Soft-Tissue Simulation for Computational Planning of Orthognathic Surgery.

Patricia Alcañiz,Carlos Illana,Ángel Villalobos,Alessandro Gutiérrez,Jesús Pérez,Miguel A Otaduy,Jorge Guiñales,Héctor Barreiro,David Miraut

doi:10.3390/jpm11100982

Abstract

Simulation technologies offer interesting opportunities for computer planning of orthognathic surgery. However, the methods used to date require tedious set up of simulation meshes based on patient imaging data, and they rely on complex simulation models that require long computations. In this work, we propose a modeling and simulation methodology that addresses model set up and runtime simulation in a holistic manner. We pay special attention to modeling the coupling of rigid-bone and soft-tissue components of the facial model, such that the resulting model is computationally simple yet accurate. The proposed simulation methodology has been evaluated on a cohort of 10 patients of orthognathic surgery, comparing quantitatively simulation results to post-operative scans. The results suggest that the proposed simulation methods admit the use of coarse simulation meshes, with planning computation times of less than 10 seconds in most cases, and with clinically viable accuracy.

Highlights

Orthognathic surgery is performed on patients who suffer from dentomaxillofacial disharmony
This study proposes a soft-tissue simulation methodology that achieves high accuracy thanks to an finite-element models (FEM) foundation, but it provides high computational efficiency for a semi-interactive planning experience
We have presented a simulation methodology for planning of orthognathic surgical interventions

Summary

Introduction

Orthognathic surgery is performed on patients who suffer from dentomaxillofacial disharmony. Deformities of maxillofacial bones may prevent proper functioning of these bones, which are key for chewing, breathing and speaking [1]. They may cause important functional problems such as sleep apnea, malocclusion problems, or lack of skeletal harmony. Planning of orthognathic surgery is carried out in close collaboration between orthodontists and maxillofacial surgeons, and leverages existing 3D surgical planning solutions [5,6,7]. Before describing in detail our methodology, we review previous work on simulation and planning procedures for orthognathic surgery. The amount of works that document the use of simulation in a clinical context is immense, and we discuss only a few with particular contributions. In [18], the authors summarize the work carried out at their lab for over 15 years, discussing possible extensions of soft-tissue simulation to the evaluation under motion or ageing of the face

Methods

Results

Discussion

Conclusion