3):125–134

    Article  PubMed  PubMed Central  Google Scholar 

  17. Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, Thomas JR (2010) Cummings otolaryngology—head and neck surgery, 5th edn. Elsevier Health Sciences, Amsterdam

    Google Scholar 

  18. Futran ND, Mendez E (2006) Developments in reconstruction of midface and maxilla. Lancet Oncol 7(3):249–258

    Article  PubMed  Google Scholar 

  19. Genden EM (2010) Reconstruction of the mandible and the maxilla: the evolution of surgical technique. Arch Facial Plast Surg 12(2):87–90

    Article  PubMed  Google Scholar 

  20. Gruss JS, Mackinnon SE (1986) Complex maxillary fractures: role of buttress reconstruction and immediate bone grafts. Plast Reconstr Surg 78(1):9–22

    Article  CAS  PubMed  Google Scholar 

  21. Hanasono MM, Silva AK, Yu P, Skoracki RJ (2013) A comprehensive algorithm for oncologic maxillary reconstruction. Plast Reconstr Surg 131(1):47–60

    Article  CAS  PubMed  Google Scholar 

  22. He Y, Zhu HG, Zhang ZY, He J, Sader R (2009) Three-dimensional model simulation and reconstruction of composite total maxillectomy defects with fibula osteomyocutaneous flap flow-through from radial forearm flap. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108(6):e6–e12

    Article  PubMed  Google Scholar 

  23. Hilloowala R, Kanth H (2007) The transmission of masticatory forces and nasal septum: structural comparison of the human skull and gothic cathedral. Cranio 25(3):166–171

    Article  PubMed  Google Scholar 

  24. Hollister SJ (2009) Scaffold design and manufacturing: from concept to clinic. Adv Mater 21(32–33):3330–3342

    Article  CAS  PubMed  Google Scholar 

  25. Hollister SJ, Maddox RD, Taboas JM (2002) Optimal design and fabrication of scaffolds to mimic tissue properties and satisfy biological constraints. Biomaterials 23(20):4095–4103

    Article  CAS  PubMed  Google Scholar 

  26. Kang H, Lin CY, Hollister SJ (2010) Topology optimization of three dimensional tissue engineering scaffold architectures for prescribed bulk modulus and diffusivity. Struct Multidiscipl Optim 42(4):633–644

    Article  Google Scholar 

  27. Koolstra JH (2002) Dynamics of the human masticatory system. Crit Rev Oral Biol Med 13(4):366–376

    Article  CAS  PubMed  Google Scholar 

  28. Manson PN, Hoopes JE, Su CT (1980) Structural pillars of the facial skeleton: an approach to the management of le fort fractures. Plast Reconstr Surg 66(1):54–62

    Article  CAS  PubMed  Google Scholar 

  29. McCarthy CM, Cordeiro PG (2010) Microvascular reconstruction of oncologic defects of the midface. Plast Reconstr Surg 126(6):1947–1959

    Article  CAS  PubMed  Google Scholar 

  30. McElhaney JH, Fogle JL, Melvin JW, Haynes RR, Roberts VL, Alem NM (1970) Mechanical properties of cranial bone. J Biomech 3(5):495

    Article  CAS  PubMed  Google Scholar 

  31. Nagasao T, Nakajima T, Kimura A, Kaneko T, Jin H, Tamaki T (2005) The dynamic role of buttress reconstruction after maxillectomy. Plast Reconstr Surg 115(5):1328–1340 discussion 1341

    Article  CAS  PubMed  Google Scholar 

  32. Neumann A, Kevenhoerster K (2009) Biomaterials for craniofacial reconstruction. GMS Curr Top Otorhinolaryngol Head Neck Surg 8:Doc08

    PubMed  Google Scholar 

  33. Nguyen TH, Paulino GH, Song J, Le CH (2010) A computational paradigm for multiresolution topology optimization (mtop). Struct Multidiscipl Optim 41(4):525–539

    Article  Google Scholar 

  34. Park J, Sutradhar A (2015) A multi-resolution method for 3d multi-material topology optimization. Comput Methods Appl Mech Eng 285:571–586

    Article  Google Scholar 

  35. Rudderman RH, Mullen RL (1992) Biomechanics of the facial skeleton. Clin Plast Surg 19(1):11–29

    CAS  PubMed  Google Scholar 

  36. Shen H, Brinson LC (2011) A numerical investigation of porous titanium as orthopedic implant material. Mech Mater 43(8):420–430

    Article  Google Scholar 

  37. Shen Y, Sun J, Li J, Li MM, Huang W, Ow A (2012) Special considerations in virtual surgical planning for secondary accurate maxillary reconstruction with vascularised fibula osteomyocutaneous flap. J Plast Reconstr Aesthet Surg 65(7):893–902

    Article  PubMed  Google Scholar 

  38. Sutradhar A, Park J, Carrau D, Miller MJ (2014) Experimental validation of 3d printed patient-specific implants using digital image correlation and finite element analysis. Comput Biol Med 52:8–17

    Article  PubMed  Google Scholar 

  39. Sutradhar A, Paulino GH, Miller MJ, Nguyen TH (2010) Topological optimization for designing patient-specific large craniofacial segmental bone replacements. Proc Natl Acad Sci USA 107(30):13222–13227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Wang S, de Sturler E, Paulino GH (2007) Large-scale topology optimization using preconditioned Krylov subspace methods with recycling. Int J Numer Methods Eng 69(12):2441–2468

    Article  Google Scholar 

  41. Yamamoto Y, Kawashima K, Sugihara T, Nohira K, Furuta Y, Fukuda S (2004) Surgical management of maxillectomy defects based on the concept of buttress reconstruction. Head Neck 26(3):247–256

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This material is based upon work supported by the National Science Foundation under Grant No. 1032884. Diana Carrau was supported by the MD Student Research Fellowship from College of Medicine, Ohio State University.

Author information

Authors and Affiliations

  1. Department of Plastic Surgery, The Ohio State University, Columbus, OH, 43210, USA

    Alok Sutradhar, Diana Carrau & Michael J. Miller

  2. Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, 43210, USA

    Alok Sutradhar & Jaejong Park

  3. Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, 02115, USA

    Tam H. Nguyen

  4. School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA

    Glaucio H. Paulino

Authors
  1. Alok Sutradhar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaejong Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Diana Carrau
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tam H. Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael J. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Glaucio H. Paulino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alok Sutradhar.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sutradhar, A., Park, J., Carrau, D. et al. Designing patient-specific 3D printed craniofacial implants using a novel topology optimization method. Med Biol Eng Comput 54, 1123–1135 (2016). https://doi.org/10.1007/s11517-015-1418-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-015-1418-0

Keywords

Search

Navigation