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Updated: Mar 16, 2026
Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
Development and refinement of computer-assisted planning and execution system for use in face-jaw-teeth
Sepehr Hashemi1, Mehran Armand, Chad R Gordon
1aHarvard School of Dental Medicine, Boston, Massachusetts bDepartment of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital cJohns Hopkins University School of Medicine, Baltimore dJohns Hopkins Applied Physics Laboratory, Laurel eDepartment of Orthopedic Surgery, The Johns Hopkins Hospital fDepartment of Mechanical Engineering, Johns Hopkins University gDepartment of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland, United States.
Purpose Of Review:
To describe the development and refinement of the computer-assisted planning and execution (CAPE) system for use in face-jaw-teeth transplants (FJTTs).
Recent Findings:
Although successful, some maxillofacial transplants result in suboptimal hybrid occlusion and may require subsequent surgical orthognathic revisions. Unfortunately, the use of traditional dental casts and splints pose several compromising shortcomings in the context of FJTT and hybrid occlusion. Computer-assisted surgery may overcome these challenges. Therefore, the use of computer-assisted orthognathic techniques and functional planning may prevent the need for such revisions and improve facial-skeletal outcomes.
Summary:
A comprehensive CAPE system for use in FJTT was developed through a multicenter collaboration and refined using plastic models, live miniature swine surgery, and human cadaver models. The system marries preoperative surgical planning and intraoperative execution by allowing on-table navigation of the donor fragment relative to recipient cranium, and real-time reporting of patient's cephalometric measurements relative to a desired dental-skeletal outcome. FJTTs using live-animal and cadaveric models demonstrate the CAPE system to be accurate in navigation and beneficial in improving hybrid occlusion and other craniofacial outcomes. Future refinement of the CAPE system includes integration of more commonly performed orthognathic/maxillofacial procedures.
