Objective and observed NecessitiesObjective and observed Necessities

Objective: Be one of the leaders in the market of the production of osseous tissue replicaand/or soft parts, and the production of implants of customized osseous tissue, from Computerized Axial Tomographies, X-rays film or MRI

Action Areas:

1ª.- The development of techniques in the preparation and study of surgical operations, which allow the surgeons, by using biomodels, made by techniques of Rapid Prototyping, to improve surgery, reducing surgery time.

2ª.- The decrease in the number of further operations and their duration due to the manufacturing of customized implants (Biocompatible materials), and to the use of Rapid Prototyping techniques which enable the surgeon to set implants as soon as possible

3ª.- the development of new bioactive technologies in the manufacturing of implants, which strengthen the osteointegration of the bone with the implant.

Osteomodel productsOsteomodel products

Replica Stage I:Getting physical Replicas in 3D, within a maximum of 2 weeks, of tissue, osseous or soft, or a

combination of both, so that the doctor can:a) Have a precise idea of the condition of the patient.b) Plan the appropriate surgical intervention.c) undertake the intervention.

Patient with adenoblastoma in the mandible

Treatment of the image to identify the affected part.

Model of Rapid Prototyping to plan appropriate intervention.

Biocompatible, not bioactive implants Stage II:Utilising the same technique used to produce replicas, with the same deadlines, we produce

implants with biocompatible and implantable material. This enables:a) to obtain personalized implants according to the need of the patient.b) The abolition of parallel interventions to obtain osseous fragments.c) A reduction in the time of intervention and of the patient recovery time.

Biocompatible and Bioactive Implants, Stage III:This is based on the same principle, but we include bioactive components (e.g. mother cells,

etc.) which allow integration, with a more effective and faster cure.

Patient with cranioencephalic trauma

3D Model taken from the medical image (e.g. CAT or MRI,…)

Plastic surgery.

Patient after

cranioplasty

Osteomodel ProductsOsteomodel Products

The production process:

Stage IFrom the CAT, resonances, etc., the hospital sends a 3D model on a magnetic support for further treatment by Osteomodel � We use a specific protocol for the production of these files for the radiologists.Sending the CD or the files to Osteomodel ftp site (osteomodel@ftp.nextvision.pt)Data processing of the gathered images, for their transformation into a cloud of dots (3D image, STL format ), which will be utilised by the manufacturing system. (SW: Mimics) Introduction of the treated images into the production system, for the manufacture of the replicas by stereolithography (SLA of 3D System), plastic sintering (SLS) and other technologies (Objet).

Stages II and IIIFrom the image transformed into cloud of dots, we obtain the negative of the osseous zone to treat (SW: 3-Matics) �By transmitting the information to the machine, we will obtain a first plastic implant for the surgeon to test with the replica produced before. (The points of fixing will be thus determined, if necessary, by the surgeon)After the surgeon has checked the implant manufactured beforehand with the counterpart, we will proceed to the manufacture of the final implant (with a biological load (Stage III) or not (Stage II)). (Metal Sintering or machining (Titanium or Peek)).

The production stagesThe production stages

Digitalisation of the medical image in 2D and obtaining a model in 3D

Process of imageand/or process of

engineering

Results : Physical

replica and/or implant

Manufacture of models

The production stagesThe production stages

Stage IStage I

Stage I : Reproduction of Osseous ModelsStage I : Reproduction of Osseous Models

CAT Images CAT Images

CD/DVDCD/DVD--FTP Treatment of the DICOM files (CAT)FTP Treatment of the DICOM files (CAT)

STL Stereolithographic Model STL Stereolithographic Model

Technique CT for StereolithographyTechnique CT for Stereolithography

Gantry tilt: 0Gantry tilt: 0ºº..

Helical technique with acquisition of 0.626 mm.Helical technique with acquisition of 0.626 mm.

Reconstruction from 0.625 to 1 mm. thickness.Reconstruction from 0.625 to 1 mm. thickness.

Overlapping of 30Overlapping of 30--50% between the images50% between the images

Reconstruction Kernel of soft parts (approx. 40).Reconstruction Kernel of soft parts (approx. 40).

Recording of the whole of images on CDRecording of the whole of images on CD--DVD format DICOM 3.0DVD format DICOM 3.0

CAT ProtocolCAT Protocol

For a perfect result and definition of the teeth, it is For a perfect result and definition of the teeth, it is preferable to use Ipreferable to use I--Cat Cat scanscan

CAT ProtocolCAT Protocol

Potential customersPotential customers

C. MaxilloC. Maxillo--facial and/or C. Plasticfacial and/or C. Plastic

Orthognatic surgery, Reconstructive surgeryOrthognatic surgery, Reconstructive surgeryTraumatismsTraumatisms

NeurosurgeryNeurosurgery

Skull Bases Tumours Skull Bases Tumours

Traumatisms (Knee), Otorhinos, Ophtalmologist (Orbit), HepatologTraumatisms (Knee), Otorhinos, Ophtalmologist (Orbit), Hepatologistist

Models for Orthognathic Surgery

Models for Reconstruction Surgery

Biomaterials Models

Maxillary Model Implantology

MAXILLOFACIAL

ApplicationApplication ExamplesExamples

SKULL BASE TUMOR

Tumor Resection Planning

ApplicationApplication ExamplesExamples

Plasties Cranial Extent PMMA

Spine Surgery Planning

NEUROSURGERY

ApplicationApplication ExamplesExamples

Model for Diagnosis, Planning, teaching patient Communication

HEPATIC

ApplicationApplication ExamplesExamples

EAR PROSTHESIS

ApplicationApplication ExamplesExamples

Implant with bar Silicone prosthesis

ApplicationApplication ExamplesExamples

BURNS SPLINT

Splint by thermoformingCAD model

Orthognatic surgery of jawbone and lifting of three partsOrthognatic surgery of jawbone and lifting of three partsThe model The model osteosynthesisosteosynthesis plates are preparedplates are prepared

4 hours duration4 hours duration

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

Example of useExample of usein Maxilloin Maxillo--facial orthognatic surgeryfacial orthognatic surgery

The advantages of preleminary The advantages of preleminary orthognatic surgeryorthognatic surgery

Real observation of the patientReal observation of the patient’’s conditions condition

PreparationPreparation of the patientof the patient’’s osteotomy with the s osteotomy with the platesplatesmodeling ready to be implanted in the operating room. The modeling ready to be implanted in the operating room. The model can be sterilized by Steris gasmodel can be sterilized by Steris gas

Simulation of the real movements of theSimulation of the real movements of the mandible through mandible through the observation of the points of impact. The points of impact the observation of the points of impact. The points of impact are laid down before.are laid down before.

Aesthetic simulationAesthetic simulation with the change of the oclusal plan.with the change of the oclusal plan.

ReductionReduction in the post surgery interventionsin the post surgery interventions

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

Example of the use inMaxillo-facial Reconstructive surgery

The advantages of the preliminary The advantages of the preliminary Reconstructive surgeryReconstructive surgery

Observation of the real patientObservation of the real patient’’s conditions condition

PreparationPreparation of the patientof the patient’’s osteotomy with the plates s osteotomy with the plates modeling ready to be implanted in the operating room.modeling ready to be implanted in the operating room.

Simulation Simulation of the real movements of the mandible by the of the real movements of the mandible by the observation of the points of impact. The points of impact are observation of the points of impact. The points of impact are laid down before.laid down before.

AestheticAesthetic simulation with the change of the oclusal plan.simulation with the change of the oclusal plan.

Reduction Reduction of the post surgery interventions.of the post surgery interventions.

Withdrawal of the fibulaWithdrawal of the fibula, necessary for the mandible. (It used as , necessary for the mandible. (It used as model in operating room)model in operating room)

SterilizationSterilization of the models to use them as guides in the real of the models to use them as guides in the real surgery.surgery.

The advantages of the preliminary Reconstructive surgery