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Special Issue "Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications"

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (1 December 2023) | Viewed by 6021

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Dr. Michael Boelstoft Holte

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1. 3D Lab Denmark, Department of Oral and Maxillofacial Surgery, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark
2. Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 6700 Esbjerg, Denmark
Interests: biomedical engineering; medical image analysis; medical 3D printing; computer-assisted surgery; virtual surgical planning; virtual rehabilitation; computer vision; image processing and analysis; pattern recognition; machine learning; artificial intelligence; computer graphics; virtual-; mixed- and augmented reality; human-computer interaction; robotics; gamification; user-centered design; usability

Special Issue Information

Dear Colleagues,

Orthognathic surgery, or corrective jaw surgery, is employed when conventional orthodontics treatment is insufficient in treating maxillofacial discrepancy caused by growth disturbances of the maxillofacial skeleton. The treatment involves surgical interventions of the jaws with the main purpose of establishing a correct dental occlusion, and optimizing facial aesthetics and functional results.

Preoperative planning of orthognathic surgery has evolved from the use of gypsum models manually mounted in an articulator and 2D cephalometry on teleradiographs, to the application of personalized 3D-printed surgical guides and implants corroborated with advanced computer-assisted surgical planning and intervention analysis in 3D. Similarly, 3D technologies have been applied in the preoperative planning and execution of oral and maxillofacial reconstructive surgery, such as personalized mandibular free-flap reconstruction using patient-specific cutting guides and implants. These 3D technologies have improved the predictability of the postoperative outcome and the surgical accuracy. Additionally, such technologies enable increased patient engagement and personalization by adjusting the procedure to the needs of each patient.

This Special Issue “Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications” of the Journal of Personalized Medicine aims to highlight the current state of the art and present the latest findings in the field of personalization of maxillofacial surgery.

Researchers are invited to submit original research and review articles, including, but not limited to, studies on predictive treatment planning, analysis of postoperative outcome, patient engagement, personalized implants, automation and the application of artificial intelligence and augmented reality in orthognathic surgery, or oral and maxillofacial reconstructive surgery.

Dr. Michael Boelstoft Holte
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

maxillofacial deformities
Reconstruction
Emerging Technologies
predictive treatment planning
analysis of postoperative outcome
patient engagement
personalized implants
automation
artificial intelligence
orthognathic surgery
virtual, augmented and mixed reality
robotic surgery

Published Papers (4 papers)

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Research

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11 pages, 1117 KiB

Open AccessArticle

A Semi-Automatic Approach for Holistic 3D Assessment of Temporomandibular Joint Changes

Michael Boelstoft Holte

Henrik Sæderup

and

Else Marie Pinholt

J. Pers. Med. 2023, 13(2), 343; https://doi.org/10.3390/jpm13020343 - 16 Feb 2023

Cited by 1 | Viewed by 891

Abstract

The literature lacks a reliable holistic approach for the three-dimensional (3D) assessment of the temporomandibular joint (TMJ) including all three adaptive processes, which are believed to contribute to the position of the mandible: (1) adaptive condylar changes, (2) glenoid fossa changes, and (3) condylar positional changes within the fossa. Hence, the purpose of the present study was to propose and assess the reliability of a semi-automatic approach for a 3D assessment of the TMJ from cone-beam computed tomography (CBCT) following orthognathic surgery. The TMJs were 3D reconstructed from a pair of superimposed pre- and postoperative (two years) CBCT scans, and spatially divided into sub-regions. The changes in the TMJ were calculated and quantified by morphovolumetrical measurements. To evaluate the reliability, intra-class correlation coefficients (ICC) were calculated at a 95% confidence interval on the measurements of two observers. The approach was deemed reliable if the ICC was good (>0.60). Pre- and postoperative CBCT scans of ten subjects (nine female; one male; mean age 25.6 years) with class II malocclusion and maxillomandibular retrognathia, who underwent bimaxillary surgery, were assessed. The inter-observer reliability of the measurements on the sample of the twenty TMJs was good to excellent, ICC range (0.71–1.00). The range of the mean absolute difference of the repeated inter-observer condylar volumetric and distance measurements, glenoid fossa surface distance measurements, and change in minimum joint space distance measurements were (1.68% (1.58)–5.01% (3.85)), (0.09 mm (0.12)–0.25 mm (0.46)), (0.05 mm (0.05)–0.08 mm (0.06)) and (0.12 mm (0.09)–0.19 mm (0.18)), respectively. The proposed semi-automatic approach demonstrated good to excellent reliability for the holistic 3D assessment of the TMJ including all three adaptive processes. Full article

(This article belongs to the Special Issue Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications)

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11 pages, 5422 KiB

Open AccessArticle

Application of Augmented Reality to Maxillary Resections: A Three-Dimensional Approach to Maxillofacial Oncologic Surgery

Francesco Ceccariglia

and

J. Pers. Med. 2022, 12(12), 2047; https://doi.org/10.3390/jpm12122047 - 12 Dec 2022

Cited by 7 | Viewed by 1317

Abstract

In the relevant global context, although virtual reality, augmented reality, and mixed reality have been emerging methodologies for several years, only now have technological and scientific advances made them suitable for revolutionizing clinical care and medical settings through the provision of advanced features and improved healthcare services. Over the past fifteen years, tools and applications using augmented reality (AR) have been designed and tested in the context of various surgical and medical disciplines, including maxillofacial surgery. The purpose of this paper is to show how a marker-less AR guidance system using the Microsoft^® HoloLens 2 can be applied in mandible and maxillary demolition surgery to guide maxillary osteotomies. We describe three mandibular and maxillary oncologic resections performed during 2021 using AR support. In these three patients, we applied a marker-less tracking method based on recognition of the patient’s facial profile. The surgeon, using HoloLens 2 smart glasses, could see the virtual surgical planning superimposed on the patient’s anatomy. We showed that performing osteotomies under AR guidance is feasible and viable, as demonstrated by comparison with osteotomies performed using CAD-CAM cutting guides. This technology has advantages and disadvantages. However, further research is needed to improve the stability and robustness of the marker-less tracking method applied to patient face recognition. Full article

(This article belongs to the Special Issue Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications)

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16 pages, 1506 KiB

Open AccessArticle

A Quantitative and Qualitative Clinical Validation of Soft Tissue Simulation for Orthognathic Surgery Planning

Alessandro Gutiérrez Venturini

Jorge Guiñales Díaz de Cevallos

José Luis del Castillo Pardo de Vera

Patricia Alcañiz Aladrén

Carlos Illana Alejandro

and

José Luis Cebrián Carretero

J. Pers. Med. 2022, 12(9), 1460; https://doi.org/10.3390/jpm12091460 - 06 Sep 2022

Viewed by 1339

Abstract

The purpose of this study was to perform a quantitative and qualitative validation of a soft tissue simulation pipeline for orthognathic surgery planning, necessary for clinical use. Simulation results were retrospectively obtained in 10 patients who underwent orthognathic surgery. Quantitatively, error was measured at 9 anatomical landmarks for each patient and different types of comparative analysis were performed considering two mesh resolutions, clinically accepted error, simulation time and error measured by means of percentage of the whole surface. Qualitatively, evaluation and binary questions were asked to two surgeons, both before and after seeing the actual surgical outcome, and their answers were compared. Finally, the quantitative and qualitative results were compared to check if these two types of validation are correlated. The quantitative results were accurate, with greater errors corresponding to gonions and lower lip. Qualitatively, surgeons answered similarly mostly and their evaluations improved when seeing the actual outcome of the surgery. The quantitative validation was not correlated to the qualitative validation. In this study, quantitative and qualitative validations were performed and compared, and the need to carry out both types of analysis in validation studies of soft tissue simulation software for orthognathic surgery planning was proved. Full article

(This article belongs to the Special Issue Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications)

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Review

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24 pages, 6394 KiB

Open AccessEditor’s ChoiceReview

Three-Dimensional Accuracy and Stability of Personalized Implants in Orthognathic Surgery: A Systematic Review and a Meta-Analysis

Alexandru Diaconu

Michael Boelstoft Holte

Gabriele Berg-Beckhoff

and

Else Marie Pinholt

J. Pers. Med. 2023, 13(1), 125; https://doi.org/10.3390/jpm13010125 - 07 Jan 2023

Cited by 7 | Viewed by 1910

Abstract

This systematic review aimed to determine the accuracy/stability of patient-specific osteosynthesis (PSI) in orthognathic surgery according to three-dimensional (3D) outcome analysis and in comparison to conventional osteosynthesis and computer-aided designed and manufactured (CAD/CAM) splints or wafers. The PRISMA guidelines were followed and six academic databases and Google Scholar were searched. Records reporting 3D accuracy/stability measurements of bony segments fixated with PSI were included. Of 485 initial records, 21 met the eligibility (566 subjects), nine of which also qualified for a meta-analysis (164 subjects). Six studies had a high risk of bias (29%), and the rest were of low or moderate risk. Procedures comprised either single-piece or segmental Le Fort I and/or mandibular osteotomy and/or genioplasty. A stratified meta-analysis including 115 subjects with single-piece Le Fort I PSI showed that the largest absolute mean deviations were 0.5 mm antero-posteriorly and 0.65° in pitch. PSIs were up to 0.85 mm and 2.35° more accurate than conventional osteosynthesis with CAD/CAM splint or wafer (p < 0.0001). However, the clinical relevance of the improved accuracy has not been shown. The literature on PSI for multi-piece Le Fort I, mandibular osteotomies and genioplasty procedure is characterized by high methodological heterogeneity and a lack of randomized controlled trials. The literature is lacking on the 3D stability of bony segments fixated with PSI. Full article

(This article belongs to the Special Issue Personalized Treatment of Maxillofacial Deformities and Reconstruction: Emerging Technologies, Methods and Applications)

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