Three-dimensional Camera Imaging in Postoperative Evaluation of Distraction Osteogenesis.

Distraction osteogenesis needs to be regularly assessed in some way to monitor the degree of advancement. X-ray is used for the general evaluation of osteotomy. However, radiation exposure should be avoided. The purpose of this study is to evaluate 3-dimensional (3D) camera imaging for postoperative evaluation. Three patients who underwent Le Fort I or III advancement osteotomy using rigid external distraction and internal distraction were observed in this study. The degrees of the distractions were evaluated using VECTRA H1 3D imaging in addition to computed tomographic (CT) scans. In the VECTRA 3D imaging, the tilt and size of the faces were corrected using the dedicated software for imaging. The preoperative and postoperative images were superimposed, and the distances of motion between the landmarks were measured. In CT scans, the bone distances between osteotomy points of the pterygomaxillary junction were analyzed. As the VECTRA 3D imaging can be compared by overlaying previous photographs, it served as a good tool to evaluate the distractions. However, both the soft-tissue movement measured by VECTRA and CT bony measurements did not match the total amount of movement for the internal distraction devices. The bony advancements were less than the amount of distraction. The soft tissues shrank after the distraction was completed in all cases. Three-dimensional camera imaging is considered to be a useful tool for the evaluation of distraction osteogenesis.

Three-Dimensional Computer-Assisted Two-Layer Elastic Models of the Face.

To make three-dimensional computer-assisted elastic models for the face, we decided on five requirements: (1) an elastic texture like skin and subcutaneous tissue; (2) the ability to take pen marking for incisions; (3) the ability to be cut with a surgical knife; (4) the ability to keep stitches in place for a long time; and (5) a layered structure. After testing many elastic solvents, we have made realistic three-dimensional computer-assisted two-layer elastic models of the face and cleft lip from the computed tomographic and magnetic resonance imaging stereolithographic data. The surface layer is made of polyurethane and the inner layer is silicone. Using this elastic model, we taught residents and young doctors how to make several typical local flaps and to perform cheiloplasty. They could experience realistic simulated surgery and understand three-dimensional movement of the flaps.