Comparing 3-dimensional virtual methods for reconstruction in craniomaxillofacial surgery

Purpose: In the present project, the virtual reconstruction of digital osteomized zygomatic bones was simulated using different methods. Materials and Methods: A total of 15 skulls were scanned using computed tomography, and a virtual osteotomy of the left zygomatic bone was performed. Next, virtual reconstructions of the missing part using mirror imaging (with and without best fit registration) and thin plate spline interpolation functions were compared with the original left zygomatic bone. Results: In general, reconstructions using thin plate spline warping showed better results than the mirroring approaches. Nevertheless, when dealing with skulls characterized by a low degree of asymmetry, mirror imaging and subsequent registration can be considered a valid and easy solution for zygomatic bone reconstruction. Conclusions: The mirroring tool is one of the possible alternatives in reconstruction, but it might not always be the optimal solution (ie, when the hemifaces are asymmetrical). In the present pilot study, we have verified that best fit registration of the mirrored unaffected hemiface and thin plate spline warping achieved better results in terms of fitting accuracy, overcoming the evident limits of the mirroring approach.