Proplan cmf software

The virtual surgical planning and titanium cutting guide 3D printing proceeded as we previously reported [2 (link),10 (link)]. Briefly, DICOM data files obtained from maxillofacial computed tomography (CT, LightSpeed CT scanner, GE Healthcare, Hatfield, UK) or cone-beam computed tomography (CBCT, i-CAT, Imaging Sciences International, Hatfield, PA, USA) were imported into the ProPlan CMF software (Materialise, Leuven, Belgium). The osteotomy lines of the coronoidectomy and condylectomy were delineated virtually based on multiplanar (axial, coronal, and sagittal) and three-dimensional (3D) views of the lesion. The data set of the bony segments after the osteotomy was virtually imported into Geomagic Studio 2013 Software (Geomagic, Durham, NC, USA) to design the TiAI64V coronoidectomy guide and the condylectomy guide, which were fabricated using a titanium 3D printer (M2 cusing Mutilaser; CONCEPTLASER, Schwabhausen, Germany) (Figure 1A,B).

The accuracy evaluation of the condylectomy in both the cutting guide group and the navigation group proceeded as previously described [9 (link),10 (link)]. Briefly, a craniomaxillofacial CT scan was taken for each patient at 3 days postoperatively. The 3D models of the virtually planned and the achieved actual residual segment of the affected condyle after condylectomy were reconstructed and overlapped using a ProPlan CMF software (Materialise, Leuven, Belgium). The overlapped STL files were then imported into Geomagic Studio 2013 Software (Geomagic, Durham, NC, USA) and the deviations were measured as mean 3D deviation and maximum 3D deviation (Figure 3A).

The MRI images were processed by ProPlan CMF software (version 1.4, Materialise, Leuven, Belgium). Three MRI images were obtained at the middle third of the condyle at each side, where the cross-section was largest. The MRI of the condyle was performed at the condylar head and the inner condylar cortex, and the largest inscribed circle in each slice was used for sampling. Measurement was repeated three times for each side. For the cerebral cortex, MRI was performed at the cerebral cortex at the inferior temporal gyrus located at the same position of the condyle. Three measurements were taken for the inscribed circle of the same area for each side, and the average was reported. The MSI of the condyle (MSI1) and cerebral cortex (MSI2) were obtained, and then the SIR (MSI1/MSI2) between them was calculated. Samples were presented as follows (Figure 1A–C). A total of 120 condyles were measured independently by a surgeon and a radiologist.