Mathematical modeling and numerical simulation in maxillofacial virtual surgery.

Computer-based surgery simulation is a rapidly emerging and increasingly important area of research that combines a number of disciplines for the common purpose of improving healthcare. The objective of this article is to provide a virtual surgery tool for accurately planning the aesthetic impact of hard and soft tissue movements in dentoskeletal malocclusions. The approach proposed here allows direct interaction with a completely three-dimensional (3D) computed tomography (CT) model of a solid, highly detailed structure of the head to obtain a realistic prediction of soft tissue behavior. We studied 25 patients who had facial malformations pre- and postoperatively with 3D hard and soft tissue CT studies, and maxillary or mandibular osteotomies were simulated. The postoperative 3D CT and facial outcomes were compared with the simulations. In 80% of the cases studied, the simulation-predicted changes, when compared with the clinical outcomes, were within the tolerance level (2 mm) established by maxillofacial surgeons.