Desenvolvimento de um método de apoio para cirurgias de reconstrução buco-maxilo-facial auxiliadas por tecnologias tridimensionais

Abstract

This work presents the development of a method to support the planning of oral and maxillofacial reconstruction surgeries, through the application of three-dimensional technologies and additive manufacturing. Thus, it seeks to promote the use of virtual analysis in preoperative processes, given all the benefits involved, both for the dental team and for the patient, as well as the insertion of Mechanical Engineering in the medical area. To enable such development, a case was selected to apply the proposed method. The conventional methods for oral and maxillofacial reconstruction surgeries, the treatment and transformation of images in the medical field, and the additive manufacturing techniques allied to the oral and maxillofacial specialty, identified in the literature, were studied. The method developed was divided into three main stages: clinical case capture and biomodel generation; file transformation into editable formats; and application of three-dimensional technologies to support surgical planning. The medical images of the case study were captured through a traditional CT scan in a 54-year-old female patient with the condition of ankylosis of the right temporomandibular joint, who underwent surgical procedures for osteoma removal in 2015, and a fixation plate was applied on the right side of the mandible. The image exam was imported into InVesalius 3.1 software and, through segmentation of the regions of interest, the biomodel of the mandible was generated and exported in STL. Subsequently, using Rhinoceros 7 software, this file was treated, in mesh format, with the necessary corrections and adjustments to enable its fabrication by rapid prototyping. The file was then transformed into a surface, and exported in STEP format, in order to be used in CAD software during the development of solutions to support the necessary procedures. As defined by the surgeon, during the surgical planning, the possibility of developing a surgical guide to assist the low condylectomy was verified. For this, the Rhinoceros 7 software was used again, aiming to reduce the number of softwares required. The 3D modeling of the guide was then performed, taking into account the operative procedures involved, as well as the materials and equipment to be used. By exporting the files in STL format, the mandible and the guide were printed and, through physical tests, the guide was perceived as approved, promoting the acceptance of the developed method for the development of similar solutions to support planning of oral and maxillofacial reconstruction surgeries. [resumo fornecido pelo autor]