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Microwave-assisted fabrication of titanium implants with controlled surface topography for rapid bone healing

Kutty MG, De A, Bhaduri SB, Yaghoubi A

ACS Appl Mater Interfaces, 2014 Aug 27;6(16):13587-93.
PMID: 25095907 DOI: 10.1021/am502967n

Morphological surface modifications have been reported to enhance the performance of biomedical implants. However, current methods of introducing graded porosity involves postprocessing techniques that lead to formation of microcracks, delamination, loss of fatigue strength, and, overall, poor mechanical properties. To address these issues, we developed a microwave sintering procedure whereby pure titanium powder can be readily densified into implants with graded porosity in a single step. Using this approach, surface topography of implants can be closely controlled to have a distinctive combination of surface area, pore size, and surface roughness. In this study, the effect of various surface topographies on in vitro response of neonatal rat calvarial osteoblast in terms of attachment and proliferation is studied. Certain graded surfaces nearly double the chance of cell viability in early stages (∼one month) and are therefore expected to improve the rate of healing. On the other hand, while the osteoblast morphology significantly differs in each sample at different periods, there is no straightforward correlation between early proliferation and quantitative surface parameters such as average roughness or surface area. This indicates that the nature of cell-surface interactions likely depends on other factors, including spatial parameters.

Matched MeSH terms: Prostheses and Implants*
Fulltext Missing Tooth: A New Technique to Maintain the Space for Prosthetic Replacement During Orthodontic Treatment - A Report of Two Cases

Radzi, Z., Yahya, N.A., Zamzam, N., Spencer, R.J.

Ann Dent, 2004;11(1):-.
MyJurnal

Missing teeth can be due to hypodontia, trauma or extraction. In general, the options for treatment depend on the severity of the hypodontia and the severity of the malocclusion. Occasionally, the space from missing teeth has to be maintained for prosthetic replacement and require an orthodontic/restorative approach. It is very important to ensure the space maintained is adequate for aesthetic reason so that it can be replaced with a prosthesis after the orthodontic treatment is completed. This article discusses a new innovation and clinical technique for maintaining this space during orthodontic treatment by using an acrylic tooth with several modifications. This innovation will be illustrated using two cases.

Matched MeSH terms: Prostheses and Implants
Fulltext Review on prophylactic antibiotics for dental patients with prosthetic joints

Chai WL, Yong CK, Ngeow WC

Ann Dent, 2003;10(1):22-26.
MyJurnal

Most prosthetic joint infections originate from wound contamination or haematogenous seeding from distant sites of infection. Bacteraemia may follow dental treatment but there is little evidence of it related to prosthetic joint infection. Nevertheless, controversy continues with regards to the effect of dental treatment in patients with prosthetic joints. This article reviews current English literature regarding the use of antibiotic prophylaxis in the dental management of patients with prosthetic joints. Routine antibiotic prophylaxis is not recommended for every patient with prosthetic joints when receiving dental treatments. However, antibiotic prophylaxis may be prescribed for high-risk groups with predisposing factors to infection when undergoing dental treatment with high risk of bacteraemia.

Matched MeSH terms: Prostheses and Implants*
Fulltext Maxillary implant-supported fixed detachable prosthesis : a case report

Abdul Aziz, A, Ahmad, S.F., Muslim, Y.R

Ann Dent, 2006;13(1):34-38.
MyJurnal

This clinical case report details the clinical sequence of a 78-year-old male receiving prosthetic rehabilitation using an implant-supported screwretained fixed partial denture. Despite the limitations imposed, the aesthetic and functional demands of the patient were fulfilled by this prosthetic rehabilitation. The importance of detailed prosthetic planning and evaluation prior to implant surgery is essential, therefore ideally, it should be done by the same operator or a team of operators working together. Problems can arise when the construction of the prosthesis is performed by other people who are not involved in the planning stage.

Matched MeSH terms: Prostheses and Implants
Polydopamine-assisted chlorhexidine immobilization on medical grade stainless steel 316L: Apatite formation and in vitro osteoblastic evaluation

Mohd Daud N, Hussein Al-Ashwal R, Abdul Kadir MR, Saidin S

Ann. Anat., 2018 Nov;220:29-37.
PMID: 30048761 DOI: 10.1016/j.aanat.2018.06.009

Immobilization of chlorhexidine (CHX) on stainless steel 316L (SS316L), assisted by a polydopamine film as an intermediate layer is projected as an approach in combating infection while aiding bone regeneration for coating development on orthopedic and dental implants. This study aimed to investigate the ability of CHX coating to promote apatite layer, osteoblast cells viability, adhesion, osteogenic differentiation and mineralization. Stainless steel 316L disks were pre-treated, grafted with a polydopamine film and immobilized with different concentrations of CHX (10-30mM). The apatite layer formation was determined through an in vitro simulated body fluid (SBF) test by ATR-FTIR and SEM-EDX analyses. The osteoblastic evaluations including cells viability, cells adhesion, osteogenic differentiation and mineralization were assessed with human fetal osteoblast cells through MTT assay, morphology evaluation under FESEM, ALP enzyme activity and Alizarin Red S assay. The apatite layer was successfully formed on the CHX coated disks, demonstrating potential excellent bioactivity property. The CHX coatings were biocompatible with the osteoblast cells at low CHX concentration (<20mM) with good adhesion on the metal surfaces. The increment of ALP activity and calcium deposition testified that the CHX coated disks able to support osteoblastic maturation and mineralization. These capabilities give a promising value to the CHX coating to be implied in bone regeneration area.

Matched MeSH terms: Prostheses and Implants
Fulltext A Systematic Analysis of Additive Manufacturing Techniques in the Bioengineering of In Vitro Cardiovascular Models

Mohanadas HP, Nair V, Doctor AA, Faudzi AAM, Tucker N, Ismail AF, et al.

Ann Biomed Eng, 2023 Nov;51(11):2365-2383.
PMID: 37466879 DOI: 10.1007/s10439-023-03322-x

Additive Manufacturing is noted for ease of product customization and short production run cost-effectiveness. As our global population approaches 8 billion, additive manufacturing has a future in maintaining and improving average human life expectancy for the same reasons that it has advantaged general manufacturing. In recent years, additive manufacturing has been applied to tissue engineering, regenerative medicine, and drug delivery. Additive Manufacturing combined with tissue engineering and biocompatibility studies offers future opportunities for various complex cardiovascular implants and surgeries. This paper is a comprehensive overview of current technological advancements in additive manufacturing with potential for cardiovascular application. The current limitations and prospects of the technology for cardiovascular applications are explored and evaluated.

Matched MeSH terms: Prostheses and Implants
Fulltext Patient-specific frontal titanium mesh fabrication using a moulding technique

Rengarajoo J, Harun RH, Royan SJ, Kohir S, Mamat MR

Ann R Coll Surg Engl, 2022 Jul;104(7):556.
PMID: 35174718 DOI: 10.1308/rcsann.2021.0299
Matched MeSH terms: Prostheses and Implants
Fulltext Spring loaded plunger attachment for retention of removable partial denture: a case report

Awang, R.A.R., Arief, E.M., Hassan, A.

Archives of Orofacial Sciences, 2008;3(1):32-35.
MyJurnal

Since the establishment of implant in dentistry, the use of removable partial denture in replacing missing teeth apparently becomes less popular. The situation is made worse by the renowned limitations of removable partial denture. One of the obvious limitations of removable partial denture, especially in replacing missing anterior teeth is the unsightly view of metal used for retentive clasp. This case report describes the use of spring loaded plunger attachments as an alternative way to achieve retention and at the same time improving the aesthetic of the prosthesis.

Matched MeSH terms: Prostheses and Implants
Fulltext Does laryngeal reinnervation or type I thyroplasty give better voice results for patients with unilateral vocal fold paralysis (VOCALIST): study protocol for a feasibility randomised controlled trial

Blackshaw H, Carding P, Jepson M, Mat Baki M, Ambler G, Schilder A, et al.

BMJ Open, 2017 Sep 29;7(9):e016871.
PMID: 28965097 DOI: 10.1136/bmjopen-2017-016871

INTRODUCTION: A functioning voice is essential for normal human communication. A good voice requires two moving vocal folds; if one fold is paralysed (unilateral vocal fold paralysis (UVFP)) people suffer from a breathy, weak voice that tires easily and is unable to function normally. UVFP can also result in choking and breathlessness. Current treatment for adults with UVFP is speech therapy to stimulate recovery of vocal fold (VF) motion or function and/or injection of the paralysed VF with a material to move it into a more favourable position for the functioning VF to close against. When these therapies are unsuccessful, or only provide temporary relief, surgery is offered. Two available surgical techniques are: (1) surgical medialisation; placing an implant near the paralysed VF to move it to the middle (thyroplasty) and/or repositioning the cartilage (arytenoid adduction) or (2) restoring the nerve supply to the VF (laryngeal reinnervation). Currently there is limited evidence to determine which surgery should be offered to adults with UVFP.
METHODS AND ANALYSIS: A feasibility study to test the practicality of running a multicentre, randomised clinical trial of surgery for UVFP, including: (1) a qualitative study to understand the recruitment process and how it operates in clinical centres and (2) a small randomised trial of 30 participants recruited at 3 UK sites comparing non-selective laryngeal reinnervation to type I thyroplasty. Participants will be followed up for 12 months. The primary outcome focuses on recruitment and retention, with secondary outcomes covering voice, swallowing and quality of life.
ETHICS AND DISSEMINATION: Ethical approval was received from National Research Ethics Service-Committee Bromley (reference 11/LO/0583). In addition to dissemination of results through presentation and publication of peer-reviewed articles, results will be shared with key clinician and patient groups required to develop the future large-scale randomised controlled trial.
TRIAL REGISTRATION NUMBER: ISRCTN90201732; 16 December 2015.

Matched MeSH terms: Prostheses and Implants
Fulltext Enhanced blood compatibility of metallocene polyethylene subjected to hydrochloric acid treatment for cardiovascular implants

Jaganathan SK, Mohandas H, Sivakumar G, Kasi P, Sudheer T, Avineri Veetil S, et al.

Biomed Res Int, 2014;2014:963149.
PMID: 24955370 DOI: 10.1155/2014/963149

Blood compatibility of metallocene polyethylene (mPE) was investigated after modifying the surface using hydrochloric acid. Contact angle of the mPE exposed to HCl poses a decrease in its value which indicates increasing wettability and better blood compatibility. Surface of mPE analyzed by using FTIR revealed no significant changes in its functional groups after treatment. Furthermore, scanning electron microscope images supported the increasing wettability through the modifications like pit formations and etching on the acid rendered surface. To evaluate the effect of acid treatment on the coagulation cascade, prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured. Both PT and APTT were delayed significantly (P < 0.05) after 60 min exposure implying improved blood compatibility of the surfaces. Hemolysis assay of the treated surface showed a remarkable decrease in the percentage of lysis of red blood cells when compared with untreated surface. Moreover, platelet adhesion assay demonstrated that HCl exposed surfaces deter the attachment of platelets and thereby reduce the chances of activation of blood coagulation cascade. These results confirmed the enhanced blood compatibility of mPE after HCl exposure which can be utilized for cardiovascular implants like artificial vascular prostheses, implants, and various blood contacting devices.

Matched MeSH terms: Prostheses and Implants/adverse effects; Prostheses and Implants/ultrastructure*
Fulltext Biomaterials in cardiovascular research: applications and clinical implications

Jaganathan SK, Supriyanto E, Murugesan S, Balaji A, Asokan MK

Biomed Res Int, 2014;2014:459465.
PMID: 24895577 DOI: 10.1155/2014/459465

Cardiovascular biomaterials (CB) dominate the category of biomaterials based on the demand and investments in this field. This review article classifies the CB into three major classes, namely, metals, polymers, and biological materials and collates the information about the CB. Blood compatibility is one of the major criteria which limit the use of biomaterials for cardiovascular application. Several key players are associated with blood compatibility and they are discussed in this paper. To enhance the compatibility of the CB, several surface modification strategies were in use currently. Some recent applications of surface modification technology on the materials for cardiovascular devices were also discussed for better understanding. Finally, the current trend of the CB, endothelization of the cardiac implants and utilization of induced human pluripotent stem cells (ihPSCs), is also presented in this review. The field of CB is growing constantly and many new investigators and researchers are developing interest in this domain. This review will serve as a one stop arrangement to quickly grasp the basic research in the field of CB.

Matched MeSH terms: Prostheses and Implants*
Fulltext Energy harvesting for the implantable biomedical devices: issues and challenges

Hannan MA, Mutashar S, Samad SA, Hussain A

Biomed Eng Online, 2014;13:79.
PMID: 24950601 DOI: 10.1186/1475-925X-13-79

The development of implanted devices is essential because of their direct effect on the lives and safety of humanity. This paper presents the current issues and challenges related to all methods used to harvest energy for implantable biomedical devices. The advantages, disadvantages, and future trends of each method are discussed. The concept of harvesting energy from environmental sources and human body motion for implantable devices has gained a new relevance. In this review, the harvesting kinetic, electromagnetic, thermal and infrared radiant energies are discussed. Current issues and challenges related to the typical applications of these methods for energy harvesting are illustrated. Suggestions and discussion of the progress of research on implantable devices are also provided. This review is expected to increase research efforts to develop the battery-less implantable devices with reduced over hole size, low power, high efficiency, high data rate, and improved reliability and feasibility. Based on current literature, we believe that the inductive coupling link is the suitable method to be used to power the battery-less devices. Therefore, in this study, the power efficiency of the inductive coupling method is validated by MATLAB based on suggested values. By further researching and improvements, in the future the implantable and portable medical devices are expected to be free of batteries.

Matched MeSH terms: Prostheses and Implants*
Fulltext Biomechanics principle of elbow joint for transhumeral prostheses: comparison of normal hand, body-powered, myoelectric & air splint prostheses

Abd Razak NA, Abu Osman NA, Gholizadeh H, Ali S

Biomed Eng Online, 2014;13:134.
PMID: 25208636 DOI: 10.1186/1475-925X-13-134

Understanding of kinematics force applied at the elbow is important in many fields, including biomechanics, biomedical engineering and rehabilitation. This paper provides a comparison of a mathematical model of elbow joint using three different types of prosthetics for transhumeral user, and characterizes the forces required to overcome the passive mechanical of the prosthetics at the residual limb.

Matched MeSH terms: Prostheses and Implants*
Bioactivity and mechanical stability of Ti-6Al-4V implants superplastically embedded with hydroxyapatite in rats

Mohd Khalid H, Jauhari I, Mohamad Wali HA, Abdulrazzaq Mahmod S

Biomed Mater, 2017 01 25;12(1):015019.
PMID: 28120816 DOI: 10.1088/1748-605X/aa4f8b

In this in vivo study, Sprague Dawley (SD) rats were used to investigate the bioactivity as well as the microstructural and mechanical properties of Ti-6Al-4V samples embedded with hydroxyapatite (HA) using two different coating methods-superplastic embedment (SPE) and superplastic deformation (SPD). The HA layer thickness for the SPE and SPD samples increased from 249.1 ± 0.6 nm to 874.8 ± 13.7 nm, and from 206.1 ± 5.8 nm to 1162.7 ± 7.9 nm respectively, after 12 weeks of implantation. The SPD sample exhibited much faster growth of newly formed HA compared to SPE. The growth of the newly formed HA was strongly dependent on the degree of HA crystallinity in the initial HA layer. After 12 weeks of implantation, the surface hardness value of the SPE and SPD samples decreased from 661 ± 0.4 HV to 586 ± 1.3 HV and from 585 ± 6.6 HV to 425 ± 86.9 HV respectively. The decrease in surface hardness values was due to the newly formed HA layer that was more porous than the initial HA layer. However, the values were still higher than the substrate surface hardness of 321 ± 28.8 HV. Wear test results suggest that the original HA layers for both samples were still strongly intact, and to a certain extent the newly grown HA layers also were strongly bound with the original HA layers. This study confirms the bioactivity and mechanical stability of the HA layer on both samples in vivo.

Matched MeSH terms: Prostheses and Implants*
Development of an implantable D-serine biosensor for in vivo monitoring using mammalian D-amino acid oxidase on a poly (o-phenylenediamine) and Nafion-modified platinum-iridium disk electrode

Zain ZM, O'Neill RD, Lowry JP, Pierce KW, Tricklebank M, Dewa A, et al.

Biosens Bioelectron, 2010 Feb 15;25(6):1454-9.
PMID: 19945264 DOI: 10.1016/j.bios.2009.10.049

D-serine has been implicated as a brain messenger, promoting not only neuronal signalling but also synaptic plasticity. Thus, a sensitive tool for D-serine monitoring in brain is required to understand the mechanisms of D-serine release from glia cells. A biosensor for direct fixed potential amperometric monitoring of D-serine incorporating mammalian D-amino acid oxidase (DAAO) immobilized on a Nafion coated poly-ortho-phenylenediamine (PPD) modified Pt-Ir disk electrode was therefore developed. The combined layers of PPD and Nafion enhanced the enzyme activity and biosensor efficiency by approximately 2-fold compared with each individual layer. A steady state response time (t(90%)) of 0.7+/-0.1s (n=8) and limit of detection 20+/-1 nM (n=8) were obtained. Cylindrical geometry showed lower sensitivity compared to disk geometry (61+/-7 microA cm(-2) mM(-1), (n=4), R(2)=0.999). Interference by ascorbic acid (AA), the main interference species in the central nervous system and other neurochemical electroactive molecules was negligible. Implantation of the electrode and microinjection of D-serine into rat brain striatal extracellular fluid demonstrated that the electrode was capable of detecting D-serine in brain tissue in vivo.

Matched MeSH terms: Prostheses and Implants*
Autologous implantation of bilayered tissue-engineered respiratory epithelium for tracheal mucosal regenesis in a sheep model

Mohd Heikal MY, Aminuddin BS, Jeevanan J, Chen HC, Sharifah SH, Ruszymah BH

Cells Tissues Organs (Print), 2010;192(5):292-302.
PMID: 20616535 DOI: 10.1159/000318675

The objective of this study was to regenerate the tracheal epithelium using autologous nasal respiratory epithelial cells in a sheep model. Respiratory epithelium and fibroblast cells were harvested from nasal turbinates and cultured for 1 week. After confluence, respiratory epithelium and fibroblast cells were suspended in autologous fibrin polymerized separately to form a tissue-engineered respiratory epithelial construct (TEREC). A 3 × 2 cm² tracheal mucosal defect was created, and implanted with TEREC and titanium mesh as a temporary scaffold. The control groups were divided into 2 groups: polymerized autologous fibrin devoid of cells (group 1), and no construct implanted (group 2). All sheep were euthanized at 4 weeks of implantation. Gross observation of the trachea showed minimal luminal stenosis formation in the experimental group compared to the control groups. Macroscopic evaluation revealed significant mucosal fibrosis in control group 1 (71.8%) as compared to the experimental group (7%). Hematoxylin and eosin staining revealed the presence of minimal overgrowth of fibrous connective tissue covered by respiratory epithelium. A positive red fluorescence staining of PKH26 on engineered tissue 4 weeks after implantation confirmed the presence of cultured nasal respiratory epithelial cells intercalated with native tracheal epithelial cells. Scanning electron microscopy showed the presence of short microvilli representing immature cilia on the surface of the epithelium. Our study showed that TEREC was a good replacement for a tracheal mucosal defect and was able to promote natural regenesis of the tracheal epithelium with minimal fibrosis. This study highlighted a new technique in the treatment of tracheal stenosis.

Matched MeSH terms: Prostheses and Implants
Fulltext Electrodeposition of Ginseng/Polyaniline Encapsulated Poly(lactic-co-glycolic Acid) Microcapsule Coating on Stainless Steel 316L at Different Deposition Parameters

Lukman SK, Al-Ashwal RH, Sultana N, Saidin S

Chem Pharm Bull (Tokyo), 2019;67(5):445-451.
PMID: 31061369 DOI: 10.1248/cpb.c18-00847

Electrodeposition is commonly used to deposit ceramic or metal coating on metallic implants. Its utilization in depositing polymer microcapsule coating is currently being explored. However, there is no encapsulation of drug within polymer microcapsules that will enhance its chemical and biological properties. Therefore, in this study, ginseng which is known for its multiple therapeutic effects was encapsulated inside biodegradable poly(lactic-co-glycolic acid) (PLGA) microcapsules to be coated on pre-treated medical grade stainless steel 316L (SS316L) using an electrodeposition technique. Polyaniline (PANI) was incorporated within the microcapsules to drive the formation of microcapsule coating. The electrodeposition was performed at different current densities (1-3 mA) and different deposition times (20-60 s). The chemical composition, morphology and wettability of the microcapsule coatings were characterized through attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), scanning electron microscopy (SEM) and contact angle analyses. The changes of electrolyte colors, before and after the electrodeposition were also observed. The addition of PANI has formed low wettability and uniform microcapsule coatings at 2 mA current density and 40 s deposition time. Reduction in the current density or deposition time caused less attachment of microcapsule coatings with high wettability records. While prolonging either one parameter has led to debris formation and melted microcapsules with non-uniform wettability measurements. The color of electrolytes was also changed from milky white to dark yellow when the current density and deposition time increased. The application of tolerable current density and deposition time is crucial to obtain a uniform microcapsule coating, projecting a controlled release of encapsulated drug.

Matched MeSH terms: Prostheses and Implants
Fulltext Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?

Akma Kamaludin NA, Ferdaus Kamudin NA, Abdullah S, Sapuan J

Chin J Traumatol, 2019 Feb;22(1):59-62.
PMID: 30745113 DOI: 10.1016/j.cjtee.2018.04.007

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.

Matched MeSH terms: Prostheses and Implants
Topology optimisation of spinal interbody cage for reducing stress shielding effect

Chuah HG, Abd Rahim I, Yusof MI

Comput Methods Biomech Biomed Engin, 2010 Jun;13(3):319-26.
PMID: 19927241 DOI: 10.1080/10255840903208189

The stress shielding effect is an event in which the replacement implant limits the load transferred to bone and the ineffective stress in the vertebrae causes bony growth to cease. In the present study, a 3D finite element L4-L5 model was developed and subjected to a 1200 N compression preload. Five groups of muscle forces were applied on L4 under flexion-extension, lateral bending and axial rotation. Topology optimisation was employed for reducing the stress shielding effect by removing the ineffective material from the design domain. The optimised design was designed with polyaryletheretherketone (PEEK) titanium and cortical materials to encounter the shielding response. The stress responses show that the new design increased the stress magnitude by at least 17.10, 18.11 and 18.43% in 4 Nm of flexion-extension, lateral bending and axial rotation, respectively. In conclusion, the material factor did not significantly alter the stress magnitude, but volume was the key factor in reducing the stress shielding effect.

Matched MeSH terms: Prostheses and Implants*
Designing 3D prosthetic templates for maxillofacial defect rehabilitation: A comparative analysis of different virtual workflows

Farook TH, Jamayet NB, Abdullah JY, Asif JA, Rajion ZA, Alam MK

Comput Biol Med, 2020 03;118:103646.
PMID: 32174323 DOI: 10.1016/j.compbiomed.2020.103646

OBJECTIVE: To design and compare the outcome of commercial (CS) and open source (OS) software-based 3D prosthetic templates for rehabilitation of maxillofacial defects using a low powered personal computer setup.
METHOD: Medical image data for five types of defects were selected, segmented, converted and decimated to 3D polygon models on a personal computer. The models were transferred to a computer aided design (CAD) software which aided in designing the prosthesis according to the virtual models. Two templates were designed for each defect, one by an OS (free) system and one by CS. The parameters for analyses were the virtual volume, Dice similarity coefficient (DSC) and Hausdorff's distance (HD) and were executed by the OS point cloud comparison tool.
RESULT: There was no significant difference (p > 0.05) between CS and OS when comparing the volume of the template outputs. While HD was within 0.05-4.33 mm, evaluation of the percentage similarity and spatial overlap following the DSC showed an average similarity of 67.7% between the two groups. The highest similarity was with orbito-facial prostheses (88.5%) and the lowest with facial plate prosthetics (28.7%).
CONCLUSION: Although CS and OS pipelines are capable of producing templates which are aesthetically and volumetrically similar, there are slight comparative discrepancies in the landmark position and spatial overlap. This is dependent on the software, associated commands and experienced decision-making. CAD-based templates can be planned on current personal computers following appropriate decimation.

Matched MeSH terms: Prostheses and Implants*

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