Because of recent advances in both CAD/CAM and in medical technology, CAD/CAM has found increasing use in medical applications and devices. Notably, CAD/CAM and 3D printing technologies are used in biomedical engineering, clinical medicine, customized medical implants, tissue engineering, dentistry, artificial joints, and robotic surgery. In this article, we shall highlight certain novel and disruptive medical technologies which are driven by CAD/CAM and 3D printing technologies.
Which Recent Disruptive Medical Technologies Were Driven By CAD/CAM?
There have been many novel medical advances in the past decade, which depend on CAD/CAM technology. Because it is not within the scope of this post to name all of the medical advances, we shall highlight two recent disruptive medical technologies.
The first disruptive medical technology within the past decade is arguably CIS (Computer-Integrated Surgery). CIS may be classified into two areas: Surgical CAD/CAM and Surgical Assistants.
Surgical CAD/CAM provides accurate registration of robotic surgical tools with respect to medical images. For example, medical images for a patient are utilized in tailoring surgical robotic movements for the patient. Doing so minimizes trauma to the patient, creates small and precise incisions, and minimizes the time for post-operative recovery. Other significant benefits provided by CIS include the ability to monitor and correct robotic movements, and to maintain consistency in performance. CIS also makes it possible to work in environments that may not be friendly to human surgeons, such in the bottom of the ocean or in outer space. The pioneer in global leader in surgical robotics is Intuitive Surgical®, which introduced the da Vinci® Surgical System in 1999.
Closely allied with CIS is the Surgical Assistant, which provides CAD/CAM technology for manipulating surgical instruments. Because of the precision provided by CAD/CAM technology, the surgeon neither has to worry about hand tremor nor about making intricate operations inside the patient’s body. These types of Surgical Assistants function as “Surgeon Extenders”, because they augment the abilities of the surgeon. Another type of Surgical Assistant, which relies on the precision provided by CAD/CAM technology, is responsible for functions such as endoscopic holding and retraction.
The second disruptive medical technology, which is dependent on CAD/CAM technology, is orthopedic or joint replacement surgery. Without CAD/CAM technology, joint replacement surgery can neither properly fit orthopedic implants, nor position the implants accurately relative to each other and to the patient’s bones. Similarly, CAD/CAM precision is essential for osteotomies (procedures for cutting and reassembling bones) and for spine surgery. For example, spine surgery often requires placing screws in the vertebrae in close proximity to the spinal cord, nerves, and blood vessels. Without CAD/CAM precision, human error during spine surgery could cause crippling paralysis or death. The pioneer in orthopedic or joint replacement surgery was Integrated Surgical Systems®, which introduced its first surgical robot in the 1980s.
In What Ways Is CAD/CAM Technology Used In Medical Devices?
There are myriads of medical devices which are driven by CAD/CAM technology. We shall list a few well-known devices and how they depend upon CAD/CAM technology:
- Dental scanners use CAD/CAM technology to provide precision in chairside milling, orthodontics and implant workflows. Because of the precision provided by CAD/CAM technology, dental surgeons find it easier to create restorations without spending time and money on retakes, remakes, and many adjustments.
- CAD software is used to assist radiologists with large workloads. For example, in mammography, CAD software highlights areas of abnormality in images, and conveys the information to referring physicians and patients.
- CAD software is used to assist radiologists in the detection of vertebral fractures and lung nodules on chest images.
- CAD technology is indispensable for creating flexible endoscopic systems. For example, Olympus® manufactures a flexible endoscope with fiber optic image transmission. The company also manufactures autoclavable video-laparoscope for maintaining a sterilized work environment, and a variable flexibility colonoscope for detecting and removing colorectal lesions. The company also provides associated visualization systems.
- 3D printing is utilized in creating models of injuries and other health issues. This ability enables physicians to develop a more precise personalized treatment plan. Research is ongoing to use 3D printing for facial reconstruction operations, cerebral aneurysm, osteoporosis and fractures, skin grafts, and many other medical innovations. It is just a matter of time until these innovations become realities in medical practice.
In What Ways Is CAD/CAM Technology Used In Medical Procedures?
There are many medical procedures which depend on CAD/CAM technology. In radiology, computer-aided detection is so important that it has been given the acronym CADx (Computer-aided Diagnosis). The primary purpose of CADx is to assist physicians in interpreting medical images. Voluminous amounts of imaging data are generated from X-rays, MRIs and Ultrasound diagnostics, and it is impossible for a few radiologists to analyze and evaluate so many images in a short time. Although CAD technology can never replace the expertise of trained physicians, CAD technology expedites and provides verification checks for diagnosing possible diseases.
As previously mentioned, CAD software is used to confirm the review and interpretation that a radiologist makes after examining a digital mammogram. CAD software is capable of detecting subtle abnormalities that could be overlooked even by the trained eye of a physician. CAD software provides additional interpretation that enables the physician to make a balanced and thorough diagnosis. For example, at the Highland Breast Imaging Center in Rochester, NY, all mammograms are reviewed by CAD technology.
Conclusion
CAD/CAM technology has made significant impact on advances in medical science and practice especially in medical diagnosis and in the design of medical devices. CADx has become an integral part of clinical practice, because CADx decreases observational oversights. CADx confirms the decisions of physicians when they interpret medical images. CADx also reduces false negative rates when physicians interpret medical images. As advances are made in diagnostic medicine, improved algorithms will be implemented in CADx software. 3D printing has become mainstream technology in dental practice, and 3D printing is being adopted at a rapid pace into tools which will assist physicians in developing improved surgical procedures and treatment plans for patients.
– The CAD Chief
