VSP® Technology

12.27.16

VSP® Cranial

The VSP Cranial product applies virtual surgical planning techniques to craniofacial cases, especially procedures related to craniosynostosis and cases that require cranial vault distraction. Online webmeeting sessions allow for planning of complex osteotomies and detailed repositioning of bony segments.  A range of age matched normative data can be digitally overlaid to help establish normal reference contour for these challenging patients. Various types of images, measurements, models, marking guides and positioning guide are then manufactured to transfer the digital plan to the operating room.

Features and Benefits

    Accurate pre-surgical visualization of cuts and movements Real-time comparison to age-matched normative anatomical contour Personalized marking and positioning guides for realization of digital plan

 


 

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07.27.16

Jaw in a Day®

Introducing Single Stage Dental Rehabilitation using VSP Reconstruction

This new addition to the VSP Reconstruction product line allows for immediate placement of a provisional dental prosthesis during a single-stage free tissue transfer jaw reconstruction surgery.The surgical planning along with guide and prosthesis designs are completed using state-of-the-art CAD/CAM technology, allowing the patient to emerge after a single surgery with a full jaw reconstruction, including dental rehabilitation.

 

Jaw in a Day is a registered trademark of David L Hirsch.

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06.13.13

VSP® Technology

3D Systems is leading the world with its vision of personalized surgery and has established a new industry segment called Virtual Surgical Planning (VSP®). Our service-based approach to personalized surgery combines expertise in medical imaging, surgical simulation and additive manufacturing. This allows surgeons of all computer backgrounds access to the most up-to-date toolbox for today’s most challenging head and neck surgical procedures. Combine a detailed virtual surgical plan with custom-engineered instrumentation and you have a winning combination of elements to ensure surgical success. Patented and clinically tested technology is available to aid surgeries ranging from trauma reconstruction of the facial skeleton to guidance of fibula free grafts to more routine orthognathic surgeries.

What is Virtual Surgical Planning?

At its most basic level, Virtual Surgical Planning (VSP®) is about utilizing medical image data to accurately plan surgery in a computer environment and then transferring that virtual plan to the patient using customized instruments. The surgeon brings his/her clinical knowledge and desired surgical plan to an online web meeting, and 3D Systems' engineers enable visualization of that plan in a virtual environment. The design team at 3D Systems then takes the completed and approved surgical plan to the next step by creating patient-specific, disposable instruments for use in the case. All of this happens in a fluid and open conversation where the surgeon has complete control of the surgical plan and the instrument design.

Virtual surgical planning is quickly becoming a standard of care for orthognathics and reconstructive maxillofacial surgeries. Common applications of this technology include:

    Orthognathic surgical planning with CAD/CAM intermediate and final splints Mandibular or maxillary reconstruction with free flaps Trauma surgery, including repositioning guides and augmented DICOM data for navigation assistance Distraction osteogenesis planning, including vector positioning and distractor placement Guidance for microtia repair using autogenous materials

VSP® Orthognathics

VSP® Microtia

 

 

VSP® Reconstruction

VSP® Distraction

 

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04.04.13

VSP® Orthognathics

3D Systems' product focused on routine orthognathic surgery is VSP® Orthognathics. Utilizing medical imaging data from a CT/CBCT, plus occlusal anatomy data, we provide a complete planning service that eliminates the need for traditional model surgery. An interactive web meeting between the surgeon and an engineer is performed to allow for simulation of the procedure, including surgically accurate placement of osteotomies and bony movements. The end result is an intermediate and final splint providing the clinical transfer of the digital plan into surgery. In addition to the splints, a case report detailing the osteotomies, movements and cephalometric movements is provided.

What is the Benefit?

At the heart of the VSP® Orthognathics product is the transition away from traditional model surgery to a more accurate, anatomically based surgical simulation method. Combine medical imaging with CT/CBCT, accurate planning of osteotomies and movements with well-fitting surgical splints, and the system removes hassle by streamlining cases and providing excellent clinical results. Surgery may be made more predictable and efficient through visualization of the anatomy through the planning process and by identifying where bony overlaps and gaps exist, all before surgery.

The Technology

More than 10 years of research and development have culminated in our streamlined product offering for orthognathic surgical planning. Keys of 3D Systems' technology include the ability to accurately integrate occlusal data from high-resolution scans of the stone models using a fiducial registration technique and their ability to fabricate guides, stents and other tools as needed for your case using additive manufacturing technologies. 3D Systems is proud to have partnered with Dolphin Imaging and their cutting-edge 3D Surgery™ software product for surgical planning in orthognathics.

Splint and Case Report Options

As the direct link to your case, the splints are highly important outputs of our system. We have the ability to design splints with a number of customizable features, such as minimizing/maximizing occlusal overlap, palatal strutting, sandwich splints (for segmental LeFort I cases) and more. Optionally for your case, 3D Systems can provide a splint made for 30-day or less intraoral use in a clear material for extended use. The surgeon will also receive a detailed case report with every set of splints, which shows the surgical plan, cephalometric movements and bony gaps/overlaps analysis.

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04.04.13

VSP® Orthognathics (2)

3D Systems' product focused on routine orthognathic surgery is VSP® Orthognathics. Utilizing medical imaging data from a CT/CBCT, plus occlusal anatomy data, we provide a complete planning service that eliminates the need for traditional model surgery. An interactive web meeting between the surgeon and an engineer is performed to allow for simulation of the procedure, including surgically accurate placement of osteotomies and bony movements. The end result is an intermediate and final splint providing the clinical transfer of the digital plan into surgery. In addition to the splints, a case report detailing the osteotomies, movements and cephalometric movements is provided.

What is the Benefit?

At the heart of the VSP® Orthognathics product is the transition away from traditional model surgery to a more accurate, anatomically based surgical simulation method. Combine medical imaging with CT/CBCT, accurate planning of osteotomies and movements with well-fitting surgical splints, and the system removes hassle by streamlining cases and providing excellent clinical results. Surgery may be made more predictable and efficient through visualization of the anatomy through the planning process and by identifying where bony overlaps and gaps exist, all before surgery.

The Technology

More than 10 years of research and development have culminated in our streamlined product offering for orthognathic surgical planning. Keys of 3D Systems' technology include the ability to accurately integrate occlusal data from high-resolution scans of the stone models using a fiducial registration technique and their ability to fabricate guides, stents and other tools as needed for your case using additive manufacturing technologies. 3D Systems is proud to have partnered with Dolphin Imaging and their cutting-edge 3D Surgery™ software product for surgical planning in orthognathics.

Splint and Case Report Options

As the direct link to your case, the splints are highly important outputs of our system. We have the ability to design splints with a number of customizable features, such as minimizing/maximizing occlusal overlap, palatal strutting, sandwich splints (for segmental LeFort I cases) and more. Optionally for your case, 3D Systems can provide a splint made for 30-day or less intraoral use in a clear material for extended use. The surgeon will also receive a detailed case report with every set of splints, which shows the surgical plan, cephalometric movements and bony gaps/overlaps analysis.

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03.25.13

VSP® Reconstruction

3D Systems' product focused on routine reconstructive surgery for the head and neck area is VSP® Reconstruction. The most popular application is for mandibular or maxillary reconstruction using the fibula free flap and other vascularized grafts. Reconstruction techniques for trauma, congenital defects or tumors of the facial skeleton also benefit from the VSP® Reconstruction product. Expertise in surgical planning, guide/template design and additive manufacturing combine to offer a product useful for improving surgeon confidence and enhancing outcomes.

What is the Benefit?

Surgeons report  that use of the VSP® Reconstruction product enables them to perform these surgeries with more confidence and a three-dimensional understanding as compared to cases without presurgical planning. Clinical articles substantiate the use of the VSP® Reconstruction templates, models and guides in helping to reduce surgical time and create more accurate reconstructions.

Distraction Osteogenesis

Planning for distraction osteogenesis includes designing placement of osteotomies, planning of distractor vectors and creation of templates for guidance of device placement, device bending and osteotomy placement. The patient’s three-dimensional anatomy is present during the planning session, and underlying teeth roots and nerves are visualized for proper distractor placement. Each case is customized to the actual distractor file you will be using during surgery.

Trauma Reconstruction

VSP® Trauma allows the surgeon to digitally reduce the fractured bony segments prior to surgery. The digitally reduced plan is transferred to the operating room through a series of models, guides, templates or digital images. We understand these are time-sensitive cases, so we make quick service a priority.

    Custom osteotomy and positioning guides can be designed specifically for your patient and your plan. Occlusal-based positioning splints are a straightforward way to achieve maximum intercuspation and establish proper jaw relationship. Digitally reduced, perfected or mirrored anatomical models can be designed for a more simplified approach to reduction.

Microtia

VSP® Microtia is a digital planning solution for autogenous ear reconstruction cases. VSP® Microtia includes planning for reconstruction with cartilage using harvest templates, suture guides and 3D custom ear shaping guides.

    Customized solutions to match patient ear type and size with patient-specific templates to guide rib cartilage harvest. Three piece ear shaping guides allow for easier visualization of anatomy and maximum efficiency in carving. 3D custom suture guide allows for easy stacking of multiple cartilage pieces and the ability to suture, pin and wire the final ear shape. The system is available exclusively through KLS Martin.

Surgical Navigation

Clinical transfer of the digital surgical plan to the patient is carried out with physical templates, models and guides, but occasionally there are cases which could benefit from the use of surgical navigation as a clinical transfer tool. 3D Systems has the ability to work in standard data formats (DICOM, STL) and with multiple manufacturers’ navigation systems.

    An altered DICOM data set can be generated and loaded into your navigation platform for real-time digital reference. If your navigation system supports three-dimensional STL file imports, this is also possible for guidance. As an adjunct to use with physical guides or used alone, this can aid cases such as pan-facial trauma reconstruction to reconstruction of the orbit or maxilla using grafts.
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03.20.13

Bibliography

Protocol
1. Xia JJ, Gateno J, Teichgraeber JF: A new clinical protocol to evaluate cranio-maxillofacial deformity and to plan surgical correction. J Oral Maxillofac Surg 67(10):2093, 2009
2. Schatz EC, Xia JJ, Gateno J: Development of a technique for recording and transferring natural head position in 3 dimensions. J Craniofacial Surg 21(5):1452-1455, 2010
3. McCormick S, Drew S: Virtual model surgery for efficient planning and surgical performance. J Oral Maxillofac Surg 69:638-644, 2011
4. Xia JJ, McGrory JK, Gateno J: A new method to orient 3-dimensional computed tomography models to the natural head position: a clinical feasibility study. J Oral Maxillofac Surg 69(3):584–591, 2011
5. Bell, RB: Computer planning and intraoperative navigation in orthognathic surgery. J Oral Maxillofac Surg 69:592-605, 2011
6. Gelesko S, Markiewicz MR, Weimer K, Bell RB: Computer-aided orthognathic surgery. Atlas Oral Maxillofacial Surg Clin N Am 20:107-118, 2012
7. Polley JW, Figueroa AA: Orthognathic positioning system: intraoperative system to transfer virtual surgical plan to operating field during orthognathics surgery. J Oral Maxillofac Surg 71: 911-920, 2013

Accuracy/Outcomes

8. Xia JJ, Phillips CV, Gateno J, Teichgraeber JF, Christensen AM, Gliddon MJ, Lemoine JJ, Liebschner MAK. Cost-effectiveness analysis for computer-aided surgical simulation in complex cranio-maxillofacial surgery. J Oral Maxillofac Surg. 64(12):1780-4, 2006
9. Xia JJ, Gateno J, Teichgraeber JF, Christensen AM, Lasky RE, Lemoine JJ, Liebschner MAK: Accuracy of a Computer-Aided Surgical Simulation (CASS) System in the Treatment of Complex Cranio-Maxillofacial Deformities: A Pilot Study. J Oral Maxillofac Surg. 65(2) 248-54, 2007
10. Xia JJ, Sheychenko L, Gateno J, Teichgraeber JF, Taylor TD, Lasky RD, English JD, Kau CH, Mcgrory KR: Outcome of computer –aided surgical simulation in the treatment of patients with craniomaxillofacial deformities. J Oral Maxillofac Surg 69(7):2014-2024, 2011
11. Hamilton T, Markiewicz MR, Jarman J: Dental outcomes in computer-aided orthognathic surgery. J Craniofac Surg 23(3):e223-e226, 2012.
12. Hsu SS, Gateno J, Bell RB, Hirsch DL, Markiewicz MR, Teichgraeber JF, Zhou X, Xia JJ: Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 71:128-142, 2013

Research / Early Development

13. Gateno J, Xia J, Teichgraeber JF, Rosen A: A new technique for the creation of a computerized composite skull model. J Oral Maxillofac Surg 61:222-227, 2003
14. Gateno J, Xia J, Teichgraeber JF: The precision of computer-generated surgical splints. J Oral Maxillofac Surg 61(7):814–817, 2003
15. Xia J, Gateno J, Teichgraeber JF: Three-dimensional computer-aided surgical simulation for maxillofacial surgery. Atlas Oral Maxillofac Surg Clinics 13:25-39, 2005
16. Gateno J, Xia J, Teichgraeber J, Christensen A, Lemoine J, Liebschner M, Gliddon M, Briggs M: Clinical feasibility of computer-aided surgical simulation in the treatment of complex cranio-maxillofacial deformities. J Oral Maxillofac Surgery. 65: 728-734, 2007.


Protocol
1. Hirsch DL, Garfein ES, Christensen AM, Weimer KA, Saadeh PB, Levine JP: Use of computer-aided design and computer-aided manufacturing to produce orthognathically ideal surgical outcomes: a paradigm shift in head and neck reconstruction. J Oral Maxillofac Surg 67:2115-2122, 2009
2. Bell RB: Computer planning and intraoperative navigation in cranio-maxillary surgery. Atlas Oral Maxillofacial Surg Clin N Am 22:135-156, 2010
3. Hanasono MM, Jacob RF, Bidaut L, Robb GL, Skoracki RJ: Midfacial reconstruction using virtual planning, rapid prototype modeling, and stereotactic navigation. Plast Reconstr Surg 126(6):2002-2006, 2010
4. Sharaf B, Levine JP, Hirsch DL, Bastidas JA, Schiff BA, Garfein ES: Importance of computer-aided design and manufacturing technology in the multidisciplinary approach to head and neck reconstruction. J Craniofac Surg 21(4):1277-1280, 2010
5. Tepper OM, Sorice S, Hershman GN, Saadeh P, Levine JP, Hirsch D: Use of virtual 3-dimensional surgery in post-traumatic craniomaxillofacial reconstruction. J Oral Maxillofac Surg 69:733-741, 2011
6. Bell, RB, Weimer KA, Dierks EJ, Buehler M, Lubek JE: Computer planning and intraoperative navigation for palatomaxillary and mandibular reconstruction with fibular free flap. J Oral Maxillofac Surg 69:724- 732, 2011
7. Bui TG, Bell RB, Dierks EJ: Technological advances in the treatment of facial trauma. Atlas Oral Maxillofacial Surg Clin N Am 20:81-94, 2012
8. Seruya M, Borsuk D, Khalifian S, Carson B, Dalesio N, Dorafshar A: Computer-aided design and manufacturing in craniosynostosis surgery. J Craniofac Surg 24: 1100-1105, 2013
9. Jacobs JMS, Dec W, Levine JP, McCarthy JG, Weimer KA, Moore K, Ceradini DJ: Best face forward: virtual modeling and custom device fabrication to optimize craniofacial vascularized composite allotransplantation. Plast. Reconstr. Surg. 131: 64, 2013
10. Matros E, Albornoz C, Rensberger M, Weimer K, Garfein E: Computer-assisted design and computer-assisted modeling technique optimization and advantages over traditional methods of osseous flap reconstruction. J Reconstr Microsurg 29(3)173-180, 2013
11. Mardini S, Alsubaie S, Cayci C, Chim H, Wetjen N: Three-dimensional preoperative virtual planning and template use for surgical correction of craniosynostosis. J Plast Reconstr & Asthetic Surg 67 (3) 336-343, 2014
12. Chim H, Wetjen N, Mardini S: Virtual surgical planning in craniofacial surgery. Semin Plast Surg 28:150-158, 2014.

Accuracy/Outcomes
13. Roser SM, Ramachandra S, Blair H, Grist W, Carlson GW, Christensen AM, Weimer KA, Steed MB: The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results. J Oral Maxillofac Surg 68:2824-2832, 2010
14. Antony AK, Chen WF, Kolokythas A, Weimer KA, Cohen MN: Use of virtual surgery and stereolithography-guided osteotomy for mandibular reconstruction with the free fibula. Plast Reconstr Surg 128(5):1080-1084, 2011
15. Markiewicz MR, Bell RB: The use of 3D imaging tools in facial plastic surgery. Facial Plast Surg Clin N Am 19:655-682, 2011
16. Haddock NT, Monaco C, Weimer KA, Hirsch DL, Levine JP, Saddeh PB: Increasing bony contact and overlap with computer-designed offset cuts in free fibula mandible reconstruction. J Craniofac Surg 2012;23: 1592-1595
17. Hanasono M, Skoracki R: Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction. Laryngoscope 000:000-000, 2012
18. Broer P, Tanna N, Franco P, Thanik V, Levine S, Garfein E, Saadeh P, Ceradini D, Hirsch D, Levine J: Ten-year evolution utilizing computer-assisted reconstruction for giant ameloblastoma. J Reconstr Microsurg 29: 173-180, 2013
19. Doscher M, Garfein E, Bent J, Tepper O: Neonatal mandibular distraction osteogenesis: converting virtual surgical planning into an operative reality. International Journal of Pediatric Otorhinolaryngology 78: 381-384, 2014
20. Saad A, Winters R, Wise MW, Dupin C, St. Hilaire H: Virtual surgical planning in complex composite maxillofacial reconstruction. Plast Reconstr Surg 132 (3): 626-633, 2013
21. Foley B, Thayer Q, Honeybrook A, McKenna S, Press S: Mandibular reconstruction using computer-aided design and computer-aided manufacturing” an analysis of surgical results. J Oral Maxillofac Surg 71: e111-e119, 2013

Case Study/Review
22. Xia JJ, Gateno J, Teichgraeber JF: A new paradigm for complex midface reconstruction: a reversed approach. J Oral Maxillofac Surg 67:693-703, 2009
23. Chandran R, Keeler GD, Christensen AM, Weimer KA, Caloss R: Application of virtual surgical planning for total joint reconstruction with a stock alloplast system. J Oral Maxillofac Surg 69:285-294, 2011
24. Markiewicz MR, Bell RB: Modern concepts in computer-assisted craniomaxillofacial reconstruction. Curr Opin Otolaryngol Head Neck Surg 19:295-301, 2011
25. Patel A, Levine J, Brecht L, Saadeh P, Hirsch DL: Digital technologies in mandibular pathology and reconstruction. Atlas Oral Maxillofacial Surg Clin N Am 20:95-106, 2012
26. Sink J, Hamlar D, Kademani D, Khariwala SS: Computer-aided stereolithography for presurgical planning in fibula free tissue reconstruction of the mandible. J Reconstr Microsurg 28:395-404, 2012
27. Haq J, Patel N, Weimer K, Matthews SN: Single stage treatment of ankylosis of the temprpmandibular joint using patient-specific total joint replacement and virtual surgical planning. British J of Oral Maxillofac Surg. 52:350-355, 2014
28. Levine J, Soo Bae J, Soares M, Brecht L, Saadeh P, Cerandini D, Hirsch D: Jaw in a day: total maxillofacial reconstruction using digital technology. Plast. Reconstr. Surg. 131:1383, 2013

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03.20.13

VSP® Microtia

VSP® Microtia is a digital planning solution for autogenous ear reconstruction cases. VSP® Microtia includes planning for reconstruction with cartilage using harvest templates, suture guides and 3D custom ear shaping guides.

    Customized solutions to match patient ear type and size with patient-specific templates to guide rib cartilage harvest. Three-piece ear shaping guides allow for easier visualization of anatomy and maximum efficiency in carving. 3D custom suture guide allows for easy stacking of multiple cartilage pieces and the ability to suture, pin and wire the final ear shape. The system is available exclusively through KLS Martin.
Read More
03.20.13

VSP® Distraction

Planning for distraction osteogenesis includes designing placement of osteotomies, planning of distractor vectors and creation of templates for guidance of device placement, device bending and osteotomy placement. The patient’s three-dimensional anatomy is present during the planning session, and underlying teeth roots and nerves are visualized for proper distractor placement. Each VSP® Distraction case is customized to the actual distractor file you will be using during surgery.

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3D Systems Healthcare 5381 South Alkire Circle, Littleton, Colorado 80127 USA | Toll Free (U.S./Canada): 1.844.643.1001 | Phone: +1.720.643.1001 | Fax: +1.720.643.1009