Abstract
We performed surgical simulation using plaster models prior to actual orthognathic surgery in patients with jaw deformity. In this study, to achieve more accurate positioning of bone segments during surgical simulation, maxillofacial computed tomography (CT) images and three-dimensional (3D) dentition model images were integrated in order to produce maxillofacial models with detailed dentition. Two adult patients with jaw deformity were selected for this study. The methods were as follows: 1) production of ceramic ball-attached reference splints, 2) acquisition of facial skeletal information from X-ray CT, 3) acquisition of dentition model information from X-ray micro-CT, 4) 3D image integration of facial skeletal information and dentition model information using reference splints for positioning, 5) production of a facial skeletal model using rapid prototyping, and 6) surgical simulation using the model produced. 3D imaging of jaw morphology and model production in each case was performed for more accurate surgical simulation. A comparison between the models after simulation and postoperative CT images was useful for feedback from oral surgeons. Furthermore, it became possible to give a more precise explanation to patients, and consistency between expected postoperative morphology and patients' esthetic requests was achieved. The results suggest that the production of models reflecting detailed dentition information can be a useful tool in orthognathic surgery.
