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Velarde K, Cafino R, Isla A, Ty KM, Palmer XL, Potter L, Nadorra L, Pueblos LV, Velasco LC. Virtual surgical planning in craniomaxillofacial surgery: a structured review. Comput Assist Surg (Abingdon) 2023; 28:2271160. [PMID: 37862041 DOI: 10.1080/24699322.2023.2271160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the development of this review. This paper aims to provide a comprehensive review of the findings of the studies by conducting an integrated approach to synthesize the literature related to the use of VSP in craniomaxillofacial surgery. Twenty-nine related articles were selected as a sample and synthesized thoroughly. These papers were grouped assigning to the four subdisciplines of craniomaxillofacial surgery: orthognathic surgery, reconstructive surgery, trauma surgery and implant surgery. The following variables - treatment time, the accuracy of VSP, clinical outcome, cost, and cost-effectiveness - were also examined. Results revealed that VSP offers advantages in craniomaxillofacial surgery over the traditional method in terms of duration, predictability and clinical outcomes. However, the cost aspect was not discussed in most papers. This structured literature review will thus provide current findings and trends and recommendations for future research on the usage of VSP in craniomaxillofacial surgery.
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Affiliation(s)
- Kaye Velarde
- Mindanao State University-Iligan Institute of Technology, Iligan City, The Philippines
| | - Rentor Cafino
- Zamboanga City Medical Center, Zamboanga City, The Philippines
| | - Armando Isla
- Mercy Community Hospital, Iligan City, The Philippines
| | - Karen Mae Ty
- University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, The Philippines
| | | | | | - Larry Nadorra
- Department of Health - Center for Health Development, Cagayan de Oro City, The Philippines
| | | | - Lemuel Clark Velasco
- Mindanao State University-Iligan Institute of Technology, Iligan City, The Philippines
- Premiere Research Institute of Science and Mathematics - Center for Computational Analytics and Modelling
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Tabchi Y, Zaoui F, Bahoum A. Accuracy of hard and soft tissue prediction using three-dimensional simulation software in bimaxillary osteotomies: A systematic review. Int Orthod 2023; 21:100802. [PMID: 37499444 DOI: 10.1016/j.ortho.2023.100802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Orthognathic surgery is considered nowadays as a revolutionary treatment option for treating skeletal discrepancies and severe malocclusions in the sagittal, vertical and transverse dimensions. This surgery allows both the restoration of facial harmony and the achievement of satisfactory dental occlusion. The technology of computer-assisted surgeries including virtual surgical simulation programs and planning software greatly contributes to providing a three-dimensional simulation and precise mobilization of the maxilla and/or mandible, thus allowing the prediction of the final outcome in soft tissues. This study aims to systematically review the available scientific literature about the accuracy of the hard and soft tissue predictions delivered by the many promoted three-dimensional simulation software. MATERIAL AND METHODS An electronic search was conducted on various databases: Medline via PubMed, The Cochrane Library, EBSCO-host, and Web of Science. The search was established on a well-defined research question following PICO principle: population, intervention, comparator and outcome. Search evaluation and the assessment of risk of bias were undertaken in each study following its type and design. RESULTS Fifteen studies were included for qualitative analysis. Seven studies evaluated the accuracy of soft tissue prediction, seven focused more on the accuracy of hard tissue and one study assessed both hard and soft tissue prediction accuracy delivered by the simulation software. Moreover, three studies were judged to be low risk and four were classified as high risk. Included studies revealed that hard tissue prediction is highly accurate and reliable, leading to clinically acceptable results. Yet, soft tissue prediction is unclear due to various factors that bias its results. Caution should therefore be taken when providing information about the soft tissue planning to patients. CONCLUSIONS Computer assisted 3D simulation protocols allow for more precise repositioning of the maxilla and/or mandible compared to conventional 2D methods. However, 3D soft tissue prediction using simulation software remains less accurate, especially in the labial region.
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Affiliation(s)
- Yosra Tabchi
- Department of Orthodontics and dentofacial Orthopedics, Faculty of Dentistry, Mohammed V University in Rabat - Souissi, Rabat, Morocco.
| | - Fatima Zaoui
- Department of Orthodontics and dentofacial Orthopedics, Faculty of Dentistry, Mohammed V University in Rabat - Souissi, Rabat, Morocco.
| | - Asmae Bahoum
- Department of Orthodontics and dentofacial Orthopedics, Faculty of Dentistry, Mohammed V University in Rabat - Souissi, Rabat, Morocco.
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Pietzka S, Fink J, Winter K, Wilde F, Schramm A, Ebeling M, Kasper R, Sakkas A. Dental Root Injuries Caused by Osteosynthesis Screws in Orthognathic Surgery-Comparison of Conventional Osteosynthesis and Osteosynthesis by CAD/CAM Drill Guides and Patient-Specific Implants. J Pers Med 2023; 13:jpm13050706. [PMID: 37240877 DOI: 10.3390/jpm13050706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND/AIM The primary aim was to evaluate the prevalence and localisation of dental injuries caused by osteosynthesis screws during orthognathic surgery, comparing two different CAD/CAM planning/surgical approaches through retrospective evaluation of post-operative computed tomography. MATERIAL AND METHODS This study considered all patients who underwent orthognathic surgery from 2010-2019. The examination for dental root injuries between conventional osteosynthesis (Maxilla conventional cohort) and osteosynthesis with patient-specific implant (Maxilla PSI cohort) was performed by evaluating the post-operative CT scans. RESULTS A total of 126 patients were included in the study. Among the 61 patients of the Maxilla conventional cohort, 10 dental root injuries in 8 patients (13.1%) were detected in the post-operative CT scan, representing 1.5% (n = 10/651) of the osteosynthesis screws inserted in proximity of the alveolar crest. No dental injury occurred following osteosynthesis in the 65 patients of the Maxillary PSI cohort (n = 0/773 screws) (p < 0.001). During a mean follow-up period of 13 months after primary surgery, none of the injured teeth showed evidence of periapical alterations and no endodontic treatments were necessary. CONCLUSIONS Maxillary positioning using CAD/CAM-fabricated drill/osteotomy guide and osteosynthesis with PSI can significantly reduce the risk for dental injury compared to the conventional procedure. However, the clinical significance of the detected dental injuries was rather minor.
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Affiliation(s)
- Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Juliana Fink
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
| | - Karsten Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, 04109 Leipzig, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Marcel Ebeling
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Robin Kasper
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
| | - Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, 89081 Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital, 89081 Ulm, Germany
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Extended Maxillary Osteotomy Guide: A Design That Allows Manipulation of the Osteotomy Direction on the Posterior and Inner Walls of the Maxilla. J Craniofac Surg 2022; 33:2146-2153. [DOI: 10.1097/scs.0000000000008740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 03/30/2022] [Indexed: 11/27/2022] Open
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Alkhayer A, Piffkó J, Lippold C, Segatto E. Accuracy of virtual planning in orthognathic surgery: a systematic review. Head Face Med 2020; 16:34. [PMID: 33272289 PMCID: PMC7716456 DOI: 10.1186/s13005-020-00250-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/24/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The elaboration of a precise pre-surgical plan is essential during surgical treatment of dentofacial deformities. The aim of this study was to evaluate the accuracy of computer-aided simulation compared with the actual surgical outcome, following orthognathic surgery reported in clinical trials. METHODS Our search was performed in PubMed, EMBASE, Cochrane Library and SciELO for articles published in the last decade. A total of 392 articles identified were assessed independently and in a blinded manner using eligibility criteria, out of which only twelve articles were selected for inclusion in our research. Data were presented using intra-class correlation coefficient, and linear and angular differences in three planes. RESULTS The comparison of the accuracy analyses of the examined method has shown an average translation (< 2 mm) in the maxilla and also in the mandible (in three planes). The accuracy values for pitch, yaw, and roll (°) were (< 2.75, < 1.7 and < 1.1) for the maxilla, respectively, and (< 2.75, < 1.8, < 1.1) for the mandible. Cone-beam computed tomography (CBCT) with intra-oral scans of the dental casts is the most used imaging protocols for virtual orthognathic planning. Furthermore, calculation of the linear and angular differences between the virtual plan and postoperative outcomes was the most frequented method used for accuracy assessment (10 out of 12 studies) and a difference less than 2 mm/° was considered acceptable and accurate. When comparing this technique with the classical planning, virtual planning appears to be more accurate, especially in terms of frontal symmetry. CONCLUSION Virtual planning seems to be an accurate and reproducible method for orthognathic treatment planning. However, more clinical trials are needed to clearly determine the accuracy and validation of the virtual planning in orthognathic surgery.
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Affiliation(s)
- Ali Alkhayer
- Craniofacial Unit, Department of Oral & Maxillofacial Surgery, University of Szeged, Tisza Lajos krt. 97, Szeged, Hungary
| | - József Piffkó
- Department of Oral & Maxillofacial Surgery, Faculty of Medicine, University of Szeged, Kálvária sugárút. 57, Szeged, Hungary
| | - Carsten Lippold
- Department of Orthodontics, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W30, Waldeyerstraße 30, 48149, Münster, Germany.
| | - Emil Segatto
- Craniofacial Unit, Department of Oral & Maxillofacial Surgery, University of Szeged, Tisza Lajos krt. 97, Szeged, Hungary
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Otranto de Britto Teixeira A, Almeida MADO, Almeida RCDC, Maués CP, Pimentel T, Ribeiro DPB, Medeiros PJD, Quintão CCA, Carvalho FDAR. Three-dimensional accuracy of virtual planning in orthognathic surgery. Am J Orthod Dentofacial Orthop 2020; 158:674-683. [PMID: 33008712 DOI: 10.1016/j.ajodo.2019.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/01/2019] [Accepted: 09/01/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to assess the accuracy of virtual surgical planning (VSP) performed by Dolphin Imaging software (version 11.9; Dolphin Imaging and Management Solutions, Chatsworth, Calif). METHODS Ten people requiring bimaxillary surgery and genioplasty were followed up prospectively. All patients had preoperative cone-beam computed tomography, plaster models, and photographs allowing for VSP. Interocclusal intermediate surgical splints were produced using a 3-dimensional (3D) printer. Postoperative images were acquired 15 days after surgery using cone-beam computed tomography. ITK-Snap (version 3.6; Cognitica, Philadelphia, Pa) allowed the segmentation of reliable 3D models. Geomagic Qualify 2013 (3D Systems, Rock Hill, SC) and MeshValmet (version 3.0) were used to identify the differences between VSP and actual surgical results through the root mean square values and the 3D translational displacement (3-axes) of the 3D centroid of each model. RESULTS Discrepancies between the VSP and the actual result were found at the mandible (P = 0.013) and the chin (P = 0.013) when considering the root mean square values. In addition, 3D centroid differences were found in the transverse and sagittal direction of the right ramus (P = 0.034 and P = 0.005, respectively) and the sagittal aspect of the left ramus (P = 0.025). Considering 2 mm as a threshold of clinical relevance, almost all the bone fragments (maxilla, proximal, and distal mandibular segments) were accurately corrected by surgery, although not in the chin. CONCLUSIONS On the basis of the obtained values, it is possible to consider the Dolphin Imaging software as clinically acceptable for performing virtual orthognathic surgical planning.
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Affiliation(s)
| | | | | | - Caroline Pelagio Maués
- Department of Orthodontics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thais Pimentel
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danilo Passeado Branco Ribeiro
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo José de Medeiros
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Catia Cardoso Abdo Quintão
- Department of Orthodontics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Wang LD, Ma W, Fu S, Zhang CB, Cui QY, Peng CB, Li M. Design and manufacture of dental-supported surgical guide for genioplasty. J Dent Sci 2020; 16:417-423. [PMID: 33384829 PMCID: PMC7770303 DOI: 10.1016/j.jds.2020.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/19/2020] [Indexed: 11/23/2022] Open
Abstract
Background/purpose Genioplasty were used widely to correct chin deformities. The purpose of this study was to design and manufacture a dental-supported surgical guide for genioplasty surgery and assess for surgical accuracy. Materials and methods eleven patients with chin deformities were treated in this study. The computed tomography (CT) data of the patient's skull and the digital dental models of stone dental models were acquired preoperatively. For each patient, a virtual three-dimensional (3D) model of the skull was constructed and enhanced with digital dental models. A surgical simulation was then performed using computer-aided surgical simulation (CASS) technology based on clinical examination and 3D cephalometry. The surgery was simulated preoperatively which allowed the design of a cutting guide and a dental-supported repositioning guide for genioplasty, which was then 3D-printed and used during operation after disinfection. After surgery, the outcome was evaluated by superimposing the postoperative CT model onto the preoperative model, recording the linear and angular deviation of landmarks and plane, then measuring the differences between the planned and actual outcomes. Results The osteotomy and repositioning were successfully performed as planned using surgical guides. No inferior alveolar nerve damage was seen in this study. The dental-supported surgical guide showed excellent accuracy, with the largest differences between the planned and the postoperative chin segment being 0.9 mm and 3.2°. Conclusion The dental-supported surgical guide designed preoperatively provided a reliable method of transfer genioplasty planning. This can assist surgeons in accurately performing osteotomy and repositioning bone segments during a genioplasty.
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Affiliation(s)
| | | | | | | | | | | | - Ming Li
- Corresponding author. Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Kunming Medical University, 1088 Middle Haiyuan Road, High-tech Zone, Kunming, 650106. China.
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Xu R, Ye N, Zhu S, Shi B, Li J, Lai W. Comparison of the postoperative and follow-up accuracy of articulator model surgery and virtual surgical planning in skeletal class III patients. Br J Oral Maxillofac Surg 2020; 58:933-939. [PMID: 32446591 DOI: 10.1016/j.bjoms.2020.04.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 04/23/2020] [Indexed: 02/08/2023]
Abstract
The aim of this study was to evaluate the postoperative and follow-up accuracy of using an intermediate occlusal splint between articulator model surgery (AMS) and virtual surgical planning (VSP) in double-jaw operations. Thirty skeletal class III patients were randomly allocated to have AMS or VSP. In the AMS group surgical planning was done through conventional articulator model surgery, and an intermediate occlusal splint made of acrylic resin was used. In the VSP group the surgical simulation was done virtually, and the same intermediate splint was used in the software and then fabricated using rapid prototyping technology. Preoperatively, one week postoperatively, and 1∼2-years later we obtained follow-up cone-beam computed tomographic (CT) images of each patient. Absolute linear differences between planned and actual outcomes, as well as planned and follow-up outcomes, were evaluated. There was no significant difference in either postoperative accuracy or follow-up accuracy between the methods, and there was no significant difference in the rate of skeletal relapse. Planning transfer by intermediate splint might therefore be the dominant factor in the final inaccuracies. The potentially greater accuracy of VSP may be realised with the help of new positioning devices instead of an intermediate splint.
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Affiliation(s)
- R Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China; State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China
| | - N Ye
- Department of Orthodontics, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, No. 639 Zhizaoju Road, Shanghai, PR China
| | - S Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China
| | - B Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China
| | - J Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China.
| | - W Lai
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China.
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Bhupali NR, Singh SP, Verma S, Rattan V, Kumar V, Verma RK. 3-Dimensional prediction of pre-surgical decompensation after atypical extractions and soft tissue simulation for ortho-surgical management of skeletal Class III malocclusion: A case report. Int Orthod 2020; 18:389-401. [PMID: 32171655 DOI: 10.1016/j.ortho.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 11/17/2022]
Abstract
Three dimensional imaging systems whether in the form of digital models, facial scanning or dolphin software play an important role in proper diagnosis and treatment planning of the orthosurgical cases. This case report highlights importance of three-dimensional treatment planning in the ortho-surgical management of the patient with skeletal Class III malocclusion involving atypical extraction. On clinical examination, patient had concave profile, prominent chin, deficient midface, flat cheekbone contour and prominent nasal projection. He had Class III molar and canine relation bilaterally with missing 12 (previously extracted), negative overbite and overjet with discordant maxillomandibular midlines. After 3-dimensional digital model set-up for occlusion planning and dolphin simulation for soft tissue prediction, extraction of left maxillary lateral incisor was planned followed by maxillary advancement and mandibular setback surgery and finish the occlusion in Class II molar relationship. After the orthodontic and orthognathic surgical treatment, the skeletal and dental imbalance was corrected, and most of the treatment objectives were achieved and patient was extremely satisfied with his facial profile. The treatment results were stable at the 3 years follow-up.
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Affiliation(s)
| | - Satinder Pal Singh
- Unit of Orthodontics & Dentofacial Orthopaedics, OHSC, PGIMER, Chandigarh, India
| | - Sanjeev Verma
- Unit of Orthodontics & Dentofacial Orthopaedics, OHSC, PGIMER, Chandigarh, India.
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, OHSC, PGIMER, Chandigarh, India
| | - Vinay Kumar
- Unit of Orthodontics & Dentofacial Orthopaedics, OHSC, PGIMER, Chandigarh, India
| | - Raj Kumar Verma
- Unit of Orthodontics & Dentofacial Orthopaedics, OHSC, PGIMER, Chandigarh, India
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The Use of Virtual Surgical-Guided Osteoplasty for Maxillofacial Brown Tumors. J Craniofac Surg 2019; 30:e551-e553. [PMID: 30939562 DOI: 10.1097/scs.0000000000005507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A 28-year-old African American female with end-stage renal disease on dialysis secondary to preeclampsia presented to the office as a referral for large multifocal tumors of maxilla and mandible. Surgical pathology and laboratory findings were supportive of secondary hyperparathyroidism leading to multifocal brown tumors. She underwent osteoplasty after using virtual surgical planning to create stereolithic models to visualize the tumor and fabricate cutting guides to minimize the risk of injury to adjacent nerves and teeth. Brown tumors can be resistant to medical management with unreliable regression in size. With the advent of customized surgical guides, more precise and judicious surgery can be performed on these types of tumors safely.
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Treatment of skeletal open bite using a navigation system: CAD/CAM osteotomy and drilling guides combined with pre-bent titanium plates. Int J Oral Maxillofac Surg 2019; 48:502-510. [DOI: 10.1016/j.ijom.2018.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 07/17/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
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Qin Z, Zhang Z, Li X, Wang Y, Wang P, Li J. One-Stage treatment for maxillofacial asymmetry with orthognathic and contouring surgery using virtual surgical planning and 3D-printed surgical templates. J Plast Reconstr Aesthet Surg 2019; 72:97-106. [DOI: 10.1016/j.bjps.2018.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 08/01/2018] [Accepted: 08/18/2018] [Indexed: 11/16/2022]
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Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
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Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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Van den Bempt M, Liebregts J, Maal T, Bergé S, Xi T. Toward a higher accuracy in orthognathic surgery by using intraoperative computer navigation, 3D surgical guides, and/or customized osteosynthesis plates: A systematic review. J Craniomaxillofac Surg 2018; 46:2108-2119. [PMID: 30420150 DOI: 10.1016/j.jcms.2018.10.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/04/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022] Open
Abstract
The aim of this study was to systematically review the accuracy of intraoperative computer navigation, three-dimensional surgical guides and customized osteosynthesis plates for the transfer of the virtual surgical plan to the patient in orthognathic surgery. A systematic review of the currently available publications was performed in databases MEDLINE, Embase, and Cochrane Library, using a PICOS search strategy, and reported according to PRISMA. The initial search yielded 3050 articles. In total, 16 studies were included for final quantitative analyses. The results of individual studies demonstrated a comparable accuracy in the transfer of planned surgical displacement of the jaws. A large variability was found with regard to the method of accuracy assessment and reported outcomes. The findings of this review show that these modern techniques have the potential to replace interocclusal splints in routine clinical practice in the future. We recommend that authors presenting new data on the accuracy of a technique should choose the method of accuracy assessment meticulously, acquiring postoperative imaging as soon as possible after surgery. They should report as much as possible, summarizing values or, ideally, even the raw data of the accuracy assessment in order to allow comparison with other techniques in a meta-analysis.
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Affiliation(s)
- Maxim Van den Bempt
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Jeroen Liebregts
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Thomas Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, the Netherlands.
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15
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Ren XC, Li YF, Liu Y, Zhu SS. Mandibular symphyseal midline distraction osteogenesis for micrognathia associated with aglossia and situs inversus totalis. Int J Oral Maxillofac Surg 2017; 46:1346-1351. [PMID: 28610820 DOI: 10.1016/j.ijom.2017.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/12/2017] [Accepted: 05/25/2017] [Indexed: 02/05/2023]
Abstract
Aglossia is a rare congenital abnormality, often associated with micrognathia and limb defects. Situs inversus totalis is also a rare congenital abnormality, defined as a mirror-image reversal of all the asymmetric organs of the thorax and abdomen. The concurrence of these two abnormalities has only been reported in eight similar cases in the literature. Although micrognathia and malocclusion were observed in all of these cases, few treatments were performed for the patients' dentofacial deformities. This report describes the case of a 7-year-old boy suffering from micrognathia, aglossia, and situs inversus totalis simultaneously, and the treatment for his micrognathia by mandibular symphyseal midline distraction osteogenesis, guided by virtual surgical planning and a three-dimensional printed surgical template. In a review of the literature, this is the first case of micrognathia associated with aglossia and situs inversus totalis that has been treated by mandibular symphyseal midline distraction osteogenesis for the dentofacial deformity.
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Affiliation(s)
- X C Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y F Li
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - S S Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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16
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Wang GY, Huang WJ, Song Q, Qin YT, Liang JF. Computer-assisted virtual preoperative planning in orthopedic surgery for acetabular fractures based on actual computed tomography data. Comput Assist Surg (Abingdon) 2016; 21:160-165. [PMID: 27973962 DOI: 10.1080/24699322.2016.1240235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Guang-Ye Wang
- Department of Orthopaedics, Shenzhen Baoan Hospital Southern Medical University, Shenzhen, China
| | - Wen-Jun Huang
- Department of Orthopaedics, Shenzhen Baoan Hospital Southern Medical University, Shenzhen, China
| | - Qi Song
- Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yun-Tian Qin
- College of Astronautics, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Jin-Feng Liang
- Department of Orthopaedics, Shenzhen Baoan Hospital Southern Medical University, Shenzhen, China
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17
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Zhang N, Liu S, Hu Z, Hu J, Zhu S, Li Y. Accuracy of virtual surgical planning in two-jaw orthognathic surgery: comparison of planned and actual results. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:143-51. [PMID: 27209483 DOI: 10.1016/j.oooo.2016.03.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 02/26/2016] [Accepted: 03/04/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aims to evaluate the accuracy of virtual surgical planning in two-jaw orthognathic surgery via quantitative comparison of preoperative planned and postoperative actual skull models. STUDY DESIGN Thirty consecutive patients who required two-jaw orthognathic surgery were included. A composite skull model was reconstructed by using Digital Imaging and Communications in Medicine (DICOM) data from spiral computed tomography (CT) and STL (stereolithography) data from surface scanning of the dental arch. LeFort I osteotomy of the maxilla and bilateral sagittal split ramus osteotomy (of the mandible were simulated by using Dolphin Imaging 11.7 Premium (Dolphin Imaging and Management Solutions, Chatsworth, CA). Genioplasty was performed, if indicated. The virtual plan was then transferred to the operation room by using three-dimensional (3-D)-printed surgical templates. Linear and angular differences between virtually simulated and postoperative skull models were evaluated. RESULTS The virtual surgical planning was successfully transferred to actual surgery with the help of 3-D-printed surgical templates. All patients were satisfied with the postoperative facial profile and occlusion. The overall mean linear difference was 0.81 mm (0.71 mm for the maxilla and 0.91 mm for the mandible); and the overall mean angular difference was 0.95 degrees. CONCLUSIONS Virtual surgical planning and 3-D-printed surgical templates facilitated the diagnosis, treatment planning, and accurate repositioning of bony segments in two-jaw orthognathic surgery.
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Affiliation(s)
- Nan Zhang
- Faculty, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuguang Liu
- Faculty, Department of Oral and Maxillofacial Surgery, Guangdong Provincial Stomatological Hospital & affiliated Stomatological Hospital of Southern Medical University, Guangzhou, China
| | - Zhiai Hu
- Faculty, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Hu
- Faculty, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- Faculty, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Yunfeng Li
- Faculty, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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18
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Li Y, Jiang Y, Ye B, Hu J, Chen Q, Zhu S. Treatment of Dentofacial Deformities Secondary to Osteochondroma of the Mandibular Condyle Using Virtual Surgical Planning and 3-Dimensional Printed Surgical Templates. J Oral Maxillofac Surg 2015; 74:349-68. [PMID: 26183010 DOI: 10.1016/j.joms.2015.06.169] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 02/05/2023]
Abstract
PURPOSE One-stage treatment for condylar osteochondroma and secondary facial deformities by resection and reconstruction of the mandibular condyle, orthognathic surgery, and mandibular contouring has been reported recently. This study investigated the clinical feasibility of treating osteochondroma of the mandibular condyle and secondary dento-maxillofacial deformities by virtual surgical planning and 3-dimensional (3D) printed surgical templates. MATERIALS AND METHODS A composite skull model with accurate dentition was obtained with data from spiral computed tomography (CT) and surface scanning of the dental arch. Virtual surgical simulation was performed using Dolphin Imaging 11.7 Premium and Mimics software after a comprehensive 3D diagnosis and surgery planning. Surgical templates were fabricated by 3D printing using data from virtual surgical simulation for guidance of excision of the mandibular condyle with osteochondroma, reconstruction of the mandibular condyle, mandibular contouring, and reconstruction of a normal occlusion. Le Fort I osteotomy of the upper jaw and genioplasty were performed when indicated. The linear difference between virtually simulated and postoperative skull models was evaluated. RESULTS All surgeries were successfully simulated using virtual surgical planning, and the guiding templates were successfully applied for all patients. Successful reconstruction of condylar function, normal occlusion, and symmetry of the facial profile was achieved. Postoperative CT scans and quantitative analysis showed that virtual surgical plans provided acceptable accuracy in the operating room. The linear difference of the incisors and first molars was no more than 1.4 mm, and the greatest difference was found for the menton landmark, which was up to 2.4 mm. CONCLUSIONS Results from this study suggested that virtual surgical planning and guiding templates facilitated accurate diagnosis, treatment planning, accurate osteotomy, repositioning of bony segments, and contouring of the mandibular border in the treatment of condylar osteochondroma and secondary facial asymmetry.
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Affiliation(s)
- Yunfeng Li
- Associate Professor, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yangmei Jiang
- Resident, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bin Ye
- Lecturer, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Hu
- Department Head, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qianming Chen
- Professor, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- Professor and Vice Chair, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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