Maxillofacial Plastic and Reconstructive Surgery

  • Volume 37
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  • Pages.44.1-44.6
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  • 2015
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Genioplasty using a simple CAD/CAM (computer-aided design and computer-aided manufacturing) surgical guide

  • Lim, Se-Ho (Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital) ;
  • Kim, Moon-Key (Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital) ;
  • Kang, Sang-Hoon (Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital)
  • Received : 2015.10.29
  • Accepted : 2015.11.16
  • Published : 2015.12.31
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Abstract

Background: The present study introduces the design and fabrication of a simple surgical guide with which to perform genioplasty. Methods: A three-dimensional reconstruction of the patient's cranio-maxilla region was built, with a dentofacial skeletal model, then derived from CT DICOM data. A surgical simulation was performed on the maxilla and mandible, using three-dimensional cephalometry. We then simulated a full genioplasty, in silico, using the three-dimensional (3D) model of the mandible, according to the final surgical treatment plan. The simulation allowed us to design a surgical guide for genioplasty, which was then computer-rendered and 3D-printed. The manufactured surgical device was ultimately used in an actual genioplasty to guide the osteotomy and to move the cut bone segment to the intended location. Results: We successfully performed the osteotomy, as planned during a genioplasty, using the computer-aided design and computer-aided manufacturing (CAD/CAM) surgical guide that we initially designed and tested using simulated surgery. Conclusions: The surgical guide that we developed proved to be a simple and practical tool with which to assist the surgeon in accurately cutting and removing bone segments, during a genioplasty surgery, as preoperatively planned during 3D surgical simulations.

Keywords

References

  1. Mazzoni S, Bianchi A, Schiariti G, Badiali G, Marchetti C (2015) Computer-aided design and computer-aided manufacturing cutting guides and customized titanium plates are useful in upper maxilla waferless repositioning. J Oral Maxillofac Surg 73:701-707 https://doi.org/10.1016/j.joms.2014.10.028
  2. Stokbro K, Aagaard E, Torkov P, Bell RB, Thygesen T (2015) Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation. Int J Oral Maxillofac Surg. doi:10.1016/j.ijom.2015.07.010
  3. Choi JW, Kim BH, Kim HS, Yu TH, Kim BC, Lee SH (2015) Three-dimensional functional unit analysis of hemifacial microsomia mandible-a preliminary report. Maxillofac Plast Reconstr Surg 37:28. doi:10.1186/s40902-015-0027-z
  4. Polley JW, Figueroa AA (2013) Orthognathic positioning system: intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery. J Oral Maxillofac Surg 71:911-920 https://doi.org/10.1016/j.joms.2012.11.004
  5. Salvato G, Chiavenna C, Meazzini MC (2014) Guide surgery osteotomy system (GSOS) a new device for treatment in orthognathic surgery. J Craniomaxillofac Surg 42:234-238 https://doi.org/10.1016/j.jcms.2013.05.006
  6. Olszewski R, Tranduy K, Reychler H (2010) Innovative procedure for computerassisted genioplasty: three-dimensional cephalometry, rapid-prototyping model and surgical splint. Int J Oral Maxillofac Surg 39:721-724 https://doi.org/10.1016/j.ijom.2010.03.018
  7. Jegal JJ, Kang SJ, Kim JW, Sun H (2013) The utility of a three-dimensional approach with T-shaped osteotomy in osseous genioplasty. Arch Plast Surg 40:433-439 https://doi.org/10.5999/aps.2013.40.4.433
  8. Kang SH, Lee JW, Lim SH, Kim YH, Kim MK (2014) Validation of mandibular genioplasty using a stereolithographic surgical guide: in vitro comparison with a manual measurement method based on preoperative surgical simulation. J Oral Maxillofac Surg 72:2032-2042 https://doi.org/10.1016/j.joms.2014.03.002
  9. Hsu SS, Gateno J, Bell RB, Hirsch DL, Markiewicz MR, Teichgraeber JF, Zhou X, Xia JJ (2013) Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 71:128-142 https://doi.org/10.1016/j.joms.2012.03.027
  10. Keyhan SO, Khiabani K, Hemmat S, Varedi P (2013) Zigzag genioplasty: a new technique for 3-dimensional reduction genioplasty. Br J Oral Maxillofac Surg 51:e317-318 https://doi.org/10.1016/j.bjoms.2013.01.013
  11. Lee S, Kim BK, Baek RM, Han J (2013) Narrowing and lengthening genioplasty with pedicled bone graft in contouring of the short and wide lower face. Aesthetic Plast Surg 37:139-143 https://doi.org/10.1007/s00266-012-0019-7
  12. Sati S, Havlik RJ (2011) An evidence-based approach to genioplasty. Plast Reconstr Surg 127:898-904 https://doi.org/10.1097/PRS.0b013e31820461c5
  13. Ahmad Akhoundi MS, Shirani G, Arshad M, Heidar H, Sodagar A (2012) Comparison of an imaging software and manual prediction of soft tissue changes after orthognathic surgery. J Dent (Tehran) 9:178-187
  14. Hierl T, Arnold S, Kruber D, Schulze FP, Humpfner-Hierl H (2013) CAD-CAMassisted esthetic facial surgery. J Oral Maxillofac Surg 71:e15-23
  15. Li B, Zhang L, Sun H, Shen SG, Wang X (2014) A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex. J Craniofac Surg 25:406-411 https://doi.org/10.1097/SCS.0000000000000673
  16. Choi JW, Jung SY, Kim HJ, Lee SH (2015) Positional symmetry of porion and external auditory meatus in facial asymmetry. Maxillofac Plast Reconstr Surg 37:33. doi:10.1186/s40902-015-0033-1

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