Application of Medical Imaging Technology in Oral and Maxillofacial Surgery

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Application of Medical Imaging Technology in Oral and Maxillofacial Surgery

Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 9, Issue 2

Abstract

Patients undergoing oral and maxillofacial surgery require recovery from dysfunction related to occlusion, eating/swallowing, speech etc. It is also essential to restore from esthetic disorders by the surgery and esthetics must not be impaired as possible even after surgery. The oral and maxillofacial surgery procedure must consider both aspects of functionality and esthetics, and the surgery must be performed with high precision. Therefore, the trend of using medical imaging technology, which has remarkably progressed in oral and maxillofacial surgery, has accelerated in recent years. Medical imaging technology enables to accurately memorize, measure, and visualize the necessary information for the operator and is indispensable for planning a surgery, assisting surgical techniques, and evaluating after surgery. This study reviews medical imaging technologies that are popular in clinical use for each major surgery in oral and maxillofacial surgery.Surgeries such as Le Fort I maxillary osteotomy, sagittal split ramus osteotomy, and intraoral vertical ramus osteotomy are performed to correct jaw deformities. Occlusal position is a criterion that determines the movement extent of the jaw. Therefore, a CAD/ CAM surgical splint is prepared in advance by surgical simulation using computed tomography (CT) [1]. A CAD/CAM surgical splint is a bite plate with indentations to the teeth cusp of the upper and lower jaw. The jaw is set at the ideal occlusal position using the splint after orthognathic surgery. Moreover, previous reports have analyzed changes in facial features [2] and morphological changes in the temporomandibular joint [3] before and after the surgery, and reports on fluid dynamics have analyzes changes in airway morphology [4] after the surgery.Dental implant surgery is a procedure in which a titanium artificial tooth root is implanted in the maxilla or mandible. The ideal implant position is simulated on CT images using implant planning software, and a mouthpiece-type surgical stent is used to correspond with it. Based on these data, the surgical stent is manufactured by a milling machine or a 3D printer [5]. The surgical stent defines the position and direction of the drill to accurately reproduce the position and orientation of the simulated hole for implantation; however, this method requires sufficient maximum mouth opening. Often, the drill cannot be inserted into the hole of the surgical stent due to long drills and thick surgical stents. Hence, the overlay system [6], which automatically registers the camera and CT images, is considered a solution because the surgical stent is no longer needed. Recently, intraoral scanners have become widespread [7], and surgical stents can be designed using computer software. That is, quickly transferring the intraoral data to the laboratory has become possible and delivering the molded model has become unnecessary.

Authors and Affiliations

Takashi Ohya, Ichiro Sakuma, Kenji Mitsudo

Keywords

Maxillofacial Surgery Dysfunction Esthetics Orthognathic Surgery Sagittal Ramus Osteotomy Mandibular Cervical Fracture Chemoradiotherapy Catheterization Preoperatively Intraoperatively

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EP ID EP591741
DOI 10.26717/BJSTR.2018.09.001777
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