Comparison of actual surgical outcomes and 3-dimensional surgical simulations.
OBJECTIVE
The advent of imaging software programs has proved to be useful for diagnosis, treatment planning, and outcome measurement, but precision of 3-dimensional (3D) surgical simulation still needs to be tested. This study was conducted to determine whether the virtual surgery performed on 3D models constructed from cone-beam computed tomography (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 postsurgery 3D models from CBCTs of 14 patients who had combined maxillary advancement and mandibular setback surgery and 6 patients who had 1-piece maxillary advancement surgery was performed. The postsurgery and virtually simulated surgery 3D models were registered at the cranial base to quantify differences between simulated and actual surgery models. Hotelling t tests 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 2- and 1-jaw surgeries.


CONCLUSIONS
Virtual surgical methods were reliably reproduced. Oral surgery residents could benefit from virtual surgical training. Computer simulation has the potential to increase predictability in the operating room.
Tucker
Scott
S
Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC, USA.
Cevidanes
Lucia Helena Soares
LH
Styner
Martin
M
Kim
Hyungmin
H
Reyes
Mauricio
M
Proffit
William
W
Turvey
Timothy
T
D000293:Adolescent; D000328:Adult; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007568:Jaw / Q000000981:diagnostic imaging; D008297:Male; D008953:Models, Anatomic; D056948:Orthognathic Surgical Procedures; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013382:Subtraction Technique; D014584:User-Computer Interface; D055815:Young Adult