Researchers at the University of Illinois are using an engineering design technique called topology optimization to offer facial reconstruction with less deformity and healt risk.  (Source: University of Illinois)
Technique also could provide structural advantages

For most people, the idea of receiving deforming damage to the face is a nightmarish situation.  Unfortunately, tens of thousands in the U.S. yearly suffer such damage -- either from physical trauma or disease -- and require facial reconstruction surgery.  Currently that surgery is a risky procedure.

Glaucio Paulino, the Donald Biggar Willett Professor of Engineering at University of Illinois explains, "The mid-face is perhaps the most complicated part of the human skeleton.  What makes mid-face reconstruction more complicated is its unusual unique shape (bones are small and delicate) and functions, and its location in an area susceptible to high contamination with bacteria."

Paulino is leading a joint team from the University of Illinois and the Ohio State University Medical Center that is exploring using an engineering technique called topology optimization to improve the process.

Topology optimization is commonly used in building engineering and automotive engineering.  The basic idea is to optimize a structure within a confined space using a set of constraints.  Describes Professor Paulino, "It tells you where to put material and where to create holes.  Essentially, the technique allows engineers to find the best solution that satisfies design requirements and constraints."

While that sounds simple, adapting the technique to facial reconstruction would prove complex, and require a wealth of variables to be considered.  The focus would be designing bones to replace damaged bone structure.  Among the variables proposed to be considered are blood flow, sinus cavities, chewing forces and soft tissue support, among other considerations.

The team has used a simple version of this approach to create several facial bones from existing bone tissue.  These bones should offer a significant advantage to facial reconstruction patients that traditional facial reconstruction bones, which are hand sculpted by specialists.  The computer modeled bones both lessen deformity and improve mechanical stability, lessening the chance of serious injury.

The next step, according to the researchers, will be to abandon the approach of using bone extracted from the shoulder blades or other areas, and instead use engineered tissues, perfectly crafted to replace the lost bone tissue.  Professor Paulino states, "This technique has the potential to pave the way toward development of tissue engineering methods to create custom fabricated living bone replacements in optimum shapes and amounts.  The possibilities are immense and we feel that we are just in the beginning of the process."

The team's results can be found published in the July 12 edition of the journal 
Proceedings of the National Academy of Sciences [the article appears to be unavailable currently on the PNAS webpage].

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