Two jaw surgery using CAD/CAM wafer based on soft tissue 3D simulation
富永和宏(Kazuhiro TOMINAGA) 九州歯科大学Kyushu Dental University
The goal of orthognathic surgery is to harmonize optimal aesthetic features with functional occlusion. To
achieve this goal, precise morphological and functional analyses as well as optimal planning of the final goal
during pre-surgical treatment is mandatory. Additionally, accurate reproduction of the simulated goal during
operation is necessary. Conventional pre-surgical planning has been made with 2D cephalometric prediction.
However, to achieve optimum aesthetic and occlusal results, 3D planning is going to be necessary. Especially
in facial asymmetry cases which need surgical correction of not only pitch and roll but yaw, 3D simulation is
mandatory. In this paper, I'm going to present two jaw surgery using intermediate wafer fabricated by CAD/
CAM based on soft tissue 3D simulation in facial asymmetry cases. Gross planning mainly relating the surgical
correction of pitch and roll of the maxilla is followed by 2D analyses. The data are introduced to 3D virtual
surgery program (SimPlant Pro OMS 10.1; Materialise Leuven, Belgium). Soft tissue surface reconstruction
after virtual surgery is visually evaluated by some orthodontists and oral surgeons. Then little by little correction
of yaw in the software is tested maintaining facial midline. The repositioning position of the maxilla in the
best aesthetic feature judged by evaluators is the final goal of the operation. In this position of the maxilla,
intermediate wafer is fabricated using CAD/CAM. This method can eliminate many time-consuming laboratory
steps. Additionally it can reduce technical errors derived from manual preparation ie, face bow transfer, manual
reposition of the plaster cast etc. I will present the accuracy of the method comparing virtual surgery and CT
taken after the operation.
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