Fogorvosi szemle, 2015 (108. évfolyam, 1-4. szám)
2015-06-01 / 2. szám
52 FOGORVOSI SZEMLE ■ 108. évf. 2. sz. 2015. Irodalom 1. Cheong YW, Lo LJ: Facial asymmetry: etiology, evaluation, and management. Chang Gung Med J 2011; 34: 341-351. 2. Bamber M, Vachiramon A: Surgical wafers: a comparative study. J Contemp Dent Pract 2005; 6: 99-106. 3. Choi JY, Song KG, Baek SH: Virtual model surgery and wafer fabrication for orthognathic surgery. Int J Oral Maxillofac Surg 2009; 38: 1306-1310. 4. Metzger MC, Hohlweg-Majert B, Schwarz U, Teschner M, Hammer B, Schmelzeisen R: Manufacturing splints for orthognathic surgery using three-dimensional printer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105: e1-7. 5. Levine JP, Patel A, Saadeh PB, Hirsch DL: Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art. J Craniofac Surg 2012; 23: 288-293. 6. Lorensen WE, Cline HE: Marching cubes: A high resolution 3D surface construction algorithm. Computer Graphics 1987; 21: 163-169. 7. Erdőhelyi B, Varga E, Kuba A: Surgical Planning Tool with Biomechanical Simulation. Proceedings of the International Conference on Computer Assisted Radiology and Surgery (CARS). Int J Cornput Assist Radiol Surg 2007; 2: S262-S263. 8. Cevidanes LH, Tucker S, Styner M, Kim H, Chapuis J, Reyes M, Proffit W, Turvey T, Jaskolka M: Three-dimensional surgical simulation. Am J Orthod Dentofacial Orthop 2010; 138: 361-371. 9. Ellis E 3rd: Accuracy of model surgery: evaluation of an old technique and introduction of a new one. J Oral Maxillofac Surg 1990; 48: 1161-1167. 10. Edler R, Wertheim D, Greenhill D: Outcome measurement in the correction of mandibular asymmetry. Am J Orthod Dentofacial Orthop 2004; 125: 435-443. 11. Hwang HS, Hwang CH, Lee KH, Kang BC: Maxillofacial 3-dimensional image analysis for the diagnosis of facial asymmetry. Am J Orthod Dentofacial Orthop 2006; 130: 779-785. 12. Gateno J, Xia JJ, Teichgraeber JF: A new three-dimensional cephalometric analysis for orthognathic surgery. J Oral Maxillofac Surg 2011; 69: 606-622. 13. Baek SH, Kang SJ, Bell WH, Chu S, Kim HK: Fabricating a surgical wafer splint by three-dimensional virtual model surgery. In: Bell WH, Guerrero CA. eds. Distraction Osteogenesis of the Facial Skeleton. Hamilton, Ontario: BC Decker, 2006: 115-130. 14. Swennen GR, Mollemans W, Schutyser F: Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging. J Oral Maxillofac Surg. 2009; 67: 2080-2092. 15. Hsu SS, Gateno J, Bell RB, Hirsch DL: Markiewicz MR, Teichgraeber JF, Zhou X, Xia JJ. Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 2013; 71: 128-142. 16. Parbatani R, Williams AC, Ireland AJ, Sandy JR: The process of orthognathic care in an NHS region. Ann R Coll Surg Engl 2010; 92: 34-39. 17. Varga E Jr, Hammer B, Hardy BM, Kamer L: The accuracy of threedimensionalmodel generation. What makes it accurate to be used for surgical planning? Int J Oral Maxillofac Surg 2013; 42: 1159-1166. Seres L, Kocsis A, Varga E, Raskó Z, Varga V, Bagó B, Varga E, Piffkó J Virtual model surgery and fabrication of a surgical wafer by rapid prototyping technology for correction of a severe mandibular asymmetry Correction of a severe facial asymmetry presents a challenge due to the geometric complexity of the dentition, the bony structures and the soft tissues. In most asymmetric cases two-jaw surgery is recommended. Manual model surgery is an essential part of treatment planning but it can be complicated, time-consuming and may contain potential errors. We present a case of a 26-year-old male with a severe right-sided hemimandibular elongation when computerized simulation surgery was performed instead of manual model surgery. High-resolution computer tomography scan was done following presurgical orthodontics and the stack images were reformatted into a three-dimensional structure. The symmetry of the maxilla was corrected via a virtual Le Fort I osteotomy with the help of a three-dimensional planning software. A virtual intermediate surgical wafer was designed and fabricated with a three-dimensional printer. Virtual bilateral sagittal split osteotomy was performed and the mandible was rotated into the correct position to visualize the movements of the osteotomized segments. Real surgery was accomplished according to the virtual plan. The splint fitted well. There is a significant improvement in the facial symmetry; the occlusion is good and stable. This case supports the usage of computer-aided surgical planning and three-dimensional rapid prototyping for the correction of facial asymmetries. Keywords: virtual model surgery, facial asymmetry, digital intermediate wafer, three-dimensional rapid prototyping
