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: Roger A Zwahlen[Show abstract] [Hide abstract]
ABSTRACT: Cone-beam Computed Tomography (CBCT) and stereophotography are two of the latest imaging modalities available for three-dimensional (3-D) visualization of craniofacial structures. However, CBCT provides only limited information on surface texture. This can be overcome by combining the bone images derived from CBCT with 3-D photographs. The objectives of this study were 1) to evaluate the feasibility of integrating 3-D Photos and CBCT images 2) to assess degree of error that may occur during the above processes and 3) to identify facial regions that would be most appropriate for 3-D image registration. CBCT scans and stereophotographic images from 29 patients were used for this study. Two 3-D images corresponding to the skin and bone were extracted from the CBCT data. The 3-D photo was superimposed on the CBCT skin image using relatively immobile areas of the face as a reference. 3-D colour maps were used to assess the accuracy of superimposition were distance differences between the CBCT and 3-D photo were recorded as the signed average and the Root Mean Square (RMS) error. The signed average and RMS of the distance differences between the registered surfaces were -0.018 (±0.129) mm and 0.739 (±0.239) mm respectively. The most errors were found in areas surrounding the lips and the eyes, while minimal errors were noted in the forehead, root of the nose and zygoma. CBCT and 3-D photographic data can be successfully fused with minimal errors. When compared to RMS, the signed average was found to under-represent the registration error. The virtual 3-D composite craniofacial models permit concurrent assessment of bone and soft tissues during diagnosis and treatment planning.PLoS ONE 01/2012; 7(11):e49585. · 3.53 Impact Factor
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ABSTRACT: PURPOSE: This retrospective study investigated 3-dimensional (3D) imaging with intraoperative Cone-Beam Computed Tomography (CBCT) in Mandibular Angle Fractures (MAF) treated by open reduction. The aim of this study was to demonstrate the image quality of intraoperative CBCT in this region and the benefit for the patients. METHODS: 83 patients with 86 MAF were included in this study. 8 patients were female and 75 male. Patient age ranged from 11 to 68 years (average age 26.8 years). All patients were examined with the mobile CBCT scanner ARCADIS Orbic 3D (Siemens Medical Solutions, Erlangen, Germany) directly after surgical treatment of the MAF. RESULTS: As a direct result of intraoperative CBCT four patients (5%) underwent intraoperative revision. The intraoperative acquisition of the data sets was uncomplicated and in all cases it was possible to effectively visualise and assess the MAF in 3D quality. CONCLUSION: The results showed that intraoperative CBCT is a reliable imaging technique for real-time intraoperative assessment of treated MAF. Use of the mobile 3D CBCT scanner is easy to integrate into routine practice and offers the advantage that immediate revision surgery can be performed.Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 01/2013; · 1.25 Impact Factor