Use of a laser-hardened three-dimensional replica for simulated surgery.

The main established approaches to preoperative surgical planning for mandibular reconstruction and correction of jaw deformities have been paper simulations using radiographic images and profile photographs of the head, and plaster model simulations of the teeth and jaws. However, these do not always provide sufficient information, especially in patients with an asymmetry. Three-dimensional images generated from computerized tomographic (CT) scans have the advantage of providing the ability to simulate the operation as well as repositioning of bones on the computer screen. Accumulated experience in cases with complicated features however, has shown that the images on the monitor often do not show the preoperative structure sufficiently accurately. The inability to perform simulated surgery exactly as in the actual operation has also proven to be a 1imitation.“5 Recently a new system for performing simulated surgery using solid replicas generated from the threedimensional computer images has been deve10ped.6-s We have been participating in this work, and have produced numerous replicas of the maxillofacial bones, which have been investigated extensively. In this article, we describe the method of simulating surgery using three-dimensional replicas and demonstrate the procedure in two patients; one with a jaw deformity treated by simultaneous maxillary advancement and mandibular retrusion, and one who required mandibular reconstruction after resection of a tumor.