SimPlant OMS is a software platform developed by Materialise Dental for the very specific purpose of allowing digital orthognathic planning and

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1 SimPlant OMS is a software platform developed by Materialise Dental for the very specific purpose of allowing digital orthognathic planning and creation of CAD/CAM intermediate and/or final splints. Medical Modeling s proprietary protocol includes use of the software in combination with accurate registration techniques for occlusal and natural head position (NHP) data.

2 SimPlant OMS Brochure

3 SimPlant OMS Workflow

4 SimPlant OMS Order Form

5 SimPlant OMS CT/CBCT Scanning Protocol

6 SimPlant OMS Guidebook

7 Why Plan an Orthognathic Case Digitally? To analyze anatomical discrepancies in pitch, roll and yaw three dimensionally To analyze how occlusal movements affect surrounding bony anatomy To utilize simulated postoperative soft tissue and bony predictions for patient education and teaching purposes To investigate multiple surgical approaches for the same patient To digitally create intermediate and final orthognathic splints using CAD/CAM technology, removing the need for traditional model surgery To reduce surgeon planning time to less than one hour for complex cases

8 Clinical Transfer Accuracy Two Important Concepts in Preparing Data for Successful Digital Orthognathic Planning 1. To produce accurate CAD/CAM splints, it is necessary to replace inaccurate occlusal surfaces from CT/CBCT scans with high resolution laser scans of the stone models 2. Accurately Reorient the patient s CT/CBCT scan to reflect their Natural Head Position (NHP) for more accurate planning

9 SimPlant OMS Startup Kit SimPlant OMS Startup Kit Provided by MM prior to Pre-Surgical Patient Visit Kit Includes 1) Software: -3DM Or - TrippLite USB 2) 3DM Orientation Sensor (with facebow attachment) 3) Blank Bite Jigs 4) Facebow 5) Guide Book 6) TrippLite USB Adaptor

10 SimPlant OMS Timeline (business days) Surgeon Medical Modeling Pre-Surgical Patient Visit To use our advanced planning protocol, MM can supply the surgeon with a SimPlant OMS Start Up Kit containing the required tools to successfully complete the visit. The surgeon will be asked to ship the following items to Medical Modeling directly following the Pre-Surgical Patient Visit: Digital Clinical Photos Upper and Lower Stone Models Bite Jig w/ Impression CT/CBCT Data Indication of Final Occlusion NHP Gyroscope Readings

11 Case Study Two-Jaw Orthognathic Surgery: Segmentalized LeFort I, Bilateral Inverted L Osteotomies and Genioplasty Courtesy of R. Bryan Bell, MD, DDS, FACS Legacy Emanuel Hospital and Health Center, Portland, Oregon

12 Create 3D Objects from CT/CBCT

13 Virtual Planning Webmeeting

14 Perform Digital Osteotomies Digital cutting planes are created Cutting planes are intersected with bone to create a digital osteotomy

15 Perform Digital Osteotomies

16 Digitally Reposition Bony Segments (Mandibular Advancement) Bony advancements are planned based on both clinical measurements and cephalometric analyses

17 Digitally Reposition Bony Segments (Maxillary Advancement)

18 Analyze Movements: Ceph Analysis

19 CAD/CAM Splints: Intermediate (Mandibular Surgery First)

20 CAD/CAM Splints: Final

21 Clinical Transfer Via Templates Courtesy of R. Bryan Bell, MD, DDS, FACS Legacy Emanuel Hospital and Health Center, Portland, Oregon

22 Bone Graft Templates Courtesy of R. Bryan Bell, MD, DDS, FACS Legacy Emanuel Hospital and Health Center, Portland, Oregon

23 Pre and Post Surgical Treatment Pre Post Courtesy of R. Bryan Bell, MD, DDS, FACS Legacy Emanuel Hospital and Health Center, Portland, Oregon

24 Summary Digital Orthognathic Planning is not a futuristic technique, it s here today Many years of optimization and research have lead to a predictable system for planning and transfer of the plan to the patient via CAD/CAM splints Not only will the use of digital technology reduce surgeon planning time (model surgery) but it will also provide more favorable outcomes by focusing on the bony anatomy level for planning

25 Selected Literature References - Bell, R: Computer planning and intraoperative navigation in cranio-maxillofacial surgery. Oral and Maxillofacial Surgery Clinics of North America 22: , Xia J, Gateno J, Teichgraeber J: New clinical protocol to evaluate craniomaxillofacial deformity and plan surgical correction. J Oral Maxillofac Surg 67: , Xia J, Gateno J, Schatz E, Weiskirscher M, English J, Teichgraeber J: Accuracy of a new technique for recording natural head position in three dimensions. Poster Presentation: ACOMS Gateno J, Xia J, Teichgraeber J, Christensen A, Lemoine J, Liebschner M, Gliddon M, Briggs M: Clinical feasibility of computer-aided surgical simulation in the treatment of complex cranio-maxillofacial deformities. J Oral Maxillofac Surg 65: , Xia J, Gateno J, Teichgraeber J, Christensen A, Lasky R, Lemoine J, Liebschner M: Accuracy of computer-aided surgical simulation (CASS) system in the treatment of patients with complex craniomaxillofacial deformity: A pilot study. J Oral Maxillofac Surg 65: , Xia J, Phillips C, Gateno J, Teichgraeber J, Christensen A, Gliddon M, Lemoine J, Liebschner M: Cost-effectiveness for a computer-aided surgical simulation in complex cranio-maxillofacial surgery. J Oral Maxillofac Surg 64: , Xia J, Gateno J, Teichgraeber J: Three-dimensional computer-aided surgical simulation for maxillofacial surgery. Atlas Oral Maxillofacial Surg Clin N Am 13: 25-39, Gateno J, Xia J, Teichgraeber J, Rosen A: A new technique for creation of a computerized composite skull model. J Oral Maxillofac Surg 61: , Gateno J, Xia J, Teichgraeber J, Rosen A, Hultgren B, Vadnais T: The precision of computer-generated surgical splints. J Oral Maxillofac Surg 61: , Gateno J, Forrest K, Camp B: A comparison of 3 methods of face-bow transfer recording: implications for orthognathic surgery. J Oral Maxillofac Surg 59: , 2001

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