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Review Article| Volume 20, ISSUE 1, P107-118, March 2012

Computer-Aided Orthognathic Surgery

  • Savannah Gelesko
    Affiliations
    Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Mail code: SDOMS, 611 Southwest Campus Drive, Portland, OR 97239, USA
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  • Michael R. Markiewicz
    Affiliations
    Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Mail code: SDOMS, 611 Southwest Campus Drive, Portland, OR 97239, USA
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  • Katherine Weimer
    Affiliations
    Virtual Surgical Planning, Medical Modeling Inc, 17301 West Colfax Avenue, Suite 300, Golden, CO 80401, USA
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  • R. Bryan Bell
    Correspondence
    Corresponding author. 1849 NW Kearney, Suite 300, Portland, OR 97209.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Mail code: SDOMS, 611 Southwest Campus Drive, Portland, OR 97239, USA

    Oral, Head, and Neck Cancer Program, Providence Cancer Center, Providence Portland Medical Center, 4805 NE Glisan Street, Portland, OR 97213, USA

    Trauma Service/Oral and Maxillofacial Surgery Service, Legacy Emanuel Medical Center, 2801 North Gantenbein, Portland, OR 97227, USA
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DOI:https://doi.org/10.1016/j.cxom.2012.01.002
Computer-Aided Orthognathic Surgery
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Next ArticleFacial Skeletal Augmentation Using Custom Facial Implants
      Virtual, or computer-aided, surgery is a process that integrates computer-aided design (CAD) and computer-aided manufacturing (CAM) into surgical treatment planning by providing a means to (1) visualize and analyze 3-dimensional (3D) images of soft tissue and skeletal anatomy, (2) perform virtual manipulations (surgery) to idealize skeletal relationships or plan soft or hard tissue operations, and (3) transfer the virtual plan to patients at the time of surgery. The conventional computed tomography (CT) scan is imported into a proprietary software program, which allows 3D analysis of a defect or deformity. This abnormal region can then be altered by mirror imaging, segmentation, and insertion to create idealized skeletal proportions. Using a CAD/CAM process, a planning model, occlusal stent, cutting guide, or custom implant can be constructed based on the idealized virtual image, which is then translated to the patients. Computer-assisted surgery is particularly useful for achieving optimal functional and esthetic results in patients with complex craniomaxillofacial deformities.
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      Further readings

        • Bell R.B.
        Computer planning and intraoperative navigation in cranio-maxillofacial surgery.
        Oral Maxillofac Surg Clin North Am. 2010; 22: 135-156
        • Bell R.B.
        Computer planning and intraoperative navigation in orthognathic surgery.
        J Oral Maxillofac Surg. 2011; 69: 592-605
        • Gateno J.
        • Xia J.
        • Teichgraeber J.F.
        • et al.
        A new technique for the creation of a computerized composite skull model.
        J Oral Maxillofac Surg. 2003; 61: 222-227
        • Gateno J.
        • Xia J.J.
        • Teichgraeber J.F.
        Effect of facial asymmetry on 2-dimensional and 3-dimensional cephalometric measurements.
        J Oral Maxillofac Surg. 2011; 69: 655-662
        • Gateno J.
        • Xia J.J.
        • Teichgraeber J.F.
        New 3-dimensional cephalometric analysis for orthognathic surgery.
        J Oral Maxillofac Surg. 2011; 69: 606-622
        • Gateno J.
        • Xia J.J.
        • Teichgraeber J.F.
        • et al.
        Clinical feasibility of computer-aided surgical simulation (CASS) in the treatment of complex cranio-maxillofacial deformities.
        J Oral Maxillofac Surg. 2007; 65: 728-734
        • McCormick S.U.
        • Drew S.J.
        Virtual model surgery for efficient planning and surgical performance.
        J Oral Maxillofac Surg. 2011; 69: 638-644
        • Markiewicz M.R.
        • Bell R.B.
        Modern concepts in computer-assisted craniomaxillofacial reconstruction.
        Curr Opin Otolaryngol Head Neck Surg. 2011; 19: 295-301
        • Markiewicz M.R.
        • Bell R.B.
        The use of 3D imaging tools in facial plastic surgery.
        Facial Plast Surg Clin North Am. 2011; 19 (ix): 655-682
        • Schatz E.C.
        • Xia J.J.
        • Gateno J.
        • et al.
        Development of a technique for recording and transferring natural head position in 3 dimensions.
        J Craniofac Surg. 2010; 21: 1452-1455
        • Xia J.
        • Ip H.H.
        • Samman N.
        • et al.
        Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy.
        Int J Oral Maxillofac Surg. 2000; 29: 11-17
        • Xia J.J.
        • Gateno J.
        • Teichgraeber J.F.
        New clinical protocol to evaluate craniomaxillofacial deformity and plan surgical correction.
        J Oral Maxillofac Surg. 2009; 67: 2093-2106
        • Xia J.J.
        • Gateno J.
        • Teichgraeber J.F.
        • et al.
        Accuracy of the computer-aided surgical simulation (CASS) system in the treatment of patients with complex craniomaxillofacial deformity: a pilot study.
        J Oral Maxillofac Surg. 2007; 65: 248-254
        • Xia J.J.
        • McGrory J.K.
        • Gateno J.
        • et al.
        A new method to orient 3-dimensional computed tomography models to the natural head position: a clinical feasibility study.
        J Oral Maxillofac Surg. 2011; 69: 584-591
        • Xia J.J.
        • Shevchenko L.
        • Gateno J.
        • et al.
        Outcome study of computer-aided surgical simulation in the treatment of patients with craniomaxillofacial deformities.
        J Oral Maxillofac Surg. 2011; 69: 2014-2024

      Article info

      Footnotes

      Funding support: The authors have no financial disclosures to declare.

      Identification

      DOI: https://doi.org/10.1016/j.cxom.2012.01.002

      Copyright

      © 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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