Printed titanium implants in UK craniomaxillofacial surgery. Part I: access to digital planning and perceived scope for use in common procedures.

Autor: Goodson AMC; Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom. Electronic address: Alex.goodson@southwales.ac.uk., Parmar S; University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom. Electronic address: Sat.Parmar@uhb.nhs.uk., Ganesh S; Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom. Electronic address: siva.ganesh@southwales.ac.uk., Zakai D; Health Education England (West Midlands), 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, United Kingdom. Electronic address: dzakai@doctors.org.uk., Shafi A; NHS Education for Scotland, Westport 102, West Port, Edinburgh, EH3 9DN, United Kingdom. Electronic address: ahadshafi@nhs.net., Wicks C; Health Education England (South West), Park House, Newbrick Rd, Stoke Gifford, Bristol BS34 8YU, United Kingdom. Electronic address: cewicks@doctors.org.uk., O'Connor R; Health Education England (East Midlands), Westbridge Place, 1 Westbridge Close, Leicester, LE3 5DR, United Kingdom. Electronic address: rory.oconnor@nuh.nhs.uk., Yeung E; Health Education England (South London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom. Electronic address: elizabethyeung@nhs.net., Khalid F; Health Education England (North West), 3 Piccadilly Place, Manchester, M1 3BN, United Kingdom. Electronic address: fkhalid1@nhs.net., Tahim A; Health Education England (North Central and East London, North West London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom. Electronic address: arpantahim@doctors.org.uk., Gowrishankar S; Health Education England (Thames Valley), Chancellor Court, John Smith Drive, Oxford Business Park, Oxford, OX4 2GX, United Kingdom. Electronic address: Siddharth.gowrishankar@ouh.nhs.uk., Hills A; Health Education England (Kent, Surrey & Sussex), 7 Bermondsey Street, London, SE1 2DD, United Kingdom. Electronic address: alexanderhills1@nhs.net., Williams EM; Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom. Electronic address: mark.williams@southwales.ac.uk.
Jazyk: angličtina
Zdroj: The British journal of oral & maxillofacial surgery [Br J Oral Maxillofac Surg] 2021 Apr; Vol. 59 (3), pp. 312-319. Date of Electronic Publication: 2020 Aug 21.
DOI: 10.1016/j.bjoms.2020.08.087
Abstrakt: This first part of a two-part study examines perceived applications for and barriers to using printed titanium in light of current caseloads, funding pathways, and use of digital planning. It aims to demonstrate the scope for printed titanium in modern practice and to guide industry about the needs of UK surgeons. A cross-sectional study over 14 weeks was performed electronically with support from the British Association of Oral and Maxillofacial Surgeons (BAOMS) and a national trainee-led recruitment team. Ethics approval was obtained at the lead centre. A total of 132 participants joined the study (70% consultants, 25% specialty registrars, and 5% other), approximating a 29% response rate from consultant/registrar BAOMS members throughout mainland UK. Eighty-eight per cent used CAD-CAM design, with highly variable funding/access, design/manufacturing workflows (in-house/outsourced). Eighty-eight per cent were involved with trauma, 61% with orthognathic, and 52% with oncology-reconstruction surgery. Favourite applications for printed titanium were orbital floor repair (89%) and free-flap jaw reconstruction (87%). Most participants also cited maxillary/zygomatic osteotomies and cranioplasty (range 61%-73%). Although a popular application (78%), the evidence base in temporomandibular joint surgery is limited. Those performing orthognathic surgery perceived more indications than those who did not (p=0.013). Key barriers included cost, turnaround time and logistics, and the need to be trained in traditional techniques. Printed titanium was useful for both common and niche procedures, but was specifically limited in emergency trauma. Most surgeons had experience in CAD-CAM surgery but technical understanding appeared unclear. Limiting factors included variable funding and production pathways, perceived costs, and logistics, but in-house design can minimise them. In part II, we quantify perceived benefits and limitations and whether surgeons' understanding and knowledge are sufficient to rationalise them.
(Copyright © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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