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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2008 August;19(2):65-71
Soft tissue simulations in orthognathic surgery: comparison between data acquired by multislice and conebeam CT
Lancellotti L. 1, Amadori S. 1, Bianchi A. 1, Marchetti C. 2, Battista G. 3
1 Oral and Maxillofacial Surgery Unit S. Orsola-Malpighi Hospital University of Bologna, Bologna, Italy
2 Department of Dental Sciences University of Bologna, Bologna, Italy
3 Clinical Department of Radiological and Histopatological Sciences S. Orsola-Malpighi Hospital University of Bologna, Bologna, Italy
Aim. After many years of orthognathic surgery there are still many difficulties in predict the extent of the skeletal movements, the response of soft tissues and the clinical final aspect. The objective of this work is to compare the data acquired by the multislice computed tomography (MSCT) and conebeam CT (CBCT) redesigned with a new software (Surgicase-CMF®, Materialise, Leuven, Belgium) that makes possible for the surgeon to foresee the final result.
Methods. Twenty patients with cranio-maxillo-facial deformations underwent a preoperative CT study; a group of 10 patients were studied with MSCT and a group of 10 patients with CBCT. The data have been 3D reconstructed. Using the program SurgiCase CMF® various osteotomies were simulated in a three-dimensional virtual environment, by applying different surgical procedures. At the end of the simulation of the hard tissues the simulation of the soft tissues was possible.
Results. Results obtained in 10 cases through a CBCT simulation had been compared with those obtained through a MSCT simulation. MSCT simulations defined an average absolute error of 0.75 mm, with a standard deviation of 0.78 mm, pointing out a percentage of error <2 mm of 90.6%. CBCT simulations defined an average absolute error of 0.94 mm, with a standard deviation of 0.90 mm, pointing out a percentage of error <2 mm of 86.80%.
Conclusion. The preliminary results allow to conclude that programming orthognathic surgery in skull-maxillofacial deformity using CBCT acquisition is reliable and can become the method of choice for a lower radiation exposure than with MSCT.