Correction of a severe facial asymmetry with computerized planning and with the use of a rapid prototyped surgical template: a case report/technique article.

Abstract

Management of significant facial asymmetry presents a challenge due to the geometric complexity of the bony and other facial structures. Manual model surgery is an essential part of treatment planning but it can be complicated, time-consuming and may contain potential errors. Computer-aided surgery has revolutionized the correction of maxillofacial deformities. The aim of this study was to report a case of facial asymmetry when computerised simulation surgery was performed instead of manual model surgery and a virtually planned wafer splint was fabricated. A 26-year-old male was presented with a severe right-sided hemimandibular elongation. Following presurgical orthodontics high-resolution computer tomography scan was performed. The stack images were reformatted into a three-dimensional structure. Virtual Le Fort-I osteotomy was performed and the symmetry of the maxilla was corrected with the help of a three-dimensional planning software. A virtual intermediate surgical wafer was designed and produced with three-dimensional rapid prototyping technology. The mandible was rotated into the correct position following virtual bilateral sagittal split osteotomy to visualize the movements of the osteotomised mandibular segments. The two-jaw procedure was performed according to the virtual plan. The facial symmetry was improved significantly and stable occlusion was achieved. This complex case shows the advantages of computer-aided surgical planning and three-dimensional rapid prototyping for the correction of facial asymmetries.

• Authors: Laszlo Seres, Endre Varga Jr, Andras Kocsis, Zoltan Rasko, Balazs Bago, Endre Varga, Jozsef Piffko
• Journal: Head & face medicine (Head Face Med) Vol. 10 Pg. 27 (Jul 11 2014) ISSN: 1746-160X [Electronic] England
• PMID: 25014992 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cephalometry
• Dental Occlusion
• Face (abnormalities, diagnostic imaging, surgery)
• Facial Asymmetry (congenital, diagnostic imaging, surgery)
• Humans
• Hyperplasia (diagnostic imaging, surgery)
• Imaging, Three-Dimensional
• Male
• Mandible (diagnostic imaging, surgery)
• Maxilla (diagnostic imaging, surgery)
• Osteotomy, Le Fort (methods)
• Surgery, Computer-Assisted (methods)
• Tomography, X-Ray Computed