When people have misaligned jaws where the upper and lower teeth donâ€™t match, the functional impact ranges from articulation and speech problems to problems with eating.
When jaw reconstruction is required, the outcome must be precise. The way people eat and bite is a very sensitive mechanism, and teeth have to meet in a certain way in order to bite and chew correctly.
Planning the surgery is the key.
A new system being used by Emory oral and maxillofacial surgeons helps them reach a level of preoperative planning that they had not been able to achieve before.
The system takes data from the patient obtained through CT scan (Computed Tomography) and optical scanning, and puts it into a software program that has been developed to allow the surgery to be performed virtually on the computer. This preoperative planning assists in the construction of an accurate intra-operative guide.
â€œThe virtually guided surgery allows us to immediately look at the outcome as we do the planning, measure the accuracy, and go back and make changes if needed,â€ explains Steven Roser, DMD, MD, chief of the Division of Oral and Maxillofacial Surgery at Emory.
Traditional planning for facial reconstruction requires the surgeon to take numerous steps to build a model of the jaw, cut the model to predict how the jaws will look and relate after surgery, and then use articulators to guide the actual surgical movements.
â€œAlthough for many years we got along well using the traditional method, much of our surgery was planned on two-dimensional records,â€ Roser explains. â€œNow, for some types of reconstructive surgeries, we can sit and plan and look and compare our clinical exam and photographs with something that is an accurate, three-dimensional representation of the patient that more closely replicates the roll, pitch and yaw of the condition.
Virtually guided surgery allows the surgical team to precisely determine the best surgery for each patient so when they go into the operating room, they have already done it on the screen. â€œIt gives us a level of confidence in the patientâ€™s final outcome that we didnâ€™t have before this technology was available.â€