Application of computer technology in complex facial deformities
1. Application of computer
technology in complex
facial deformities
Dr. Emmanuel Azariah MDS FIBOMS FIBCSOMS
Associate Professor, Faculty of Dental Sciences,
Sri Ramachandra Institute of Higher Education and Research
2. Maxillofacial Imaging
• now any MDCT data set can be
converted to a 3D image
• the pixels in between the two
slices is calculated by the
software algorithm.
• so thinner the slice less
calculation or computers
imagination
• less than 1mm is ideal
• images should be acquired in
DICOM (Digital Imaging and
Communications in Medicine)
4. Computer Aided Surgery -
CAS
• Virtual Models - Physical Models
• Surgical Simulation - creating a treatment plan
• Creating Splints, cutting Guides, implant designs
• Navigational Surgery
5. CFD - Unilateral Ankylosis
case of Unilateral Ankylosis
Ankylosis release twice
No reconstruction of Ramus condyle Unit at surgery
complaints of Facial Symmetry
NO LEFT RAMUS CONDYLE UNIT
8. Treatment Plan
• Lefort I , BSSRO, Genioplasty
• ? Left Proximal Segment control without Condyle
reconstruction.
• Patient weary to extensive procedures
• Plan B
13. Treatment Plan
Cutting Guides for resection of Ankylosis
cutting guides for osteotomies
Custom Joint Prosthesis
Screw lengths for various regions
15. Tooth Supported Splints
or
Bone Supported
• CT Data does not give accurate tooth morphology
• additional data of dentition
• IO Scans, Dental Models scanned.
• additional armamentarium
• additional cost
• same errors possible.
23. ck: Precise osteotomies for ….. Robin sequence using virtual surgical planning. Int. J. Oral Maxillofac. Surg. 2018; 47: 35– 43. ã
24. cost involved clinical use
Virtual Model to
Physical Model
free - 50K
understanding the
pathology
patient education
OSIRIX
DDS-Pro
Inorbitec
Simulation $ 20-30 per model
can be used for
planning proposed
movement
DDS-Pro
6-10 Lakhs
Soft tissue prediction
and splint fabrication
Nemo Ceph
Proplan CMF
Patient Specific
Implants
30+ Lakhs Design PSI
Mimics Innovation
Suite
Navigation Surgery
Precise Surgical
execution of Planned
Procedures
Stryker
Brainlabs
25. CAS
• Precision in surgery
• Reduction in surgical time
• Predictable Surgical Results
• There is a cost involved