• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.41.1-41.6
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• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• Korean Journal of Computational Design and Engineering
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• v.21 no.2
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• pp.196-203
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• 2016

In this paper, we propose a virtual surgical planning system specialized to mandible reconstruction surgery. Mandible reconstruction surgery is one of the most difficult surgeries, even for experienced surgeons. Compared to the traditional surgical procedures, virtual surgical planning can reduce the operation time in operating room while expecting better surgical outcome with optimized planning. However, with existing software systems, it requires much time and manual operations in virtual surgical planning. To reduce preparation time and improve accuracy of virtual surgical planning, we have developed optimized functions for virtual surgical simulation of mandible reconstruction with user-friendly interface. We found that the proposed system shortened the preparation time by half compared to the existing system from the experiments. The proposed system supports surgeons to make accurate plan faster and easier. The virtually planned results are used to make surgical cutting guide by 3D printing, and this will enhance surgical performance in operating room.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.309-316
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• 2012

Computer aided design and manufacturing (CAD/CAM) technology today is the standard in manufacturing industry. The application of the CAD/CAM technology, together with the emerging 3D medical images based virtual surgical planning (VSP) technology, to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD/CAM technology including: data acquisition, virtual surgical and treatment planning, individual implant design and fabrication, and outcome assessment. It focuses primarily on the technical aspects of the VSP and CAD/CAM system to improve the predictability of the planning and outcome.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.71-75
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• 2015

To overcome limitations of conventional diagnosis and planning for orthognathic surgery, surgeons have begun to use 3-dimensional (3D) virtual simulation to plan complex orthognathic surgery. In many literatures, it has shown that better surgical outcome achieved with 3D virtual simulation than that with conventional methods. But, there is still lack of data about accuracy of maxillary segmental surgery with 3D virtual simulation. The purpose of this paper was to report the case of maxillary segmental orthognathic surgery with 3D virtual simulation and to assess the actual surgical outcome. Though the result was clinically acceptable, discrepancy between 3D simulation and actual surgery was not superior compared with conventional method. The accuracy of 3D simulation surgery and intermediate wafer fabrication for maxillary segmental surgery needs to be improved. Advancement in 3D software program and careful surgical technique will make it more precise and reliable method.

• Archives of Plastic Surgery
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• v.51 no.3
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• pp.268-274
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• 2024

Most Asians have a nose with a short columella and a low dorsum; augmentation rhinoplasty using implants is commonly performed in Asian countries to achieve a taller and more well-defined nasal dorsum. However, the current knowledge is insufficient to fully understand the various subjective desires of patients, reflect on them during surgery, or to objectively analyze the results after surgery. Advances in digital imaging technologies, such as 3D printing and 3D scanning, have transformed the medical system from hospital-centric to patient-centric throughout the medical field. In this study, we applied these techniques to rhinoplasty. First, we used virtual 3D plastic surgery software to enable surgical planning through objectified numerical calculations based on the visualized data of the patient's medical images rather than simple virtual plastic surgery. Second, the customized nasal implant was manufactured by reflecting the patient's anatomical shape and virtual 3D plastic surgery data. Taken together, we describe the surgical results of applying these rhinoplasty solutions in four patients. Our experience indicates that high fidelity and patient satisfaction can be achieved by applying these techniques.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.35.1-35.7
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• 2019

Background: The purpose of this study was to measure the time of the conventional surgical planning (CSP) and virtual surgical planning (VSP) in orthognathic surgery and to compare them in terms of cost. Material and method: This is a retrospective study of the patients who underwent orthognathic surgery at the Pusan National University Dental Hospital from December 2017 to August 2018. All the patients were analyzed through both CSP and VSP, and all the surgical stents were fabricated through manual and three-dimensional (3D) printing. The predictor variables were the planning method (CSP vs. VSP) and the surgery type (group I: Le Fort I osteotomy + bilateral sagittal split osteotomy [LFI+BSSO] or group II: only bilateral sagittal split osteotomy [BSSO]), and the outcomes were the time and cost. The results were analyzed using the paired t test. Results: Thirty patients (12 females, 18 males) met the inclusion criteria, and 17 patients were excluded from the study due to missing or incomplete data. There were 20 group I patients (LFI+BSSO regardless of genioplasty) and 10 group II patients (BSSO regardless of genioplasty). The average time of CSP for group I was 385 ± 7.8 min, and that for group II was 195 ± 8.33 min. The time reduction rate of VSP compared with CSP was 62.8% in group I and 41.5% in group II. On the other hand, there was no statistically significant cost reduction. Conclusions: The time investment in VSP in this study was significantly smaller than that in CSP, and the difference was greater in group I than in group II.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.381-389
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• 2013

Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.

• Journal of International Society for Simulation Surgery
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• v.4 no.1
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• pp.9-12
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• 2017

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

• The Journal of the Korean dental association
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• v.52 no.10
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• pp.596-601
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• 2014

Computer-aided surgery is popular and useful in the field of oral and maxillofacial surgery, because of the possibility of simulation with a high accuracy. In all aspects of surgery, proper planning facilitates more predictable operative results, however before the use of virtual planning, much of this relied on 2-dimensional (2-D) imaging for treatment planning on a 3-dimensional (3-D) object and surgical trial and error. With real-time instrument positioning and clear anatomic identification, a computer-assisted navigation system (CANS) is exceptionally helpful in maxillofacial surgery. These techniques enable performing precise bony ablation and reconstruction, and also decrease surgical time and donor site defect.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.3
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• pp.253-260
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• 2021

Therapeutic injections into the craniofacial region can be a complex procedure because of the nature of its anatomical structure. This technical note demonstrates a process for creating an extra-oral template to inject therapeutic substances into the temporomandibular joint and the lateral pterygoid muscle. The described process involves merging cone-beam computed tomography data and extra-oral facial scans obtained using a mobile device to establish a correlated data set for virtual planning. Virtual injection points were simulated using existing dental implant planning software to assist clinicians in precisely targeting specific anatomical structures. A template was designed and then 3D printed. The printed template showed adequate surface fit. This innovative process demonstrates a potential new clinical technique. However, further validation and in vivo trials are necessary to assess its full potential.