Computer-Aided Maxillofacial Surgery: An Update
ABSTRACT Recent developments in technology have revolutionized medicine and surgery. This article aims at providing an update on the current trends in computer-aided maxillofacial surgery and illustrates these advances with clinical cases.
The PubMed database was searched for articles published during the past 5 years using the keywords "maxillofacial" and "surgery, computer-assisted." Full texts of relevant articles were retrieved, and their study details were extracted.
Among the 133 articles, most focused on cone-beam computed tomography (CBCT), stereophotography, surgical panning software, and intraoperative navigation. Stereophotography produces 3D facial photographs with natural color and texture, whereas CBCT generates excellent hard-tissue images with a substantially lower radiation than conventional CT scans. Information gathered from CBCT and stereophotography can be used for accurate diagnosis, virtual planning, and simulation of surgery with the aid of specialized software. The preplanned treatment can be executed accurately via intraoperative surgical navigation.
Tremendous potential exists for computer-aided maxillofacial surgery as it moves from research to clinical care.
SourceAvailable from: Carla Evans[Show abstract] [Hide abstract]
ABSTRACT: Aims. To summarize the potential benefits and risks of maxillofacial cone beam computed tomography (CBCT) use in orthodontic diagnosis, treatment and outcomes and to provide clinical guidance to dental practitioners. Methods. This statement was developed by consensus agreement of a panel convened by the American Academy of Oral and Maxillofacial Radiology (AAOMR). The literature on the clinical efficacy of and radiation dose concepts associated with CBCT in all aspects of orthodontic practice was reviewed. Results. The panel concluded that the use of CBCT in orthodontic treatment should be justified on an individual basis, based on clinical presentation. This statement provides general recommendations, specific use selection recommendations, optimization protocols, and radiation-dose, risk-assessment strategies for CBCT imaging in orthodontic diagnosis, treatment and outcomes. Conclusions. The AAOMR supports the safe use of CBCT in dentistry. This position statement is periodically revised to reflect new evidence and, without reapproval, becomes invalid after 5 years.Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 08/2013; 116(2):238-257. DOI:10.1016/j.oooo.2013.06.002 · 1.46 Impact Factor
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ABSTRACT: Purpose Correction of post traumatic orbital and zygomatic deformity is a challenge for maxillofacial surgeons. Integration of different technologies, such as software planning, surgical navigation and stereolithographic models, opens new horizons in terms of the surgeons’ ability to tailor reconstruction to individual patients. The purpose of this study was to analyze surgical results, in order to verify the suitability, effectiveness and reproducibility of this new protocol. Methods Eleven patients were included in the study. Inclusion criteria were: unilateral orbital pathology; associated diplopia and enophthalmos or exophthalmos, and zygomatic deformities. Syndromic patients were excluded. Pre-surgical planning was performed with iPlan 3.0 CMF software and we used Vector Vision II (BrainLab, Feldkirchen, Germany) for surgical navigation. We used 1:1 skull stereolithographic models for all the patients. Orbital reconstructions were performed with a titanium orbital mesh. The results refer to: correction of the deformities, exophthalmos, enophthalmos and diplopia; correspondence between reconstruction mesh positioning and preoperative planning mirroring; and the difference between the reconstructed orbital volume and the healthy orbital volume. Results Correspondence between the post-operative reconstruction mesh position and the presurgical virtual planning has an average margin of error of less than 1.3 mm. In terms of en- and exophthalmos corrections, we have always had an adequate clinical outcome with a significant change in the projection of the eyeball. In all cases treated, there was a complete resolution of diplopia. The calculation of orbital volume highlighted that the volume of the reconstructed orbit, in most cases, was equal to the healthy orbital volume, with a positive or negative variation of less than 1 cm3. Conclusion The proposed protocol incorporates all the latest technologies to plan the virtual reconstruction surgery in detail. The results obtained from our experience are very encouraging and lead us to pursue this path.Journal of Cranio-Maxillofacial Surgery 10/2014; DOI:10.1016/j.jcms.2014.09.009 · 2.60 Impact Factor
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ABSTRACT: Background. Orthognathic surgery leads to alteration of the spatial relationship of the mandible and maxilla resulting changes in the degree of facial projection. Traditional 2-dimensional cephalometry and photographic techniques do not provide data on facial depth. Though stereophotogrammetry can be used as a noninvasive method for evaluating facial depth, the unavailability of ethnicity-specific norms hinder its routine use in clinical practice. The objectives of this study were to (a) generate an analytic scheme suitable for evaluating facial depth using stereophotogrammetry and (b) create normative data for the facial depth measurements for young Hong Kong Chinese adults. Methods. Stereophotographic images from 41 male and 45 female ethnic Chinese young adults without facial deformities were analyzed. Facial depth measurements were performed based on standard anthropometric landmarks, with the aid of 3dMDVultus software. Results. All facial depth measurements were found in absolute terms to be significantly higher in males. In contrast, the upper face, maxillary, and sublabial depth indices were significantly higher in females, whereas no significant gender differences emerged for lower facial and maxillomandibular indices. Conclusions. A novel method of using stereophotographic images for quantifying facial depth was evaluated. Normative facial depth measurements for young Hong Kong Chinese adults were established. This gender-specific database can be used as a reference in the diagnosis, treatment planning, or evaluation of outcomes after surgical correction of facial deformities.Surgical Innovation 02/2013; 21(1). DOI:10.1177/1553350613475883 · 1.34 Impact Factor