title: CBCT combining with plaster models: application in virtual three-dimensional subapical segmental osteotomy to obtain more precise occlusal splint.
abstract: Anterior subapical segmental osteotomy is considered to be an important surgical technique to obtain functional occlusion and improve the facial profile for patients with maxillary and mandibular protrusion or retrusion, and some complications, such as ischemic necrosis of the distal segment, devitalization of the teeth adjacent to the osteotomy site, and inadequate movement space of segment for obtaining a good occlusion or facial profile, usually exist during surgery. Imprecise measurement of root length, interradicular distance, and intertooth distance based on traditional panoramic radiography that demonstrated existing horizontal distortion and vertical distortion may play an important role in resulting in these problems. In addition, the root is invisible for surgical simulation in traditional plaster models. The recently developed cone-beam computed tomography (CBCT) presents a higher spatial resolution with a lower radiation dose, simultaneously with excellent accuracy and without magnification of images. The presented technique was used to obtain a precise occlusal splint in virtual 3D subapical segmental osteotomy by combining CBCT with plaster models that could guarantee the measurement accuracy of root length, interradicular distance, and intertooth distance, followed by the result of fewer tooth root damage and more precise forecasting of available movement space of jaw segment. Combining with other advantages of virtual 3D surgery, such as precise teeth surface of plaster models, soft tissue simulation, genoplasty simulation, and zygoma plasty simulation, this presented technique may offer a preferable method to patients who need subapical segmental osteotomy.
authors.affiliation: Department of Oral and Cranio-maxillofacial Science, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Jiewen
authors.initials: J
authors.lastname: Dai
authors.forename: Guanghong
authors.initials: G
authors.lastname: Hu
authors.forename: Xudong
authors.initials: X
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Tang
authors.forename: Yuefu
authors.initials: Y
authors.lastname: Dong
authors.forename: Hao
authors.initials: H
authors.lastname: Yuan
authors.forename: Pengfei
authors.initials: P
authors.lastname: Xin
authors.forename: Tong
authors.initials: T
authors.lastname: Yang
authors.forename: Steve Guofang
authors.initials: SG
authors.lastname: Shen
mesh_terms: D054893:Cone-Beam Computed Tomography; D006801:Humans; D021621:Imaging, Three-Dimensional; D008313:Malocclusion, Angle Class III / Q000000981:diagnostic imaging* / Q000601:surgery*; D003765:Models, Dental; D017090:Occlusal Splints; D010027:Osteotomy / Q000379:methods; D011862:Radiography, Panoramic