Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy

Area of Science:

• Maxillofacial Surgery
• 3D Imaging in Medicine
• Virtual Surgical Planning

Background:

• Conventional methods for evaluating maxillofacial deformities are reliable, but 3D imaging (CT scans, laser scanning) enhances understanding of skeletal and soft tissue structures.
• Virtual technologies are increasingly used in maxillofacial surgery, showing precision and reliability, though their application in complex procedures remains debated.
• Limited experience and scientific literature exist for complex three-part maxillary surgery, highlighting the need for reliable planning methods.

Observation:

• A young patient with a complex long-face dentofacial deformity underwent bimaxillary surgery with three-part maxillary segmentation.
• The entire surgical plan was executed using a virtual workflow, incorporating pre- and postoperative CT scans and optical scans of plaster models.
• Postoperative maxillary segments were superimposed onto presurgical models to analyze differences using a color-coded map.

Findings:

• The virtual workflow for three-part maxillary surgery demonstrated high precision and reliability.
• Comparison of pre- and postoperative data revealed only mild differences near osteotomy lines.
• Excellent coincidence was observed between the bony surfaces and teeth in the postoperative state compared to the presurgical state.

Implications:

• Virtual surgical planning is a precise and reliable tool for complex maxillofacial procedures like three-part maxillary surgery.
• This case study supports the use of virtual workflows in overcoming the limitations of current scientific literature for rare and complex surgical cases.
• The findings encourage wider adoption of advanced imaging and virtual planning in maxillofacial surgery for improved patient outcomes.