3D CT Virtual Surgical Planning software?

[secondtimearound]

I am gearing up for my second round of surgery.

I had a LF1/BSSO/genio for class 3 bite, openbite, crossbite, and asymmetry over ten years ago. I will be getting now a SARPE followed by revision LF1/BSSO.

I am not interested in leaving anything to chance the second time around.

I'm wondering if once I get my CT scans done, there might be a good program I can use to do my own virtual surgical planning and play with it a bit.

Do you guys know what programs the maxillofacial surgeons typically use for this?

[PloskoPlus]

Dolphin. I don't think they are trivial to use. I suspect that's why my bum surgeon didn't use it - too complicated for him.

[XXRyanXXL]

My surgeon said they don't use the dolphin software anymore because it doesn't give realistic results, too many people were relying on the data sets from the imaging software but there's many more variables that affects the outcome and I suppose they got sued in the past.

You can go to https://www.3dsystems.com/healthcare
and purchase a commercial license.

[kavan]

To the best of my knowledge, DOLPHIN and other surgical planning software is a 'Class #' medical device. (I forget the class number) and I believe they limit the sale to med professionals.

[secondtimearound]

Secondtime around, are you having surgery with the same surgeon? Why is it that you need revision?

I am not going to the same surgeon as I have a degree of lost trust for him. More so we riding exactly part on good terms at our last visit as I expressed frustration with my outcome. I have no animosity toward him, as I feel he did a good job with the plan that was made, but the plan was wholly inadequate.

I'm not sure how he would feel about me a second time around. I will probably consult with him at least to get his opinion before going ahead. That was 13 years ago I last spoke to him so hopefully we can just start again to an extent.

Probably I will go to Caminiti who at one time was a student of my surgeon, Tocchio.

Here's a summary of my history.

I had my first procedure done by Dr. Claudio Tocchio which went poorly. I had no complications of the surgery itself. It was just the surgical plan was completely inadequate for my degree of malocclusion and I am still in very bad shape. I had an open bite, cross bite, underbite, and facial asymmetry. He barely touched my asymmetry, they tried to manage my crossbite through orthodontics alone, leading to relapse. I now still have all the same issues, just reduced by at most 50%.

I have consulted with Dr. Marco Caminiti in the past year about doing a revision. Caminiti seemed to grasp the issues very well and was very happy to try to help me. He was surprised by how my case was handled in the first place. He offered me a SARPE and revision BSSO/LF1. In my case, he said as I need 1.1 cm upper jaw widening, even a multipiece LF1 will not suffice, so it must be SARPE. I will probably go with Caminiti for this as I had a good feeling for him. Also helpful is that he worked with Tocchio when he was training himself, so he recognizes and is familiar with all of Tocchio's hardware (which is now in my face).

I got his name by calling around jaw surgeons and asking who would be willing to do a revision. One female jaw surgeon I spoke to said "If anyone can handle it, it's Dr. Caminiti". He teaches at U of T also for what it's worth.

Good to see his name mentioned above.

I looked at the other two names - Dr. Jeff Fialkov is a plastic surgeon not a jaw surgeon. Dr. Oleh Antonyshyn looks interesting. He's known to be good? If so, I think I will go see him as well for another opinion. Can't hurt to get more opinions.

The only negative I had from my consult with Caminiti is he wanted to "pin" my right TMJ intraoperatively to make it more stable for the procedure. I am very much against this as my TMJs are in the best shape they've been in for my adult life and I really don't want to f**k with them. When I see him again in ~5 months for getting the surgical process started, I plan to explain this to him, and if he's adamant about the pinning I'll have to go to someone else. He seems very nice and flexible though.

I also didn't discuss with him virtual surgical planning so I'm not sure to what extent he does this.