Three-dimensional virtual-reality surgical planning and soft-tissue prediction for orthognathic surgery

Abstract

Complex maxillofacial malformations continue to present challenges in analysis and correction beyond modern technology. The purpose of this paper is to present a virtual-reality workbench for surgeons to perform virtual orthognathic surgical planning and soft-tissue prediction in three dimensions. A resulting surgical planning system, i.e., three-dimensional virtual-reality surgical-planning and soft-tissue prediction for orthognathic surgery, consists of four major stages: computed tomography (CT) data post-processing and reconstruction, three-dimensional (3-D) color facial soft-tissue model generation, virtual surgical planning and simulation, soft-tissue-change preoperative prediction. The surgical planning and simulation are based on a 3-D CT reconstructed bone model, whereas the soft-tissue prediction is based on color texture-mapped and individualized facial soft-tissue model. Our approach is able to provide a quantitative osteotomy-simulated bone model and prediction of postoperative appearance with photorealistic quality. The prediction appearance can be visualized from any arbitrary viewing point using a low-cost personal-computer-based system. This cost-effective solution can be easily adopted in any hospital for daily use.

One visualization simulation operation system for distal femoral fracture

“…With the development and penetration of medical 3D imaging and computer technology, virtual surgical training has become a very promising research direction. In recent years, researchers have developed a series of virtual surgery planning system in order to meet the needs of orthopedic clinical, such as computer-aided 3D virtual bone cutting system, [ 6 ] virtual arthroscopic surgery simulation system, [ 7 ] and virtual knee joint replacement surgery system. [ 8 ] These systems can presently be applied to orthopedic clinical problems with acceptable results.…”

A Novel Precise Optical Navigation System for Craniomaxillofacial Surgery Registered With an Occlusal Splint

“…However, in many cases, it is difficult to transmit complex visual planning information to the actual surgical site only by imagination. 19 , 20 , 22 – 24 Cranio-maxillofacial surgery requires reliable protection of key anatomical structures and accurate osteotomy, 23 , 25 – 27 which makes it one of the most promising areas for image-guided surgery. 21 , 28 However, the actual use of CAS is subject to many restrictions and is still in the experimental stage.…”

Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning

“…Yet attaining both is difficult because these attributes are inversely related. Several models have been used to simulate soft-tissue deformations both commercially and in research, including: empirical-based models [8,9,46,47], mass spring models [48–50], mass tensor models [51,52] and finite element models (FEM) [47,49,51–56]. Among these, FEM is reported to be the most common, accurate and biomechanically relevant method [57–60].…”

“…In the 3D Cephalometric Analysis module, our innovative 3D cephalometry [24,25], which solves many problems associated with current 2D and purported 3D cephalometry, is incorporated for the first time. In the Virtual Osteotomy module, various osteotomies (cuts) to the 3D bones are performed to simulate orthognathic surgery [3,7,8,10,13,20]. In the Surgical Simulation module, a surgical plan is formulated.…”