Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone beam computed tomography data.
OBJECTIVE
Facial soft tissue prediction in orthognathic surgery could be a valuable aid to preview the results and determine the best surgical treatment. After many years, considerable difficulties are still present in the prediction of the clinical final aspect. The object of the present study was to validate new soft tissue simulation software (SurgiCase CMF; Materialise, Leuven, Belgium), using data acquired by cone beam computed tomography (CBCT), that makes it possible to foresee the final result.


METHODS
Ten patients with craniomaxillofacial deformations underwent CBCT before surgery. Using the SurgiCase CMF software, the data were reconstructed in 3 dimensions, and various osteotomies were simulated in a 3-dimensional virtual environment by applying different surgical procedures. At 6 months after surgery, the patients underwent repeat CBCT. Thus, it was possible to superimpose the pre- and postoperative CBCT studies to evaluate the reproducibility and reliability of the software.


RESULTS
CBCT simulations defined an average absolute error of 0.94 mm, a standard deviation of 0.90 mm, and a percentage of error less than 2 mm of 86.80%.


CONCLUSIONS
The preliminary results have allowed us to conclude that simulations in orthognathic surgery for skull-maxillofacial deformities using CBCT acquisition are reliable, in addition to the low radiation exposure, and could become the reference standard to plan surgical treatment.
Bianchi
Alberto
A
Oral and Maxillofacial Surgery Unit, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. alberto.bianchi@aosp.bo.it
Muyldermans
Louis
L
Di Martino
Mirko
M
Lancellotti
Lorenzo
L
Amadori
Sara
S
Sarti
Alessandro
A
Marchetti
Claudio
C
D000293:Adolescent; D000328:Adult; D002508:Cephalometry / Q000295:instrumentation / Q000379:methods; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005145:Face / Q000033:anatomy & histology; D005147:Facial Bones / Q000033:anatomy & histology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods; D008297:Male; D019767:Maxillofacial Abnormalities / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D012886:Skull / Q000601:surgery; D012986:Software Validation; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult