Comparison of Actual Surgical Outcomes and 3-Dimensional Surgical Simulations

Abstract

Purpose-The advent of imaging software programs have proved to be useful for diagnosis, treatment planning, and outcome measurement, but precision of 3D surgical simulation still needs to be tested. This study was conducted to determine if the virtual surgery performed on 3D models constructed from Cone-beam CT (CBCT) can correctly simulate the actual surgical outcome and to validate the ability of this emerging technology to recreate the orthognathic surgery hard tissue movements in 3 translational and 3 rotational planes of space.Methods-Construction of pre-and post-surgery 3D models from CBCTs of 14 patients who had combined maxillary advancement and mandibular setback surgery and 6 patients who had one-piece maxillary advancement surgery was performed. The post-surgery and virtually simulated surgery 3D models were registered at the cranial base to quantify differences between simulated and actual surgery models. Hotelling T-test were used to assess the differences between simulated and actual surgical outcomes.Results-For all anatomic regions of interest, there was no statistically significant difference between the simulated and the actual surgical models. The right lateral ramus was the only region that showed a statistically significant, but small difference when comparing two-and one-jaw surgeries.Conclusions-Virtual surgical methods were reliably reproduced, oral surgery residents could benefit from virtual surgical training, and computer simulation has the potential to increase predictability in the operating room.

Comparison of precision and accuracy of linear measurements performed by two different imaging software programs and obtained from 3D-CBCT images for Le Fort I osteotomy

“…[1][2][3] Advances in craniofacial imaging and image acquisition techniques, such as the introduction of cone beam CT (CBCT), have improved the understanding of anatomical structures and possible anatomical differences. Improved visualization quality could prevent surgery-related complications such as haemorrhage, 3 permanent neural disorders and unplanned fractures.…”

“…4 The three-dimensional (3D) software programs currently available have been developed specifically to assist diagnosis and treatment planning and to predict outcomes related to orthognathic surgery. 1,2,5,6 However, there are many commercial and open-source software programs available on the market with different linear measurement methods. Some of these software applications determine linear measurements based on pre-determined points that are marked using multiplanar reconstruction (true 3D measurements-Vitrea software; Vital Images Inc., Plymouth, MN), as opposed to other applications that perform measurements on the 3D reconstructed images (OsiriX software; Pixmeo, Geneva, Switzerland).…”

Accuracy of Maxillary Segmental Osteotomy using 3D Simulation: A Case Report

“…The precision of imaging of the occlusal surfaces, streak artefacts by metal restorations, errors in the progress like fusion of images, reconstruction of 3D objects and surgical factors could be the reasons of discrepancy. The success criterion remains a difference of maximum 2 mm between the virtual planned surgery and the actual surgical outcome (8).…”

Evaluation of a portable image overlay projector for the visualisation of surgical navigation data: phantom studies

“…4 unmodified original 3D anatomical models from navigation/planning software employed in previous surgical procedures. a Liver resection plan, b CMF osteotomy plan, c proximal tibia resection plan models of the mandible, target tumour and the mandibular branch of the facial nerve were segmented from NewTom CBCT images using ITK-SNAP as described in [19], see Fig. 4b.…”