Published Article / Extensive work has been done in the area of manufacturing implants for medical purposes, and more recently the development of customised implants. Areas of application include cranio/maxillo-facial implants, dental drill guides, hip, knee and shoulder replacements, as well as different implants for the spine. Due to their high prevalence and complex anatomical geometry the purpose of this study is to investigate the current state of the industry regarding customised medical implants for cranio/maxillofacial and orthopaedic surgery. Implant customisation has far-reaching benefits, and a collective approach to solving current difficulties will require an in-depth study of successes already achieved. Several issues in this regard are examined, including what defines customisation, regulatory issues that govern customisation and design constraints, trends in different areas of application, suitable materials, and finally which manufacturing techniques are being employed, with a focus on the use of Layer Manufacturing technologies and their role in custom-made medical implants.

<p>New Virtual Reality technologies provide the possibility of widening access to information in data. Haptics, the technology of touch, could be an interesting future aid and have large impact on medical applications. The use of haptic devices allows computer users to use their sense of touch, in order to feel virtual objects with a high degree of realism. </p><p>The aim of the thesis is to investigate the potential deployment and the benefits of using haptic force feedback instruments in maxillo-facial surgery. Based on a produced test application, the thesis includes suggested recommendations for future haptic implementations. </p><p>At the Department of Maxillo-Facial Surgery, at the Karolinska Hospital in Stockholm, Virtual Reality technologies are used as an aid to a limited extent during the production of physical medical models. The physical medical models are produced with Rapid Prototyping techniques. This process is examined and described in the thesis. Moreover, the future of the physical medical models is outlined, and a future alternative visualizing patient data in 3D and use haptics as an interaction tool, is described. Furthermore, we have examined the present use of haptic technology in medicine, and the benefits of using the technology as an aid for diagnostic and treatment planning. </p><p>Based on a presented literature study and an international outlook, we found that haptics could improve the management of medical models. The technology could be an aid, both for physical models as well as for virtual models. We found three different ways of implementing haptics in maxillo-facial surgery. A haptic system could be developed in order to only manage virtual medical models and be an alternative solution to the complete Rapid Prototyping process. A haptic system could serve as a software, handling the image processing and interfacing from a medical scanner to an Rapid Prototyping system. A haptic system could be developed as an alternative interaction tool, which could be implemented as an additional function in currently used image processing software, in order to improve the management of virtual medical models before the Rapid Prototyping process. </p><p>An implementation for planning and examination in maxillo-facial surgery, using haptic force feedback interaction, is developed and evaluated. The test implementation is underlying our aim of investigating the potential deployment and the benefits of using haptic force feedback instruments in maxillo-facial surgery. </p><p>After discussing the possible future of our implementation and the future of haptic force feedback in maxillo-facial surgery, a recommendation is given as a conclusion of our total work.</p>

New Virtual Reality technologies provide the possibility of widening access to information in data. Haptics, the technology of touch, could be an interesting future aid and have large impact on medical applications. The use of haptic devices allows computer users to use their sense of touch, in order to feel virtual objects with a high degree of realism. The aim of the thesis is to investigate the potential deployment and the benefits of using haptic force feedback instruments in maxillo-facial surgery. Based on a produced test application, the thesis includes suggested recommendations for future haptic implementations. At the Department of Maxillo-Facial Surgery, at the Karolinska Hospital in Stockholm, Virtual Reality technologies are used as an aid to a limited extent during the production of physical medical models. The physical medical models are produced with Rapid Prototyping techniques. This process is examined and described in the thesis. Moreover, the future of the physical medical models is outlined, and a future alternative visualizing patient data in 3D and use haptics as an interaction tool, is described. Furthermore, we have examined the present use of haptic technology in medicine, and the benefits of using the technology as an aid for diagnostic and treatment planning. Based on a presented literature study and an international outlook, we found that haptics could improve the management of medical models. The technology could be an aid, both for physical models as well as for virtual models. We found three different ways of implementing haptics in maxillo-facial surgery. A haptic system could be developed in order to only manage virtual medical models and be an alternative solution to the complete Rapid Prototyping process. A haptic system could serve as a software, handling the image processing and interfacing from a medical scanner to an Rapid Prototyping system. A haptic system could be developed as an alternative interaction tool, which could be implemented as an additional function in currently used image processing software, in order to improve the management of virtual medical models before the Rapid Prototyping process. An implementation for planning and examination in maxillo-facial surgery, using haptic force feedback interaction, is developed and evaluated. The test implementation is underlying our aim of investigating the potential deployment and the benefits of using haptic force feedback instruments in maxillo-facial surgery. After discussing the possible future of our implementation and the future of haptic force feedback in maxillo-facial surgery, a recommendation is given as a conclusion of our total work.

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Cette thèse est consacrée à l'étude d'équations de réaction-diffusion dans un environnement périodique en temps. Ces équations modélisent l'évolution d'une tumeur cancéreuse en présence d'un traitement qui correspond à une immunothérapie dans la première partie du manuscrit, et à une chimiothérapie cytotoxique dans la suite.On considère dans un premier temps des nonlinéarités périodiques en temps pour lesquelles 0 et 1 sont des états d'équilibre linéairement stables. On étudie l'unicité, la monotonie et la stabilité de fronts pulsatoires. On exhibe également des cas d'existence et de non-existence de telles solutions. Dans la deuxième partie de la thèse, on commence par travailler sur des nonlinéarités périodiques en temps qui sont la somme d'une fonction positive traduisant la croissance de la tumeur et d'un terme de mort de cellules cancéreuses du au traitement. On s'intéresse aux états d'équilibres de telles nonlinéarités, et on va déduire de cette étude des propriétés de propagation de perturbations et l'existence de fronts pulsatoires. On raffine ensuite le modèle en considérant des nonlinéarités qui sont la somme d'une fonction asymptotiquement périodique en temps et d'un terme perturbatif. On prouve notamment que les propriétés relatives à la propagation de perturbations restent valables dans ce cadre là. Pour finir, on s'intéresse à l'influence du protocole de traitement. / This phD thesis investigates reaction-diffusion equations in a time periodic environment. These equations model the evolution of a cancerous tumor in the presence of a treatment that corresponds to an immunotherapy in the firs part of the manuscript, and to a cytotoxic chemotherapy after. We begin by considering time-periodic nonlinearities for which 0 and 1 are linearly stable equilibrium states. We study uniqueness, monotonicity and stability of pulsating fronts. We also provide some conditions for the existence and non-existence of such solutions.In the second part of the manuscript, we begin by working on time-periodic nonlinearities which are the sum of a positive function which stands for the growth of the tumor in the absence of treatment and of a death term of cancerous cells due to treatment. We are interested in equilibrium states of such nonlinearities, and we will infer from this study spreading properties and existence of pulsating fronts. We then refine the model by considering nonlinearities which are the sum of an asymptotic periodic nonlinearity and of a small perturbation. In particular we prove that the spreading properties remain valid in this case. To finish, we are interested in the influence of the protocol of the treatment.