3-H in 3-D: Envisaging Beyond the Current Hype, the Hope and Hurdles of Three-Dimensional “Virtual Planning” in Orthognathic Surgery

Abstract

Recent technical and technological advancements in orthognathic surgery concepts, intricate in the diagnosis and treatment planning for corrections of dento-facial deformities, have achieved stable oro-dental functional occlusion and facial esthetic harmony. Undeniably, this can be attributed to the integration of modern, innovative and advanced facial analysis and computer-aided imaging exams into well-orchestrated and executed orthodontic and surgical methods. Three-Dimensional (3-D) virtual planning is a fine example. Today, the acquisition of 3-D images of a patient's craniofacial complex via cone-beam computed tomography (CBCT), supported by software tools allowing the construction of 3-D dynamic and interactive visual models, eliminates the uncertainty experienced with two-dimensional images. Thereby allowing for a more accurate or predictable treatment plan and efficient surgery, especially for patients with complex dento-facial deformities. This review article aims to describe the current benefits as well as shortcomings of 3-D virtual planning via discussing examples and illustrations from orthognathic procedures, attained from the reported English and Spanish literature during the last 10 years. It is designed to deliver updated and practical guidelines for dental practitioners and specialists (particularly, oral and maxillofacial), as well as researchers involved in 3-D virtual approaches as an alternative to conventional/traditional surgical planning; thereby validating its superiority or benefits in terms of outcome prediction for soft and hard tissues, operational timeand cost-effectiveness; for its integration in day-today practise.

Virtual Surgical Planning: Modeling from the Present to the Future

“…Therefore, it is becoming more essential to select the most appropriate surgical procedure for a particular patient. In this regard, Gracia-Abuter et al [ 49 ] are of the view that 3D image acquisition using CBCT scans permits the construction of dynamic and interactive 3D visual models, which in turn allow accurate or predictable VSP and efficient surgical procedures for patients with complex craniofacial issues.…”