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
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)
Complex Facial
Deformities
• Asymmetries
• condylar problems
• syndromes
Computer Aided Surgery -
CAS
• Virtual Models - Physical Models
• Surgical Simulation - creating a treatment plan
• Creating Splints, cutting Guides, implant designs
• Navigational Surgery
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
Treatment Plan
• Lefort I , BSSRO, Genioplasty
• ? Left Proximal Segment control without Condyle
reconstruction.
• Patient weary to extensive procedures
• Plan B
courtesy : Dr. Pramod Subash, Amrita Institute
Treatment Plan
Cutting Guides for resection of Ankylosis
cutting guides for osteotomies
Custom Joint Prosthesis
Screw lengths for various regions
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.
Bone Supported Splints
Navigation in CFD
CAS - Distraction
Osteogenesis in CFD
ck: Precise osteotomies for ….. Robin sequence using virtual surgical planning. Int. J. Oral Maxillofac. Surg. 2018; 47: 35– 43. ã
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
CAS
• Precision in surgery
• Reduction in surgical time
• Predictable Surgical Results
• There is a cost involved
Thank you

Application of computer technology in complex facial deformities

  • 1.
    Application of computer technologyin 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 • nowany 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)
  • 3.
    Complex Facial Deformities • Asymmetries •condylar problems • syndromes
  • 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 - UnilateralAnkylosis 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 • LefortI , BSSRO, Genioplasty • ? Left Proximal Segment control without Condyle reconstruction. • Patient weary to extensive procedures • Plan B
  • 12.
    courtesy : Dr.Pramod Subash, Amrita Institute
  • 13.
    Treatment Plan Cutting Guidesfor resection of Ankylosis cutting guides for osteotomies Custom Joint Prosthesis Screw lengths for various regions
  • 15.
    Tooth Supported Splints or BoneSupported • CT Data does not give accurate tooth morphology • additional data of dentition • IO Scans, Dental Models scanned. • additional armamentarium • additional cost • same errors possible.
  • 16.
  • 18.
  • 22.
  • 23.
    ck: Precise osteotomiesfor ….. Robin sequence using virtual surgical planning. Int. J. Oral Maxillofac. Surg. 2018; 47: 35– 43. ã
  • 24.
    cost involved clinicaluse 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 insurgery • Reduction in surgical time • Predictable Surgical Results • There is a cost involved
  • 26.