ORAL AND MAXILLOFACIAL SURGERY
THE USE OF 3D VIRTUAL PLANNING AND 3D PRINTING FOR THE TREATMENT OF FACIAL ASYMMETRY : A CASE REPORT
Eman Shaheen 1 , 2a * , Constantinus Politis 1 , 2b
1
Department of Imaging & Pathology , Faculty of Medicine , KU Leuven , Belgium
2
Department of Oral and Maxillofacial Surgery , University Hospitals Leuven , Belgium a
BSc , MSc , PhD , Clinical Engineer b
MD , DDS , MHA , MM , PhD , Professor and Head of Department of Oral and Maxillofacial
Received : September 07 , 2016 Accepted : December 07 , 2016
Available online : December 08 , 2016
Cite this article : Shaheen E , Politis C . The use of 3D virtual planning and 3D printing for the treatment of facial asymmetry : a case report . Stoma Edu J . 2016 ; 3 ( 2 ): 156-161 .
ABSTRACT
Introduction : Facial asymmetry is a three-dimensional problem and is common in humans . Depending on the severity of the condition and the cause , several treatment modalities are proposed . In this study , we report on our workflow treating facial mandibular asymmetries without malocclusion . Methodology : CT scans were used for preoperative planning and postoperative evaluation . 3D planning using the mirroring technique was presented and afterwards a simulated extension was 3D printed and used during the surgery for accurate harvesting and placement of the bone graft . Results : The surgical actual outcome when compared to the simulation revealed good approximation with a mean of 0.29 (± 1.73 ) mm . Conclusion : The proposed method can be considered promising for the treatment of facial mandibular asymmetry without affecting the occlusion . However , a larger scale prospective study should be conducted to confirm these findings . Keywords : facial asymmetry , 3D virtual planning , 3D printing .
1 . Introduction People with facial asymmetry are commonly seen in the general population . The developmental type of facial asymmetry is idiopathic and nonsyndromic in nature 1 . Facial asymmetry may cause esthetic , malocclusion or other problems to the patients . Different treatment modalities of facial asymmetry have been proposed including orthodontic appliances for mild asymmetry in children 2 . For more severe asymmetries , involving dental , skeletal and soft tissue components , a combination of orthodontic and orthognathic management are recommended . Orthognathic surgery can be accompanied by mandibular angle reduction , genioplasty , bony augmentation , etc 1 . The aim of this study was to present the use of 3D virtual planning and printing as surgical assistance to the treatment of facial mandibular asymmetry with autogenous appositional bone graft .
2 . Materials and Methods A patient was presented with complaints of facial asymmetry to the department of Oral and maxillofacial surgery , University hospitals of Leuven , Belgium . The patient had no complaints regarding functional occlusion , only esthetic . After clinical and radiographic examination , the patient was diagnosed with neutral occlusion within normal skeletal and dental midlines , good transverse ratio , end-to-end in the front with a chin deviation to the left . The procedure recommended for this patient was treatment of mandibular asymmetry with autogenous bone graft . Indication for this patient was purely esthetic . Ethical approval was obtained from the Ethical Review Board of the University Hospitals Leuven ( S57587 ).
* Corresponding author :
Eman Shaheen , BSc , MSc , PhD , Clinical Engineer , Responsible of the 3D Surgical Orthognathic Lab , Department of Oral and Maxillofacial Surgery , University Hospitals Leuven , Campus Sint-Rafaël , Kapucijnenvoer 33 , BE-3000 Leuven , Belgium Tel / Fax : + 32 16 341854 ; e-mail : eman . shaheen @ uzleuven . be
156 STOMA . EDUJ ( 2016 ) 3 ( 2 )