A simulator for maxillofacial surgery integrating 3D cephalometry and orthodontia.

OBJECTIVES: This paper presents a new simulator for maxillofacial surgery that gathers the dental and maxillofacial analyses together into a single computer-assisted procedure. The idea is to first propose a repositioning of the maxilla via the introduction of 3D cephalometry applied to a 3D virtual model of the patient's skull. Orthodontic data are then integrated into this model, using optical measurements of plaster casts of the teeth. MATERIALS AND METHODS: The feasibility of the maxillofacial demonstrator was first evaluated on a dry skull. To simulate malformations (and thus simulate a "real" patient), the skull was modified and manually cut by the surgeon to generate a given maxillofacial malformation (with asymmetries in the sagittal, frontal, and axial planes). RESULTS: The validation of our simulator consisted of evaluating its ability to propose a bone repositioning diagnosis that would restore the skull to its original configuration. An initial qualitative validation is provided in this paper, with a 1.5-mm error in the repositioning diagnosis. CONCLUSIONS: These results mainly validate the concept of a maxillofacial numerical simulator that integrates 3D cephalometry and guarantees a correct dental occlusion.