A Practical Guide to Virtual Planning of Orthognathic Surgery and Splint Design Using Virtual Dentoskeletal Model

Reem Sh. Mahmood; Sadiq J. Hamandi; Akmam H. Al-Mahdi

doi:10.29194/NJES.27010009

Authors

Reem Sh. Mahmood Department of Biomedical Engineering, College of Engineering, Al-Nahrain University, Baghdad, Iraq.
Sadiq J. Hamandi Department of Biomedical Engineering, College of Engineering, Al-Nahrain University, Baghdad, Iraq.
Akmam H. Al-Mahdi Medical City - Oral & Maxillofacial Surgery Department BDS, FICMS, HiDLM, MFDSRCPS (Glas.), FDCRCS (Eng)

DOI:

https://doi.org/10.29194/NJES.27010009

Keywords:

Digital Dental Model, CBCT Scan, Structure-From-Motion Photogrammetry Method, Virtual Dentoskeletal Model, Virtual Planning of Orthognathic Surgery, Splint Design

Abstract

The present work is a manual that describes the practical aspects of optimizing dental precision by virtual dentoskeletal modeling, use the precises model in virtual planning, and splint design of orthognathic surgery. A single case study is used to demonstrate the stages involved in this approach, which include acquiring CBCT scan data and digital dental models, incorporating this data into developing a virtual dentoskeletal model using superimposition process to replace the unclear teeth. Utilizes virtual assessment and three-dimensional cephalometry to diagnose the maxillofacial deformity of the patient correctly. The results of the diagnosis played a crucial role in formulating a comprehensive plan for dental alignment, which involved osteotomy and correction of bone positions. The final step is to create a personalized splint. The importance of virtual tools is highlighted in our work to optimizing dental precision, diagnose and treat maxillofacial deformities. Present a virtual planning methodology for orthognathic surgeons as well as researchers.

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References

G. R. Swennen, “3D virtual treatment planning of orthognathic surgery,” 3D virtual treatment planning of orthognathic surgery: a step-by-step approach for orthodontists and surgeons, pp. 217-277, 2017.

J. Xia, H. H. Ip, N. Samman, D. Wang, C. S. Kot, R. W. Yeung, and H. Tideman, “Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy,” International journal of oral and maxillofacial surgery, vol. 29, no. 1, pp. 11-17, 2000.

G. R. Swennen, W. Mollemans, and F. Schutyser, “Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging,” Journal of oral and maxillofacial surgery, vol. 67, no. 10, pp. 2080-2092, 2009.

S.-J. Lee, J.-Y. Yoo, S.-Y. Woo, H. J. Yang, J.-e. Kim, K.-H. Huh, S.-S. Lee, M.-S. Heo, S. J. Hwang, and W.-J. Yi, “A complete digital workflow for planning, simulation, and evaluation in orthognathic surgery,” Journal of Clinical Medicine, vol. 10, no. 17, pp. 4000, 2021.

B. F. Gribel, M. N. Gribel, D. C. Frazão, J. A. McNamara Jr, and F. R. Manzi, “Accuracy and reliability of craniometric measurements on lateral cephalometry and 3D measurements on CBCT scans,” The Angle Orthodontist, vol. 81, no. 1, pp. 26-35, 2011.

S. A. Khazal, and M. H. Ali, “An Accelerated Iterative Cone Beam Computed Tomography Image Reconstruction Approach,” Al-Nahrain Journal for Engineering Sciences, vol. 22, no. 4, pp. 307-314, 2019.

R. Jacobs, B. Salmon, M. Codari, B. Hassan, and M. M. Bornstein, “Cone beam computed tomography in implant dentistry: recommendations for clinical use,” BMC Oral Health, vol. 18, no. 1, pp. 1-16, 2018.

E. Nkenke, S. Zachow, M. Benz, T. Maier, K. Veit, M. Kramer, S. Benz, G. Hausler, F. W. Neukam, and M. Lell, “Fusion of computed tomography data and optical 3D images of the dentition for streak artefact correction in the simulation of orthognathic surgery,” Dentomaxillofacial Radiology, vol. 33, no. 4, pp. 226-232, 2004.

B. Zou, J.-H. Kim, S.-H. Kim, T.-H. Choi, Y. Shin, Y.-A. Kook, and N.-K. Lee, “Accuracy of a surface-based fusion method when integrating digital models and the cone beam computed tomography scans with metal artifacts,” Scientific Reports, vol. 12, no. 1, pp. 8034, 2022.

R. S. Mahmood, S. J. Hamandi, and A. H. Al-Mahdi, “Three-Dimensional Cephalometric Analysis of Virtual Dentoskeletal Model (in press),” International Journal of Advanced Technology and Engineering Exploration.

R. S. Mahmood, S. J. Hamandi, and A. H. Al-Mahdi, “Create Virtual Dentoskeletal Model by Superimposing Digital Dental Cast into Cone-Beam Computed Tomography Scan, (in press),” International Journal for Computer Assisted Radiology and Surgery

G. Swennen, M. Mommaerts, J. Abeloos, C. De Clercq, P. Lamoral, N. Neyt, J. Casselman, and F. Schutyser, “A cone-beam CT based technique to augment the 3D virtual skull model with a detailed dental surface,” International journal of oral and maxillofacial surgery, vol. 38, no. 1, pp. 48-57, 2009.

G. R. Swennen, W. Mollemans, C. De Clercq, J. Abeloos, P. Lamoral, F. Lippens, N. Neyt, J. Casselman, and F. Schutyser, “A cone-beam computed tomography triple scan procedure to obtain a three-dimensional augmented virtual skull model appropriate for orthognathic surgery planning,” Journal of Craniofacial Surgery, vol. 20, no. 2, pp. 297-307, 2009.

F. Baan, R. Bruggink, J. Nijsink, T. Maal, and E. Ongkosuwito, “Fusion of intra-oral scans in cone-beam computed tomography scans,” Clinical oral investigations, vol. 25, pp. 77-85, 2021.

J. Gateno, J. Xia, J. F. Teichgraeber, and A. Rosen, “A new technique for the creation of a computerized composite skull model,” Journal of oral and maxillofacial surgery, vol. 61, no. 2, pp. 222-227, 2003.

R. S. Mahmood, S. J. Hamandi, and A. H. Al-Mahdi, “Creating a Digital 3D Model of the Dental Cast Using Structure-from-Motion Photogrammetry Technique,” International Journal of Online and Biomedical Engineering (iJOE), vol. 19, no. 03, pp. 4-17, 2023.

G. K. Sason, G. Mistry, R. Tabassum, and O. Shetty, “A comparative evaluation of intraoral and extraoral digital impressions: An in vivo study,” The Journal of the Indian Prosthodontic Society, vol. 18, no. 2, pp. 108, 2018.

O. de Waard, F. Baan, L. Verhamme, H. Breuning, A. M. Kuijpers-Jagtman, and T. Maal, “A novel method for fusion of intra-oral scans and cone-beam computed tomography scans for orthognathic surgery planning,” Journal of Cranio-Maxillofacial Surgery, vol. 44, no. 2, pp. 160-166, 2016.

H. Rudolph, H. Salmen, M. Moldan, K. Kuhn, V. Sichwardt, B. Wöstmann, and R. G. Luthardt, “Accuracy of intraoral and extraoral digital data acquisition for dental restorations,” Journal of Applied Oral Science, vol. 24, pp. 85-94, 2016.

J. Xia, J. Gateno, J. Teichgraeber, P. Yuan, K.-C. Chen, J. Li, X. Zhang, Z. Tang, and D. Alfi, “Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence,” International journal of oral and maxillofacial surgery, vol. 44, no. 12, pp. 1431-1440, 2015.

J. Xia, J. Gateno, J. Teichgraeber, P. Yuan, J. Li, K.-C. Chen, A. Jajoo, M. Nicol, and D. Alfi, “Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 2: three-dimensional cephalometry,” International journal of oral and maxillofacial surgery, vol. 44, no. 12, pp. 1441-1450, 2015.

J. J. Xia, J. Gateno, and J. F. Teichgraeber, “New clinical protocol to evaluate craniomaxillofacial deformity and plan surgical correction,” Journal of Oral and Maxillofacial Surgery, vol. 67, no. 10, pp. 2093-2106, 2009.

H. Popat, and S. Richmond, “New developments in: three‐dimensional planning for orthognathic surgery,” Journal of orthodontics, vol. 37, no. 1, pp. 62-71, 2010.

G. R. Swennen, F. A. Schutyser, and J.-E. Hausamen, Three-dimensional cephalometry: a color atlas and manual: Springer Science & Business Media, 2005.

C. D. Donaldson, M. Manisali, and F. B. Naini, “Three-dimensional virtual surgical planning (3D-VSP) in orthognathic surgery: Advantages, disadvantages and pitfalls,” Journal of Orthodontics, vol. 48, no. 1, pp. 52-63, 2021.

F. Hernández-Alfaro, and R. Guijarro-Martinez, “New protocol for three-dimensional surgical planning and CAD/CAM splint generation in orthognathic surgery: an in vitro and in vivo study,” International journal of oral and maxillofacial surgery, vol. 42, no. 12, pp. 1547-1556, 2013.

S. Bobek, B. Farrell, C. Choi, B. Farrell, K. Weimer, and M. Tucker, “Virtual surgical planning for orthognathic surgery using digital data transfer and an intraoral fiducial marker: the charlotte method,” Journal of Oral and Maxillofacial Surgery, vol. 73, no. 6, pp. 1143-1158, 2015.

B. B. Farrell, P. B. Franco, and M. R. Tucker, “Virtual surgical planning in orthognathic surgery,” Oral and Maxillofacial Surgery Clinics, vol. 26, no. 4, pp. 459-473, 2014.

E. Shaheen, S. Shujaat, T. Saeed, R. Jacobs, and C. Politis, “Three-dimensional planning accuracy and follow-up protocol in orthognathic surgery: a validation study,” International journal of oral and maxillofacial surgery, vol. 48, no. 1, pp. 71-76, 2019.

M. H. Elnagar, S. Aronovich, and B. Kusnoto, “Digital workflow for combined orthodontics and orthognathic surgery,” Oral and Maxillofacial Surgery Clinics, vol. 32, no. 1, pp. 1-14, 2020.

G. Lauria, L. Sineo, and S. Ficarra, “A detailed method for creating digital 3D models of human crania: an example of close-range photogrammetry based on the use of structure-from-motion (SfM) in virtual anthropology,” Archaeological and Anthropological Sciences, vol. 14, no. 3, pp. 42, 2022.

R. S. Mahmood, S. J. Hamandi, and A. H. Al-Mahdi, “Create a virtual dentoskeletal model by superimposing digital dental cast into CBCT scan, (in press),” Bulletin of the Polish Academy of Sciences: Technical Sciences, 2023.

U. Mangal, J. J. Hwang, H. Jo, S. M. Lee, Y.-H. Jung, B.-H. Cho, J.-Y. Cha, and S.-H. Choi, “Effects of changes in the Frankfort horizontal plane definition on the three-dimensional cephalometric evaluation of symmetry,” Applied Sciences, vol. 10, no. 22, pp. 7956, 2020.

D. Zhang, S. Wang, J. Li, and Y. Zhou, “Novel method of constructing a stable reference frame for 3-dimensional cephalometric analysis,” American Journal of Orthodontics and Dentofacial Orthopedics, vol. 154, no. 3, pp. 397-404, 2018.

P. Pittayapat, R. Jacobs, M. M. Bornstein, G. A. Odri, I. Lambrichts, G. Willems, C. Politis, and R. Olszewski, “Three-dimensional Frankfort horizontal plane for 3D cephalometry: a comparative assessment of conventional versus novel landmarks and horizontal planes,” European journal of orthodontics, vol. 40, no. 3, pp. 239-248, 2018.

G. R. Swennen, F. Schutyser, E.-L. Barth, P. De Groeve, and A. De Mey, “A new method of 3-D cephalometry Part I: the anatomic Cartesian 3-D reference system,” Journal of craniofacial surgery, vol. 17, no. 2, pp. 314-325, 2006.

C. C. Steiner, “The use of cephalometrics as an aid to planning and assessing orthodontic treatment: report of a case,” American journal of orthodontics, vol. 46, no. 10, pp. 721-735, 1960.

A. E. F. de Oliveira, L. H. S. Cevidanes, C. Phillips, A. Motta, B. Burke, and D. Tyndall, “Observer reliability of three-dimensional cephalometric landmark identification on cone-beam computerized tomography,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, vol. 107, no. 2, pp. 256-265, 2009.

C. C. Steiner, “Cephalometrics for you and me,” American journal of orthodontics, vol. 39, no. 10, pp. 729-755, 1953.

G. R. Swennen, and F. Schutyser, “Three-dimensional cephalometry: spiral multi-slice vs cone-beam computed tomography,” American Journal of Orthodontics and Dentofacial Orthopedics, vol. 130, no. 3, pp. 410-416, 2006.

G. Swennen, E.-L. Barth, C. Eulzer, and F. Schutyser, “The use of a new 3D splint and double CT scan procedure to obtain an accurate anatomic virtual augmented model of the skull,” International journal of oral and maxillofacial surgery, vol. 36, no. 2, pp. 146-152, 2007.

U. Oz, K. Orhan, and N. Abe, “Comparison of linear and angular measurements using two-dimensional conventional methods and three-dimensional cone beam CT images reconstructed from a volumetric rendering program in vivo,” Dentomaxillofacial Radiology, vol. 40, no. 8, pp. 492-500, 2011.

L. Schieffer, L. Latzko, H. Ulmer, N. Schenz-Spisic, U. Lepperdinger, M. Paulus, and A. G. Crismani, “Comparison between stone and digital cast measurements in mixed dentition: Validity, reliability, reproducibility, and objectivity,” Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie, vol. 83, no. Suppl 1, pp. 75-84, 2022.

J. Asquith, T. Gillgrass, and P. Mossey, “Three-dimensional imaging of orthodontic models: a pilot study,” The European Journal of Orthodontics, vol. 29, no. 5, pp. 517-522, 2007.