N.T.S.™ ♂ (Normocephalic Templating System: Adult Male Cranium and Mandible)

Severe maxillofacial trauma presents a daunting task for both the novice and experienced surgeon. Maxillofacial trauma such as pan-facial injuries, where standard landmarks have been lost, make it difficult to return the maxillofacial skeleton to its pre-existing form. Most practicing surgeons treating these injuries could benefit from a reliable and reusable solution for templating to aid in the treatment of severe maxillofacial trauma. 3D Systems has developed an anthropometrically normal, reusable titanium alloy skull to accomplish just this. Titanium was the material of choice based on its biocompatibility, thermal stability with repeat sterilization and its stability during repeated bending of titanium fixation plates. Use of an anthropometrically normal titanium skull is an excellent surgical adjunct in the primary management of severe maxillofacial trauma. The skull has been used in cases of pan-facial injuries, in addition to severe fractures of the frontal sinus, orbit, zygomatic-maxillary complex and edentulous maxilla. Using the titanium skull as a template for plate bending resulted in less manipulation of plates and therefore a biomechanically stronger fixation.1 In many cases, a postoperative CT was obtained, revealing excellent bony reduction and symmetry.2

1DeLong B, Weimer K, Press S: Development of an anthropometric skull for use in severe maxillofacial trauma reconstruction. AAOMS 94th Annual Meeting, San Diego, CA 2012.
2Lewallen J, Frederick J, Press S: Modifications of a halo-supported external fixator as an adjunct to complex maxillofacial trauma: a report of 10 cases. J Maxillofac Trauma 1:2-12, 2012.

N.T.S.™ ♂ Development

A combination of Steiner and COGS analyses were used to develop a set of normative values and measurements on both cephalometric and AP radiographs of a late-twenties white male. Computed tomography (CT) data with 0.4mm spatial resolution was obtained of the maxillofacial skeleton from this generally normal patient. A three-dimensional digital model of the facial skeleton was reconstructed. In an interactive planning conference between the surgeons and the engineers, a 3D model of the skeleton was osteotomized and repositioned to achieve the normal values and measurements determined by the Steiner and COGS analyses. Once normalized, the skull was then perfected to finalize dimensions, morphology and aesthetics. The digital skull was then transformed into a physical, titanium alloy model using the Electron Beam Melting (EBM) additive manufacturing technique. N.T.S.™ ♂ was developed in conjunction with Brent DeLong, DDS and Steven Press, DDS and is available exclusively through 3D Systems.

 

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