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Tailoredimplant

- User Guide -

- 28/08/2017 -
- Tailoredimplant User Guide -

Table of Contents

Table of Contents 2

1: Welcome to Tailoredimplant 6
1.0: Introduction 7
1.0.1: Recommended system requirements 7

1.0.2: DICOM files 7

1.1: Start 8
1.1.1: Product type 8

1.1.2: Start Tailoredimplant 8

1.1.3: Update/Download 8

2: DICOM conversion 9
2.0: Global controls 10
2.0.1: Mouse/keyboard controls 10

2.1: DICOM import 11


2.1.1: Select DICOM 11

2.1.2: Relative distance 11

2.1.3: Force Orthogonal 11

2.1.4: Import/Update 12

2.1.5: Volumes list 12

2.2: 3D volume preparation 13


2.2.1: Slice 13

2.2.2: Threshold filter 13

2.2.3: Transparency 13

2.2.4: DICOM images ortho view 14

2.2.5: 3D volume view controls 14

2.2.5.1: Rotx 14

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2.2.5.2: Roty 14

2.2.5.3: Zoom 14

2.2.5.4: Axial, Sagittal, Coronal, Opposite side, and View all 14

2.2.6: Help 14

2.2.7: Next 14

2.2.8: Confirm 14

3: Graft design 15
3.0: Global controls 16
3.0.1: Top bar 16

3.0.1.1: Restart 16

3.0.1.2: Get quotation 16

3.0.1.3: Quit 16

3.0.2: Bottom bar 17

3.0.2.1: Manipulator translate/rotate/scale 17

3.0.2.2: Toggle bone transparency 17

3.0.2.3: Hide/Show implants 17

3.0.2.4: Top/bottom/front/back/left/right 17

3.0.2.5: Zoom +/- 17

3.0.2.6: 2D/3D 17

3.0.2.7: View selected 17

3.0.2.8: View all 17

3.0.2.9: Quad/Single view 18

3.0.2.10: Slicing 18

3.0.2.11: Ruler/protractor 19

3.0.3: Main scene 19

3.0.3.1: Mouse left-click 19

3.0.3.2: Mouse right-click 19

3.0.3.3: Mouse wheel-scroll 19

3.0.3.4: Mouse wheel-click/middle-click 19

3.0.3.5: Keyboard right numpad 20

3.1: Model preparation 21

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3.1.1: Delete selection 21

3.1.2: Remove non-linked 21

3.1.3: Fill Mesh 21

3.1.4: Deselect all 21

3.1.5: Restart 22

3.1.6: Next 22

3.2: Bone graft selection 23


3.2.1: Select graft 23

3.2.2: View supplier details 24

3.2.3: Back 24

3.2.4: Next 24

3.3: Implants attachment 25


3.3.1: Select implant 25

3.3.2: Import implant 25

3.3.3: Back 25

3.3.4: Next 26

3.3.5: Current selection 26

3.3.6: Delete 26

3.4: Graft production 27


3.4.1: Import graft 27

3.4.2: Rename 27

3.4.3: Loc/Rot/Scale 28

3.4.4: Back 28

3.4.5: Next 28

3.4.6: Current selection 28

3.4.7: Toggle graft transparency 29

3.4.8: Delete 29

3.5: Graft smooth 30


3.5.1: Size 30

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3.5.2: Strength 30

3.5.3: Add/Subtract 31

3.5.4: Back 31

3.5.5: Next 31

3.5.6: Current selection 31

3.6: Graft refinement 32


3.6.1: Remove non-linked 32

3.6.2: Delete selection 33

3.6.3: Hide/Show main bone 33

3.6.4: Back 33

3.6.5: Next 33

3.6.6: Graft selection 33

3.7: Graft screws 34


3.7.1: Import screw 34

3.7.2: Rename 34

3.7.3: Loc/Rot/Scale 34

3.7.4: Back 35

3.7.5: Next 35

3.7.6: Screw selection 35

3.7.8: Delete 35

3.8: Export 36
3.8.1: Clinical case ID 36

3.8.2: Patient name 36

3.8.3: Back 36

3.8.4: Export mesh 36

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- Tailoredimplant User Guide -

1: Welcome to Tailoredimplant
TailoredImplant is a Patient Specific Implant (PSI) interface portal between oral, maxilo-
facial, orthopedic surgeons and manufacturers of individualized implants.

At Tailoredimplant surgeons own all the decision-making procedures.

Our goal is to achieve a better communication between surgeons and manufacturers.

With TailoredImplant, surgeons can design by their own the individualized grafts/implants
to their patients without any 3D modeling knowledge but only technical medical issues,
also it allows to follow the manufacturing process achieving final results like first idealized.

Tailoredimplant is a Class 1 active medical device.

We are linking the engineering production procedures with doctors anatomy knowledge
due to their experience.

The main reason surgeons don't use individualized grafts is the big gap that exits in what
they really want to be designed and the conception of the final product. That's why at
Tailoredimplant surgeons have the power to decide. You don't need to know anything
about 3D modeling once the software guides you through all the designing process.

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1.0: Introduction
Our software will guide the user step by step and on each phase it will only allows the
actions of that current design phase.

With this the error chance is reduced and the user is abstracted of the background
procedures and only needs to perform the medical actions.

1.0.1: Recommended system requirements


Operating system: Windows 10.

Processor: Intel Core i7 or compatible.

RAM Memory: 16GB.

Graphics Card: Nvidia or ATI with minimum 2GB available.

Monitor: 19inch 1080px x 1920px.

Hard drive: 2GB free space.

Keyboard: regular with numpad.

Mouse: 3 button with scroll wheel.

1.0.2: DICOM files


The used files should have .dcm extension and each slice must be an horizontal cut of
the bone.

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1.1: Start
Double-click on the shortcut created on your desktop named Tailoredimplant and an
automatic updater will start.

On the Tailoredimplant launcher the user can select the type of product to design, and
perform software updates if a newer version is available.

Tailoredimplant requires persistent internet connection during the program execution.

1.1: TAILOREDIMPLANT LAUNCHER.

1.1.1: Product type


Select the type of product the user wants to design.

1.1.2: Start Tailoredimplant


Starts the production process based on the selected option previously.

1.1.3: Update/Download
If an update is available the user will be prompted to a mandatory update.

Depending on the size of the update file the user will be sent to the download page of the
new version or will be asked to update the existing version automatically.

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2: DICOM conversion
At this stage you will be able to generate a 3D volume from a selected DICOM.

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2.0: Global controls


These controls are available on the 3D objects scene.

2.0.1: Mouse/keyboard controls


Mouse left click and drag: rotate the scene.

Mouse wheel/middle click and drag: move the scene.

CTRL on keyboard + mouse wheel/middle click and drag: zoom in and zoom out.

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2.1: DICOM import


DICOM images selection.

2.1: DICOM IMPORT SCREEN

2.1.1: Select DICOM


Select the folder where you have the DICOM files to be imported.

The DICOM lookup is recursive, so it will import all the subfolders included in the selected
directory, it is recommended to select only the folder with the wanted DICOM files to
speed up the conversion.

2.1.2: Relative distance


Relative distance between DICOM slices. Adjust the value to split the DICOM files in
dierent parts or on a single 3D volume. Set the value to make sure all your DICOM files
are imported to the same 3D volume, otherwise unwanted cuts might be performed on
the volumes.

2.1.3: Force Orthogonal


Use when the imported DICOMS are not in the correct position or proportion in order to
force it. (It might slow down the process.)

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2.1.4: Import/Update
Confirm the selected directory and the relative distance between cuts and import or
update the 3D volumes list bellow.

2.1.5: Volumes list


After Import/Update the 3D volumes list will be updated and you can toggle between the
available volumes. Select the one you want to perform the intervention.

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2.2: 3D volume preparation


3D volume construction.

2.2: 3D VOLUME CONFIRMATION SCREEN

2.2.1: Slice
You can slice the 3D volume performing top and bottom cuts to convert only the desired
zones. In order to use this feature make sure you DICOM files are generated with
horizontal slices. It is recommended to cut the despicable areas in order to improve
processing speed during edition. You can enable or disable it.

2.2.2: Threshold filter


You can adjust the DICOM images filter to highlight the areas of the DICOM that will be
read as bone to segment the 3D model.

2.2.3: Transparency
You can set the transparency level of the 3D model to check the critical areas of the bone
in the DICOM images. This features allows the user to check the nerves for example.

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2.2.4: DICOM images ortho view


Allows you to see the DICOM images on 2D along the axial, sagittal and coronal cuts.

2.2.5: 3D volume view controls


Used to change the scene view.

2.2.5.1: Rotx
Rotate the 3D volume along the X axis.

2.2.5.2: Roty
Rotate the 3D volume along the Y axis.

2.2.5.3: Zoom
Zoom in and zoom out the 3D volume.

2.2.5.4: Axial, Sagittal, Coronal, Opposite side, and View all


Controls to allow view the dierent positions of the 3D volume.

2.2.6: Help
Open tips and help for the current panel.

2.2.7: Next
Preview the final 3D volume.

2.2.8: Confirm
Confirm the 3D volume and jumps to the next phase.

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3: Graft design
At this stage the user will be able to start the graft creation.

On the image bellow you can see the dierent working areas that we will describe next.

RED: TOP BAR.

GREEN: CURRENT STEP/SCENE ACTIONS.

YELLOW: MAIN SCENE OBJECTS.

BLUE: BOTTOM BAR.

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3.0: Global controls


The controls shown here are available during the whole processes in this step 3.

3.0.1: Top bar


The top bar has some info about the current process and some global actions can be
performed anytime during this step 3.

3.0.1.1: Restart
Undo all changes in this step 3 and restart the graft design.

3.0.1.2: Get quotation


Display a preview of the current designs' price.

3.0.1.2: GET QUOTATION SCREEN

3.0.1.3: Quit
Exit and return to desktop.

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3.0.2: Bottom bar


The bottom bar has generic actions that can be performed during the step 3 phases,
some options might not be able to fit in the bar so you need to use the scroll-wheel on
your mouse over the bottom bar to move the options.

3.0.2: BOTTOM BAR SCREEN

3.0.2.1: Manipulator translate/rotate/scale


Select the type of action you want to perform to the currently selected object.

3.0.2.2: Toggle bone transparency


Alternate the main bone between transparent and opaque.

3.0.2.3: Hide/Show implants


Hide or show the implants, if they exist.

3.0.2.4: Top/bottom/front/back/left/right
Select the type of view cut you want so see.

3.0.2.5: Zoom +/-


Zoom in or out of the current display.

3.0.2.6: 2D/3D
Toggle between orthogonal and perspective view.

3.0.2.7: View selected


Focus the view to the currently selected objects.

3.0.2.8: View all


Focus the view to include all objects in the display scene.

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3.0.2.9: Quad/Single view


Toggle between single 3D view or quad view where you can see the 3 axis xyz cuts and a
3D view.

3.0.2.9: QUAD VIEW SCREEN

3.0.2.10: Slicing
Slice the current view to see the inside parts of the objects. You can increment or
decrement and reset the cut area.

3.0.2.10: USING SLICING SCREEN

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3.0.2.11: Ruler/protractor
Used to take measures on the scene. You can select the points by click and drag the left-
mouse button. If you click also on the keyboard button CTRL the points are forced to be
on the near surface. Click ESQ on the keyboard to quit the ruler mode.

3.0.2.11: RULER SCREEN

3.0.3: Main scene


Here will be placed all the objects and modifiers/actions.

3.0.3.1: Mouse left-click


Set the 3D cursor position. All the imported objects will be placed where the cursor is set.

3.0.3.2: Mouse right-click


Used to select the available objects on the current scene. When allowed you can select
multiple objects but clicking also SHIFT on your keyboard.

3.0.3.3: Mouse wheel-scroll


Zoom in and zoom out the scene.

Scroll with SHIFT on your keyboard to move the scene up and down.

Scroll with CTRL on your keyboard to move the scene left and right.

3.0.3.4: Mouse wheel-click/middle-click


Click and drag to rotate the scene.

Click with SHIFT on your keyboard to move the scene.

Click with CTRL on your keyboard to zoom in and zoom out the scene.

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3.0.3.5: Keyboard right numpad


1 to set the front view.

3 to set the front right.

7 to set the front top.

CTRL + 1 to set the back view.

CTRL + 3 to set the left view.

CTRL + 7 to set the bottom view.

2 to rotate the view down.

8 to rotate the view up.

4 to rotate the view left.

6 to rotate the view right.

CTRL + 2 to move the view down.

CTRL + 8 to move the view up.

CTRL + 4 to move the view left.

CTRL + 6 to move the view right.

5 to toggle between perspective and orthogonal view.

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3.1: Model preparation


Remove the useless areas of the 3D volume to speed up the processing calculations.

3.1.1: Delete selection


You can select an area with the left-click and drag on your mouse and then delete it.

3.1.2: Remove non-linked


You can select an area with the left-click and drag on your mouse and then delete all the
areas that are not connected to the selection.

3.1.2: SELECTION TO REMOVE NON-LINKED SCREEN

3.1.3: Fill Mesh


Used to fill the holes in the volume. It is automatically performed when the user proceeds
to the next step.

3.1.4: Deselect all


Deselect the current selection.

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3.1.5: Restart
Undo the current phase actions.

3.1.6: Next
Jumps to the next phase: bone graft selection.

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3.2: Bone graft selection


Select the supplier/manufacturer of the graft you want to design.

3.2: BONE GRAFT SELECTION SCREEN

3.2.1: Select graft


A list of the dierent grafts available.

3.2.1: SELECT GRAFT OPTIONS AVAILABLE SCREEN

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3.2.2: View supplier details


Opens the webpage of the current selected graft manufacturer on the tailoredimplant.com
platform. A brief description of the selected graft is shown.

3.2.3: Back
Undo the current step changes and return to the previous phase: model preparation.

3.2.4: Next
Jumps to the next phase: implants attachment.

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3.3: Implants attachment


Allows the doctor to preview the implants position.

3.3.1: Select implant


List of the available implant dummies.

3.1.1: IMPLANT SELECTION OPTIONS AVAILABLE SCREEN

3.3.2: Import implant


Import the selected implant to the selected position.

3.3.2: IMPLANT POSITION SCREEN

3.3.3: Back
Undo the current step changes and return to the previous phase: bone graft selection.

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3.3.4: Next
Jumps to the next phase: graft production.

3.3.5: Current selection


A list of the imported implants, select them by clicking on the name.

3.3.6: Delete
Removes the selected implant.

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3.4: Graft production


At this stage the user will import a graft and place it on the desired zone.

3.4.1: Import graft


Import a graft to the selected position.

3.4.1: GRAFT POSITION SCREEN

3.4.2: Rename
Rename the current selected graft. It is recommended to name every graft to ease their
identification.

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3.4.3: Loc/Rot/Scale
Select the intended type of manipulation. The user can scale, rotate and move the graft
with the buttons bellow.

3.4.3: GRAFT MANIPULATION OPTIONS SCREEN

3.4.4: Back
Undo the current step changes and return to the previous phase: implants attachment.

3.4.5: Next
Jumps to the next phase: graft smooth.

3.4.6: Current selection


A list of the imported grafts, select them by clicking on the name.

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3.4.7: Toggle graft transparency


Alternate the selected graft between transparent and opaque.

3.4.7: GRAFT TRANSPARENCY SCREEN

3.4.8: Delete
Removes the selected graft.

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3.5: Graft smooth


At this stage the user will work on the graft smoothing so that the graft fits seamlessly
into the bone.

The user will click and drag over the rough surfaces until it suits the area using a brush
tool.

A useful tip is to apply a smooth to the objects at the end with a big size and low strength
so the objects have no rough regions.

3.5: GRAFT SMOOTH SCREEN

3.5.1: Size
Size of the circle/region that will be aected.

3.5.2: Strength
Sets the strength of the smooth eect when applied.

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3.5.3: Add/Subtract
Select add if you want to grow up the graft, or subtract you you want to reduce the graft
surface.

3.5.3: ADD/SUBTRACT SMOOTH OPTIONS SCREEN

3.5.4: Back
Undo the current step changes and return to the previous phase: graft production.

3.5.5: Next
Jumps to the next phase graft refinement.

3.5.6: Current selection


A list of the imported grafts, select them by clicking on the name. The smooth tool will
only modify the selected graft.

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3.6: Graft refinement


At this stage the user is allowed to remove the useless parts of the graft.

3.6: GRAFT REFINEMENT SCREEN

3.6.1: Remove non-linked


You can select an area with the left-click and drag on your mouse and then delete all the
areas that are not connected to the selection.

3.6.1: REMOVE NON-LINKED SCREEN

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3.6.2: Delete selection


You can select an area with the left-click and drag on your mouse and then delete it.

3.6.3: Hide/Show main bone


Toggle the main bone visibility.

3.6.4: Back
Undo the current step changes and return to the previous phase: graft smooth.

3.6.5: Next
Jumps to the next phase: graft screws.

3.6.6: Graft selection


A list of the imported grafts, select them by clicking on the name. The actions will only
modify the selected graft.

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3.7: Graft screws


At this stage the user is allowed to place the screws to hold de graft to the bone.

3.7.1: Import screw


Import a screw to the selected position.

3.7.1: SCREW IMPORT SCREEN

3.7.2: Rename
Rename the current selected screw. It is recommended to name every screw to ease their
identification.

3.7.3: Loc/Rot/Scale
Select the intended type of manipulation. The user can scale, rotate and move the screw
with the buttons bellow.

3.7.3: SCREEN LOC/ROT/SCALE WITH SLICING ACTIVATED SCREEN

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3.7.3B: SCREW MOVE Z-AXIS SCREEN

3.7.4: Back
Undo the current step changes and return to the previous phase: graft refinement.

3.7.5: Next
Jumps to the next phase: export.

3.7.6: Screw selection


A list of the imported screws, select them by clicking on the name. The actions will only
modify the selected screw.

3.7.8: Delete
Removes the selected screw.

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3.8: Export
In this panel the user must fill some details about the patient and the surgery and can
preview the final quotation with each graft info.

3.8: EXPORT PANEL SCREEN

3.8.1: Clinical case ID


Set the clinical case identifier.

3.8.2: Patient name


Set the patient name.

3.8.3: Back
Undo the current step changes and return to the previous phase: graft screws.

3.8.4: Export mesh


Export the current design to Tailoredimplant online platform where de doctor can follow
the grafts production process.

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