VSP Craniomaxillofacial Solutions

Craniomaxillofacial Surgical Planning

3D Systems' VSP^® surgical planning solutions for craniomaxillofacial (CMF) applications received FDA clearance as a service-based approach to personalized surgery over 10 years ago.

3D Systems and Stryker Corporation have partnered to provide surgeons with best-in-class products and services for craniomaxillofacial surgeries. As a leader in personalized healthcare solutions, 3D Systems has planned and delivered devices for more than 140,000 patient-specific cases. The Stryker Craniomaxillofacial business specializes in providing patient-specific options and innovative solutions that help drive efficiencies in surgical suites. The combination of Stryker’s specialized team and advanced implants with 3D Systems' cutting-edge 3D printing technologies and expert consulting services positions both companies to provide a superior level of service to healthcare professionals who use these revolutionary solutions.

More about VSP Guide Options >>

Craniomaxillofacial Applications

This complete planning service eliminates the need for traditional model surgery. The first step is an interactive web meeting between the surgeon and an engineer where they simulate the procedure, including surgically accurate placement of osteotomies and bony movements. The result is an intermediate and final splint providing the clinical transfer of the digital plan into surgery. Splints are designed with several customizable features, such as minimizing/maximizing occlusal overlap, palatal strutting, sandwich splints, and more. Final surgical splints are produced in a clear material approved for up to 30 days of intraoral use. Additional patient-specific surgical guides can also be produced as required.

VSP Orthognathics solution provides a variety of guide options

This surgical planning solution is intended for head and neck reconstruction. The most widely used application is for mandibular or maxillary reconstruction using the fibula free flap and other vascularized grafts. It can also be used for reconstruction techniques for trauma, congenital defects or tumors of the facial skeleton. Surgeons report that use of the VSP Reconstruction solution enables them to perform these surgeries with more confidence and a three-dimensional perspective as compared to cases without pre-surgical planning. Dozens of peer reviewed journal articles substantiate the use of the VSP Reconstruction models, guides, and templates to reduce surgical time and create more accurate reconstructions.

Benefits

Surgeons report that use of the VSP Reconstruction product enables them to perform these surgeries with more confidence and a 3D understanding as compared to cases without pre-surgical planning. Dozens of peer reviewed journal articles substantiate the use of the VSP Reconstruction templates, models and guides in helping to reduce surgical time and create more accurate reconstructions.

Deliverables

Reconstructed model of the anatomy showing the proposed post-operative outcome with graft in place.
Patient specific resection guide(s) for the maxilla and/or mandible, to allow accurate transfer of the digital plan.
Graft osteotomy guide for the donor site that contains precise osteotomies to create closing wedges, if needed.
Metal instrument(s) that fit into the resection or osteotomy guides to provide for more accurate osteotomies and eliminate debris.

Demo of 3D print rendering of a jaw reconstruction

VSP Reconstruction mandible model with pre-planned cut lines

This solution applies proven and FDA-cleared virtual surgical planning techniques to craniofacial cases, especially procedures related to craniosynostosis and cases that require cranial vault distraction. Building on the success of the renowned VSP surgical planning solutions, VSP Cranial delivers improved surgical outcomes to surgeons by providing accurate pre-surgical visualization of cuts and movements, real-time comparison to age-matched normative anatomical contour, and personalized marking and positioning guides for realization of a digital plan.

VSP Cranial provides advanced visualization for pre-surgical planning

These surgical planning solutions for distraction osteogenesis include 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 3D anatomy is reviewed 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 to be used during surgery. Some uses of VSP Distraction include osteotomy placement, identifying a distraction vector plan, creation of templates to guide device placement, and facilitation of pre-operative hardware set up.

VSP Distraction anatomic models with guides

VSP Distraction enables osteotomy planning

This solution 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. Since these are typically time-sensitive cases, 3D Systems makes quick service a priority. Deliverables for VSP Trauma cases include patient-specific osteotomy and positioning guides, occlusal-based positioning splints, and digitally reduced, perfected or mirrored anatomic models. Modified DICOM can be produced based on the surgical plan for use in intraoperative stereotactic navigation systems.

Facilitating trauma reduction surgery with repositioning guides

Jaw in a Day^® enables 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, is 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.

Technical Requirements

Fine-cut CMF and fibula donor site CT scans (protocols available).
Occlusal stone models and/or intraoral occlusal scans.
Completed order form.
Lead-time is 3-4 weeks from receipt of data to surgery.

Clinical Considerations

Patient selection considerations:
- Benign lesions
- Minimal soft tissue loss
- Bone loss of greater than 6cm
Fibula guide must be reproduced perfectly on the fibula (using special features/shape of guide).
Consider using tooth-borne resection guides.
Implants with guided system must be tapped and at bone level.
Occlusal splint is a must.
Provide enough room for bone, soft tissue, and prosthesis to fit comfortably (about 12mm mini-mum clearance from FFF to opposing dental arch).
Custom reconstruction plate recommended, though may be slightly more difficult to inset with dental prosthesis.

Jaw in a Day allows for immediate placement of a provisional dental prosthesis

Protocols
Journal References

VSP Guide Options

3D Systems is always innovating its products and services to address the needs of surgeons performing maxillofacial and reconstructive surgeries. 3D Systems’ surgical guide options offer unprecedented flexibility in design and are capable of having lower profile designs to enhance visibility and access in the surgical site, while also possessing improved strength and rigidity.

Hybrid Guides

Multi-material benefits: Low profile, easy guide placement, and more

The latest enhancement to the surgical planning solutions portfolio, VSP Hybrid Guides provide you with occlusal registration from a nylon guide for accurate placement plus the increased strength and rigidity¹ of a titanium cutting and drilling guide. These guides are assembled with easy-to-use connection sites that are engineered to confirm a proper connection. Depending on your preference, patient-specific instruments can be designed that allow multiple cutting and drilling locations on a single occlusal-based guide.
Titanium Guides

Material made 20x stronger¹; enables customization, increased visualization, lower profile

With titanium, you can experience increased strength over our traditional guides, allowing cutting and drilling directly through the guides. Maximize functionality of the guides by altering cut slots to match your surgical blade. Choose the height of your drill guide and cutting slots to control trajectory or reduce guide profile height. With slimmer profiles, the guides can provide easier placement in areas with limited exposure plus increased visibility with the new cellular structure.
Nylon Guides

Material made 88% tougher¹, customized by you, for you.

Nylon guides can better withstand mechanical forces, providing an improved performance. Select occlusal or bone-borne guides to fit your surgical needs. Further customize the guides with optional features such as nasal floor registration. Slimmer profile guides can provide easier placement in areas with limited exposure. Improve your visibility of the surgical site with lower profiles and a new cellular structure design which can help you better see anatomy.
Photopolymer

Proven since the start, the original guide.

Used in thousands of cases, our traditional guide helped create the personalized medicine approach. Designed from the VSP session, these surgical guides are the physical output of the pre-planned surgery. They can assist you with patient-specific marking, positioning, and osteotomy decisions in the OR.

References:

1: Data compared to 3D Systems’ Traditional cutting and marking guides. Proprietary mechanical validation testing data on file at 3D Systems.

VSP End-to-End Workflow in Action

Integrating precision healthcare with 3D technologies for better surgical outcomes

Digitize

Process patient-specific medical data into a digital 3D model
Plan

Schedule online surgical planning meeting between surgeon and 3D Systems biomedical engineer
Design

Create patient-specific 3D models, guides and templates
Manufacture

3D print models and guides to smoothly transition surgical plan into operating room
Inspect

Put models through 3D Systems’ intensive quality control system
Deliver

Transfer virtual plan to the operating room with patient-specific models and guides

Download the VSP Infographic

Complete an Order

Uploading your files to begin a case is an easy 2 step process. Step 1, upload medical imaging data by clicking on the link below. Step 2, download and complete the order form and email it to vsp@3dsystems.com. Having trouble? Contact our support team via email vsp@3dsystems.com or call our offices for assistance +1 720 643 1001.

Step 1

Upload Patient's CT scans with the DICOM image upload tool. We recommend that you zip your DICOM folder into one zip file and then send that zip file.

Upload your Medical Data
Step 2

Download and complete your order form.