title: Three-dimensional planning in craniomaxillofacial surgery.
abstract: BACKGROUND
  Three-dimensional (3D) planning in oral and maxillofacial surgery has become a standard in the planification of a variety of conditions such as dental implants and orthognathic surgery. By using custom-made cutting and positioning guides, the virtual surgery is exported to the operating room, increasing precision and improving results.
  
  
  METHODS
  We present our experience in the treatment of craniofacial deformities with 3D planning. Software to plan the different procedures has been selected for each case, depending on the procedure (Nobel Clinician, Kodak 3DS, Simplant O&O, Dolphin 3D, Timeus, Mimics and 3-Matic). The treatment protocol is exposed step by step from virtual planning, design, and printing of the cutting and positioning guides to patients' outcomes.
  
  
  CONCLUSIONS
  3D planning reduces the surgical time and allows predicting possible difficulties and complications. On the other hand, it increases preoperative planning time and needs a learning curve. The only drawback is the cost of the procedure. At present, the additional preoperative work can be justified because of surgical time reduction and more predictable results. In the future, the cost and time investment will be reduced. 3D planning is here to stay. It is already a fact in craniofacial surgery and the investment is completely justified by the risk reduction and precise results.
authors.affiliation: Department of Pediatric Surgery, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Rubio-Palau
authors.affiliation: Department of Pediatric Anesthesiology, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Prieto-Gundin
authors.affiliation: Department of Pediatric Surgery, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Asteria Albert
authors.initials: AA
authors.lastname: Cazalla
authors.affiliation: Department of Pediatric Surgery, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Miguel Bejarano
authors.initials: MB
authors.lastname: Serrano
authors.affiliation: Department of Neurosurgery, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Gemma Garcia
authors.initials: GG
authors.lastname: Fructuoso
authors.affiliation: Department of Pediatric Surgery, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Francisco Parri
authors.initials: FP
authors.lastname: Ferrandis
authors.affiliation: Department of Orthodontics, Hospital Sant Joan de Déu (Barcelona Children's Hospital), Barcelona, Spain.
authors.forename: Alejandro Rivera
authors.initials: AR
authors.lastname: Baró
keywords: Craniofacial surgery; craniosynostosis orthognathic surgery; distraction; three-dimensional planning; virtual surgery