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Workflow for Robotic Point-of-Care Manufacturing of Personalized Maxillofacial Graft Fixation Hardware

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Abstract

As of this writing, Point-of-Care Manufacturing (POCM) occurs at a handful of advanced tertiary and quaternary care medical centers. These services are mainly limited to 3D printed anatomic models whose shapes derive primarily from CT or MR imaging. In far fewer cases, Virtual Surgical Planning (VSP) and 3D printed surgical guides are manufactured and surgical models are used to pre-bend fixation hardware, produce osteotomy guides, or in the fewest cases, fabricate personalized implants. Ensuring safe and effective POCM is highly relevant to rapidly emerging and time-sensitive personalized interventions for cardiac, trauma, cancer resection/radiosurgery, and neurological surgery. These rapidly emerging cases may not have time for current centralized production services to respond or the return on investment is insufficient motivation. However, patient awareness of the rise of POCM has put a premium on determining design and fabrication workflows that would be needed to provide these patients with personalized procedure planning, surgical guides, and implantable devices. This opportunity could also leverage Metamorphic Manufacturing (MM), Hybrid Autonomous Manufacturing (HAM), and the benefits of Integrated Computational Materials Engineering (ICME). The overarching goal of MM is to design a personalized device’s shape simultaneously with its function and a fabrication strategy that uses manufacturing modalities and device materials that can ensure the output of a device with optimal shape and mechanical performance. As an initiative in this discipline, we report here on preliminary design and early-stage, partial testing of a workflow that embraces the benefits of MM, HAM, and ICME for the design and fabrication of personalized mandibular graft fixation hardware.

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Acknowledgements

The authors wish to acknowledge a President’s Research Excellence (PRE) Catalyst grant “Hybrid Autonomous Point-of-Care Manufacturing” from The Ohio State University and an NSF Engineering Research Center grant (EEC-2133630) “Hybrid Autonomous Manufacturing Moving from Evolution to Revolution (ERC-HAMMER). We are grateful to Trevor Ross and Amanee Abu Arish for their assistance drafting some of the figures in this manuscript.

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Authors and Affiliations

  1. Tecnologico de Monterrey, School of Engineering and Sciences, 2501 Eugenio Garza Sada Ave, 64849, Monterrey, NL, Mexico

    Javier Vazquez-Armendariz, Luis H. Olivas-Alanis & Ciro A. Rodriguez

  2. Department of Materials Science and Engineering, The Ohio State University, 140 W 19Th Ave, Columbus, OH, 43212, USA

    Javier Vazquez-Armendariz, Luis H. Olivas-Alanis, Ciro A. Rodriguez, Stephen Niezgoda, Glenn Daehn & David Dean

  3. Center for Design and Manufacturing Excellence, The Ohio State University, 1314 Kinnear Rd, Columbus, OH, 43212, USA

    Tobias Mahan

  4. Department of Integrated Systems Engineering, The Ohio State University, 1971 Neil Ave, Columbus, OH, 43210, USA

    Michael Groeber

  5. Department of Radiology Neurosurgery and Anatomy, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Jonathan M. Morris

  6. Department of Oral and Maxillofacial Surgery, The Ohio State University, 305 W. 12Th Ave, Columbus, OH, 43210, USA

    Hany Emam

  7. Department of Plastic and Reconstructive Surgery, The Ohio State University, 915 Olentangy River Rd, Columbus, OH, 43212, USA

    Roman Skoracki & David Dean

  8. Department of Mechanical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL, 60208, USA

    Jian Cao

  9. Department of Radiology, V.A. Puget Sound Healthcare System, 660 St. Columbian Way, Seattle, WA, 98108, USA

    Beth Ripley & Joseph Iaquinto

  10. Department of Mechanical and Aerospace Engineering, The Ohio State University, 201 W 19Th Ave, Columbus, OH, 43212, USA

    Stephen Niezgoda

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  1. Javier Vazquez-Armendariz
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Four of the authors (MG, SN, GD, and DD) have filed a pending patent application on some of the subject matter of this paper.

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Vazquez-Armendariz, J., Olivas-Alanis, L.H., Mahan, T. et al. Workflow for Robotic Point-of-Care Manufacturing of Personalized Maxillofacial Graft Fixation Hardware. Integr Mater Manuf Innov 12, 92–104 (2023). https://doi.org/10.1007/s40192-023-00298-3

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