The CENTER for TECHNOLOGY ASSISTED RECONSTRUCTIVE SURGERY (CTARS) is a unique organization that aims to make India, a world-leader in the application, research and development of advanced technologies for reconstructive surgery and prosthetic rehabilitation.
This organization offers a unique combination of surgical and technical expertise of maxillofacial surgeons, plastic surgeons, orthopedic surgeons, engineers, product designers and software professionals. Through joint research and clinical application, the centre aims to pioneer the effective application of Design and Manufacturing technologies in reconstructive surgery.
Every clinician/surgeon's operating styles and treatment plan is UNIQUE and that is why at CTARS we believe that everyone should get individualized attention, help them customize their treatment, plan their surgery and in turn produce customized treatment solutions.
This makes CTARS the one-stop solution for all your patient-specific needs; custom implants, anatomical models, surgical guides and patient-specific services.
3D printing or additive manufacturing is a process of making three dimensional solid objects from a digital file. The creation of a 3D printed object is achieved using additive processes. In an additive process an object is created by laying down successive layers of material until the object is created. Each of these layers can be seen as a thinly sliced horizontal cross-section of the eventual object.
How does 3D printing work?
It all starts with making a virtual design of the object you want to create. This virtual design is for instance a CAD (Computer Aided Design) file. This CAD file is created using a 3D modeling application or with a 3D scanner (to copy an existing object). A 3D scanner can make a 3D digital copy of an object.
3D scanners use different technologies to generate a 3D model. Examples are: time-of-flight, structured / modulated light, volumetric scanning and many more.
From 3D model to 3D Printer
You will have to prepare a 3D model before it is ready to be 3D printed. This is what they call slicing. Slicing is dividing a 3D model into hundreds or thousands of horizontal layers and needs to be done with software. Sometimes a 3D model can be sliced from within a 3D modeling software application. It is also possible that you are forced to use a certain slicing tool for a certain 3D printer. When the 3D model is sliced, you are ready to feed it to your 3D printer. This can be done via USB, SD or wifi. It really depends on what brand and type 3D Printer you have. When a file is uploaded in a 3D printer, the object is ready to be 3D printed layer by layer. The 3D printer reads every slice (2D image) and creates a three dimensional object.
There is a multitude of experimental Rapid Prototype methodologies either in development or used by small groups of individuals. This section will focus on RP techniques that are currently commercially available, including Stereolithography (SLA), Selective Laser Sintering (SLS®), Laminated Object Manufacturing (LOM™), Fused Deposition Modeling (FDM), Solid Ground Curing (SGC), and Ink Jet printing techniques.
The impact of the CAD/CAM technology, in particular, the rapid prototyping (RP) technology, together with the available of the 3D medical images (CT and magnetic resonance imaging [MRI]) and medical image analysis software, has been transforming clinical practice in craniomaxillofacial surgery in the past decades. Today the applications extend from the custom fabricated craniofacial prosthetic implants  to occlusal guides for orthognathic surgical procedures.
Computer assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for presurgical planning, and for guiding or performing surgical interventions. CAS is also known as computer aided surgery, computer assisted intervention, image guided surgery and surgical navigation
The most important component for CAS is the development of an accurate model of the patient. This can be conducted through a number of medical imaging technologies including CT, MRI, x-rays, ultrasound plus many more. For the generation of this model, the anatomical region to be operated has to be scanned and uploaded into the computer system. An example data set can include the collection of data compiled with 180 CT slices, that are 1 mm apart, each having 512 by 512 pixels. The contrasts of the 3D dataset (with its tens of millions of pixels) provide the detail of soft vs hard tissue structures, and thus allow a computer to differentiate, and visually separate for a human, the different tissues and structures. The image data taken from a patient will often include intentional landmark features, in order to be able to later realign the virtual dataset against the actual patient during surgery.
• Develop and provide patient specific facial implants/prosthesis designed collaboratively with surgeons, prosthodontists and technologists.
• Create a virtual environment for surgeons, researchers, trainees and designers to be able to work, design and develop.
• Design and Manufacture stereolithographic models, prosthesis, implants, surgical guides, instruments and appliances. patient-Specific Surgical Guides are metal or polymer Additively Manufactured (or "3D Printed") devices which translate virtual surgical plans precisely and predictably into the operating theatre. They are designed to sit securely onto unaffected anatomical landmarks and to guide saw cutting vectors, drilling angles, drilling locations and bone repositioning. Typical applications include: controlling osteotomy cuts and bone repositioning, tumour excision and resection, implant placement for prosthesis retention and accurate fibula flap harvesting (amongst other possible grafts) for facial reconstruction.
• Provide high quality courses and workshops for clinicians and associated professionals.
• Provide a basis for the further development of collaboration with other groups in related fields.
• Develop new techniques and approaches that can be reliably transferred into a clinical environment.
Physically reproducing your patient's anatomy offers better insight to the complexity of the specific pathology, and provides additional information to come to a diagnosis. These models help you assess the situation and decide on a plan of action before entering the operating room, so you can be better prepared and increase your efficiency in the operating room.
An anatomical model will allow you to do many things before even stepping into the operating room.
Use the anatomical model to already bend your plates to the patient's skeletal structure before surgery, so you don't have to do that anymore in the operating room.
Before you go into surgery, you can use an anatomical model to prepare yourself. You can use an anatomical model to draw your surgical plan upon. Or you can cut and drill in your model. We can also highlight certain bone fragments on the model. The more preparations are done preoperatively, the less one needs to do during surgery.
An anatomical model is also a great communication tool. You can show it to your fellow surgeons and colleagues to get their ideas and feedback.
If you are going to implant a patient-specific implant, you can test the perfect fit on the anatomical model. Also, we can deliver a model implant; that way you don't have to test with the real implant.
Modern 3D virtual planning for orthognathic surgery has critical advantages compared to conventional treatment planning. In the traditional method, in order to achieve a precise diagnosis of the dentoskeletal deformity and create a treatment plan intraoperatively reproducible, it is necessary to collect data from different sources, such as photographs, cephalograms, dental casts, physical examination along with face bow record and its transfer to semi-adjustable articulators, and measurement of plaster casts movement, according to the surgical simulation. Simulating the operation on plaster dental casts is difficult, especially in cases of complicated two-jaw surgery, as it requires many laboratory-based steps that are time-consuming and may lead to potential errors.
As a result of developments in 3D imaging technology, surgeons are provided with extra information that could not be obtained from lateral cephalogram alone, thus improving the quality of preoperative planning. 3D printing technology allows us to replicate more closely the actual patient while providing access to more and higher-quality information about patient’s 3D anatomy and improving the ability to identify conditions that are not detectable with 2D conventional imaging techniques, thus improving the accuracy and reliability of diagnosis and treatment. Moreover, unlike conventional model surgery on dental casts, this technology allows to virtually perform multiple simulations of different osteotomies and skeletal movements in order to evaluate multiple surgical plans.
At CTARS, the Orthognathic splints that we produce are made up of polyjet and printed using 3D Polyjet technology.
No two patient’s teeth are the same. That's why each and every CTARS IPS guide is custom made to fit your implant plan and patient's anatomy. CTARS IPS is available with tooth or bone (dentulous or edentulous) support.
With CTARS IPS, the implantologist not only decreases the procedure time, but also increases the accuracy of the procedure and patient comfort. Surgery time is reduced by 50% to 60%
People of all ages can face surgical problems that sometimes may require them to undergo osteotomies. The bone defects that remain after craniotomies create emotional, functional, physical and aesthetic disturbances that can change patients' lives. The reconstruction of large/complex osseous defects still presents great challenges. And little is known on the best way to approach these challenges. The answer to this is custom-made Implants. Custom-made Implants ensure better patient and surgeon satisfaction, in the reconstruction or augmentation of bone defects that no other treatment can foresee in.
With the right expertise and technical know-how of our team at CTARS - together we create what you envision. You give us your input on implantation approach (shape, spacings, fixation, choice of material and more), and we will take care of the design and the appropriate production method to realize your custom implant. Even today the Gold standard in biocompatible material is TITANIUM – the material of choice. But newer materials and newer researches are opening doors to different forms of materials and different combinations of metals that can be used inside the body. At CTARS, our customized implants are printed in Titanium* and PEEK**
A virtual surgical plan is only valuable when you can translate it accurately to the operating room. An effective way to do it is by creating Surgical Guides. A surgical guide or template is a small customized tool that guides your saw and/or drill in the planned direction. It fits exactly on a predetermined part of the patient's bone, making sure you cut and drill at the right place, under the right angle and to the right depth. We can assist you with a full pre-operative surgical plan, including the cutting planes and drill holes and their respective angles. To transfer this plan to the actual procedure, one needs to create surgical guides.
Eventually, this is what it is all about - to help patients improve their quality of life and put a smile back on their faces.
CTARS is “For Surgeons – By Surgeons”. Maxillofacial surgeons, plastic surgeons, oncologic surgeons, orthopedic and neurosurgeons, and finally dental surgeons make up our surgical team. The design team is also made up of engineers and designers whose core expertise is in working with Mimics, Haptics and other healthcare designing software. All the work goes through the concerned surgeons for their advise on designs and is brought before the panel before it is delivered to the client/customer.
Managing DirectorCTARS is “For Surgeons – By Surgeons”. Maxillofacial surgeons, plastic surgeons, oncologic surgeons, orthopedic and neurosurgeons, and finally dental surgeons make up our surgical team. The design team is also made up of engineers and designers whose core expertise is in working with Mimics, Haptics and other healthcare designing software. All the work goes through the concerned surgeons for their advise on designs and is brought before the panel before it is delivered to the client/customer.
DirectorEndodontist/professor in dept of conervative dentistry at sri Ramachandra university/director Dr Hannah is a pillar of support and is the brain behind development of CTARS. An eminent speaker in field of dentistry at national level, she has numerous national and international ublications to her credits
CEODr. Karthik is a maxillofacial surgeon by profession with over 8 years of surgical experience. He along with Dr. John have been the founding members of CTARS. He also heads the virtual planning and designing unit at CTARS with a core focus on Orthognathic surgical advances.
Technical DirectorIraimudi is an engineer by profession and an MS in the field of additive manufacturing. Having more than 3+ years of experience, he is the anchor of CTARS designing unit. A unique engineer with a special interest in healthcare. Well versed in CAD designing and 3D printing.
Haptic DesignThe youngest member in the team. JP is also an engineer by profession and brings in a lot of youthfullness to the whole unit. His strength is in 3D designing unit with Haptics technology.
No. 29, Pudupalli Street, (Opp.to St. Antony's Girls School)
Santhome, Chennai - 600 004. Tamilnadu, India.
Phone:+91-044-24611186, Mob: +91 9962125457, 9841825457.
Dr. John Nesan +91-99621 25457, E-mail: email@example.com