title: Correction of a severe facial asymmetry with computerized planning and with the use of a rapid prototyped surgical template: a case report/technique article.
abstract: Management of significant facial asymmetry presents a challenge due to the geometric complexity of the bony and other facial structures. Manual model surgery is an essential part of treatment planning but it can be complicated, time-consuming and may contain potential errors. Computer-aided surgery has revolutionized the correction of maxillofacial deformities. The aim of this study was to report a case of facial asymmetry when computerised simulation surgery was performed instead of manual model surgery and a virtually planned wafer splint was fabricated. A 26-year-old male was presented with a severe right-sided hemimandibular elongation. Following presurgical orthodontics high-resolution computer tomography scan was performed. The stack images were reformatted into a three-dimensional structure. Virtual Le Fort-I osteotomy was performed and the symmetry of the maxilla was corrected with the help of a three-dimensional planning software. A virtual intermediate surgical wafer was designed and produced with three-dimensional rapid prototyping technology. The mandible was rotated into the correct position following virtual bilateral sagittal split osteotomy to visualize the movements of the osteotomised mandibular segments. The two-jaw procedure was performed according to the virtual plan. The facial symmetry was improved significantly and stable occlusion was achieved. This complex case shows the advantages of computer-aided surgical planning and three-dimensional rapid prototyping for the correction of facial asymmetries.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Szeged, Kalvaria sgt, 57, 6725 Szeged, Hungary. seresl@yahoo.com.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Seres
authors.forename: Endre
authors.initials: E
authors.lastname: Varga
authors.forename: Andras
authors.initials: A
authors.lastname: Kocsis
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Rasko
authors.forename: Balazs
authors.initials: B
authors.lastname: Bago
authors.forename: Endre
authors.initials: E
authors.lastname: Varga
authors.forename: Jozsef
authors.initials: J
authors.lastname: Piffko
mesh_terms: D000328:Adult; D002508:Cephalometry; D003766:Dental Occlusion; D005145:Face / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005146:Facial Asymmetry / Q000151:congenital* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000601:surgery*; D021621:Imaging, Three-Dimensional; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D019340:Osteotomy, Le Fort / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed