title: Accuracy of three-dimensional soft tissue simulation in bimaxillary osteotomies.
abstract: The purpose of this study was to evaluate the accuracy of an algorithm based on the mass tensor model (MTM) for computerized 3D simulation of soft-tissue changes following bimaxillary osteotomy, and to identify patient and surgery-related factors that may affect the accuracy of the simulation. Sixty patients (mean age 26.0 years) who had undergone bimaxillary osteotomy, participated in this study. Cone beam CT scans were acquired pre- and one year postoperatively. The 3D rendered pre- and postoperative scans were matched. The maxilla and mandible were segmented and aligned to the postoperative position. 3D distance maps and cephalometric analyses were used to quantify the simulation error. The mean absolute error between the 3D simulation and the actual postoperative facial profile was 0.81 ± 0.22 mm for the face as a whole. The accuracy of the simulation (average absolute error ≤2 mm) for the whole face and for the upper lip, lower lip and chin subregions were 100%, 93%, 90% and 95%, respectively. The predictability was correlated with the magnitude of the maxillary and mandibular advancement, age and V-Y closure. It was concluded that the MTM-based soft tissue simulation for bimaxillary surgery was accurate for clinical use, though patients should be informed of possible variation in the predicted lip position.
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Jeroen.Liebregts@radboudumc.nl.
authors: Jeroen
authors: J
authors: Liebregts
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Tong.Xi@radboudumc.nl.
authors: Tong
authors: T
authors: Xi
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: timmermans_maarten@hotmail.com.
authors: Maarten
authors: M
authors: Timmermans
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Martien.deKoning@radboudumc.nl.
authors: Martien
authors: M
authors: de Koning
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Stefaan.Berge@radboudumc.nl.
authors: Stefaan
authors: S
authors: Bergé
authors: Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Wagenerlaan 55, 6815 AD, Arnhem, The Netherlands. Electronic address: thoppenreijs@rijnstate.nl.
authors: Theo
authors: T
authors: Hoppenreijs
authors: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Thomas.Maal@radboudumc.nl.
authors: Thomas
authors: T
authors: Maal
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000465:Algorithms; D002508:Cephalometry / Q000706:statistics & numerical data*; D002680:Chin / Q000033:anatomy & histology; D003198:Computer Simulation / Q000706:statistics & numerical data*; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D008046:Lip / Q000033:anatomy & histology; D008297:Male; D019186:Mandibular Advancement / Q000706:statistics & numerical data; D063168:Mandibular Osteotomy / Q000706:statistics & numerical data*; D063166:Maxillary Osteotomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D019340:Osteotomy, Le Fort / Q000706:statistics & numerical data; D059229:Osteotomy, Sagittal Split Ramus / Q000706:statistics & numerical data; D013524:Surgical Flaps / Q000601:surgery; D014584:User-Computer Interface; D055815:Young Adult
keywords: 3D simulation; Bimaxillary surgery; CBCT; Mass tensor model; Orthognathic surgery; Soft tissue simulation