Emerging Technologies in Oral and Maxillofacial Surgery

Preface
Contents
About the Editors
The Emergence of Advance Technologies and Industrial Revolutions
	1	 Introduction
	References
CBCT and MRI Data Acquisition as a Basis for Computer-Assisted Maxillofacial Treatments
	1	 Introduction
	2	 Invention of Cone Beam Computed Tomography (CBCT)
	3	 Principles of Image Production
	4	 CBCT Resolution and Voxel Size
	5	 Field of View (FOV)
	6	 CBCT and Artifacts
	7	 Clinical Reflections
	8	 Magnetic Resonance Imaging (MRI)
	9	 Principles of Image Production
	10	 MRI and Artifacts
	11	 Application of MRI in Maxillofacial Imaging
	12	 Conclusion
	References
Data Storing and Conversion in Computer-Assisted Oral and Maxillofacial Treatments
	1	 Introduction
	2	 Image Acquisition and DICOM
	3	 Image Processing
	4	 STL File Preparation
	5	 Three-Dimensional (3D) Printing
	6	 Clinical Cases
		6.1	 Craniofacial and Maxillofacial Defect Reconstruction in Traumatic Cases (Fig. 9)
		6.2	 Maxillofacial Defect Reconstruction in Tumor Cases (Fig. 10)
		6.3	 Careful Assessment of Maxillofacial Vital Anatomic Structures (Fig. 11)
		6.4	 Orthognathic Surgery and Splint Design (Fig. 12)
		6.5	 Dental Implant Surgical Guide (Fig. 13)
	7	 Conclusion
	References
Classification of Cutting-Edge Additive Manufacturing Techniques
	1	 Introduction
	2	 Fused Deposition Molding (FDM)
		2.1	 Prominent Features
		2.2	 Employed Material
		2.3	 Clinical Application
		2.4	 Low-Temperature Deposition Manufacturing (LDM)
		2.5	 Powder Melt Extrusion
	3	 Computer-Aided Wet-Spinning
		3.1	 Prominent Features and Employed Materials
	4	 Inkjet Printing
		4.1	 Classifications
			4.1.1	 Continuous Inkjet (CIJ)
			4.1.2	 Drop-on-Demand (DOD) Inkjet
				Thermal Inkjet
				Piezoelectric Inkjet
				Electrostatic, Electrohydrodynamic, Solenoid Valve, and Acoustic Inkjet
		4.2	 Fields of Applications
		4.3	 Investigations and Employed Materials
	5	 Stereolithography (SLA)
		5.1	 Prominent Features
		5.2	 Employed Materials
		5.3	 Clinical Application
		5.4	 Digital Light Processing
	6	 Selective Laser Sintering (SLS)
		6.1	 Prominent Features
		6.2	 Employed Materials
		6.3	 Clinical Application
		6.4	 Direct Metal Laser Sintering (DMLS)
		6.5	 Electron Beam Melting (EBM)
	References
Rapid Prototyping Models in Oral and Maxillofacial Surgery: History, Definition, and Indications
	1	 Introduction
	2	 Treatment Planning
	3	 Training and Simulation
	References
Bone Contouring in Oral and Maxillofacial Surgery: Definition, Indications, and Manufacturing Considerations
	1	 Introduction
	2	 Indication of Facial Bone Contouring
		2.1	 Calvaria
		2.2	 Orbit
		2.3	 Malar
	3	 Different Material and Their Properties
		3.1	 Peek
		3.2	 Titanium
		3.3	 PMMA
	4	 Clinical Workflow
	5	 Complications
		5.1	 Infection
		5.2	 Wound Dehiscence
		5.3	 Other Complications
	References
Functional Bone Replacement in Oral and Maxillofacial Surgery: Definition, Indications, and Manufacturing Considerations
	1	 Introduction
	2	 Patient-Specific Prosthesis
	3	 Mandibular Ramus/Condyle Unit (RCU) Reconstruction
	4	 Total Mandibular Reconstruction
	5	 Delayed Functional Bone Replacement
	6	 Case Presentation
		6.1	 Prosthesis Design and Manufacturing
		6.2	 Treatment Procedure
	7	 Conclusion
	References
Functional Bone Regeneration in Oral and Maxillofacial Surgery: History, Definition, and Indications
	1	 Introduction
	2	 Definition
	3	 Functional and Biological Considerations
		3.1	 Porosity
		3.2	 Mechanical Properties
		3.3	 Degradation
	4	 Indications
	5	 Risk Factors
		5.1	 Recipient Site Characteristics
		5.2	 Vascularity
	6	 Treatment Planning
		6.1	 Scaffold Manufacturing Considerations
			6.1.1	 Material
				Polymers
					Polycaprolactone (PCL)
					Poly Lactic Acid (PLA)
					Poly(Lactic-co-Glycolic Acid) (PLGA)
					Alginate
					Chitosan
				Bioceramics
					Calcium Phosphate Compounds
					Hydroxyapatite (HA)
					Bioglass
			6.1.2	 Composition Technique
			6.1.3	 Designing
			6.1.4	 Fabrication Technique
		6.2	 Surgical Technique
	7	 Prognosis
	References
In Situ Bone Regeneration in Oral and Maxillofacial Surgery: Definition, Indications, and Manufacturing Considerations
	1	 Introduction
	2	 Protected Healing Space
		2.1	 Clinical Applications
			2.1.1	 Ridge Augmentation
			2.1.2	 Reconstruction
				Maxillary Bone Defects
				Mandibular Bone Defects
		2.2	 Clinically Employed Materials and Fabrication Methods
			2.2.1	 Titanium
			2.2.2	 Polyether-Ether-Ketone (PEEK)
			2.2.3	 Hydroxyapatite (HA)/Poly-L-Lactide (PLLA)
		2.3	 Clinical Advantages
			2.3.1	 Operation Time
			2.3.2	 Necessity and Extension of Grafting
			2.3.3	 Surgical Quality and Accuracy
			2.3.4	 Postoperative Period
		2.4	 Complications
			2.4.1	 Potential Complications After Applying In Situ Bone Regeneration PSIs
				Wound Dehiscence and PSI Exposure
				Transient Paresthesia
				Postoperative Deviation and Nonoptimal Reproducibility
			2.4.2	 Regenerative Rates After Complications
			2.4.3	 How to Prevent Complications After Applying In Situ Bone Regeneration PSIs
	3	 Recipient Site Characteristics
		3.1	 Enhancing Regenerative Potential of Recipient Site
		3.2	 Clinical Applications
			3.2.1	 RhPDGF-BB
			3.2.2	 RhBMP-2
			3.2.3	 PRF
		3.3	 Potential Methods
			3.3.1	 Antibody-Mediated Osseous Regeneration (AMOR)
			3.3.2	 Bioactive Molecules
			3.3.3	 Gene Delivery
				Long Noncoding RNAs (lncRNAs)
				MicroRNAs
				Plasmid DNAs
		3.4	 Spontaneous De Novo Bone Formation
		3.5	 Ridge Augmentation and Simultaneous Implant Placement
		3.6	 Patient-Related Factors
			3.6.1	 Vascularization
			3.6.2	 Age
	References
Digitally Assisted Orthognathic Surgical Planning: Definition, History, and Innovation
	1	 Introduction
	2	 History of Planning Orthognathic Surgery
	3	 Two-dimensional Orthognathic Surgical Planning
	4	 Three-dimensional Orthognathic Surgical Planning
		4.1	 Data Collection
			4.1.1	 Skull and Jaw Bones
			4.1.2	 Dentition
				CBCT Cast Scan
				Intraoral Laser Scan (IOS)
			4.1.3	 3D Soft Tissue Data
		4.2	 Three-Dimensional Model Acquisition and Virtual Osteotomies
		4.3	 3D Prediction
	5	 Surgical Splint
		5.1	 Dental “Nonanatomical” Splint
			5.1.1	 Dental “Conventional” Occlusal Splint
		5.2	 Anatomical Splints and Printed Plates
	6	 Innovations in Digital Planning and Future Perspectives
		6.1	 Virtual Reality
		6.2	 Augmented Reality
		6.3	 Dynamic Navigation
		6.4	 Robotic Orthognathic
	References
Application of Advanced Technologies in Facial Cosmetic Surgery: History, Definition, and Indication
	1	 Introduction
	2	 Computer Technology
	3	 Three-Dimensional (3D) Methods
		3.1	 Stereolithography (SL)
	4	 Fused Deposition Modeling
	5	 PolyJet Technique
	6	 Facial Prosthetics
	7	 Virtual Surgical Planning (VSP) and Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM)
		7.1	 The Steps of Virtual Surgery Planning
	8	 Endoscopically Assisted Surgery
	9	 Piezoelectric
	10	 Plasma Science
	References
Fabricating Dental Implants with Predesigned Structure
	1	 Introduction
	2	 Customized Implants
	3	 The Subperiosteal 3D-Printed Prosthesis and Additively Manufactured Subperiosteal Jaw Implants (AMSJI®)
	4	 Introducing an Innovative Design for Prefabricated Subperiosteal Implants
	5	 Complications with Prefabricated Implants and Potential Causes
		5.1	 Technique-Related Complications
		5.2	 Design/Manufacturing-Related Complications
	6	 Future of Dental Implant Customization
	7	 Conclusion
	References
Definition, History, and Indications of Robotic Surgery in Oral and Maxillofacial Surgery
	1	 Definition
	2	 History
		2.1	 Generation I
		2.2	 Generation II
		2.3	 Generation III
	3	 Introduction
	4	 Indications of Robotic Surgery in Oral and Maxillofacial Surgery
		4.1	 Head and Neck Tumors
			4.1.1	 The Oral Cavity, Oropharynx, Nasopharynx, and Laryngopharynx
			4.1.2	 The Parapharyngeal Space
			4.1.3	 Thyroid Gland and Mediastinal Parathyroid
			4.1.4	 Salivary Glands
			4.1.5	 Neck Dissection
			4.1.6	 Post-ablative Defect Reconstruction
		4.2	 Cleft Lip and Palate
		4.3	 Rare Congenital Deformities
			4.3.1	 Teratoma
			4.3.2	 Surgical Management
			4.3.3	 Lingual Thyroglossal Duct Cyst
			4.3.4	 Laryngocele
			4.3.5	 Ectopic Lingual Thyroid
		4.4	 Maxillofacial Traumatology
		4.5	 Orthognathic Surgery
		4.6	 OSAS
		4.7	 Dental Surgery
	5	 Advantages and Limitations
		5.1	 Advantages
			5.1.1	 Magnified Three-Dimensional Visualization
			5.1.2	 Breaking the Limit of Human Hands
			5.1.3	Minimally Invasive Technique
			5.1.4	 Excellent Manipulability
		5.2	 Limitations of Robotic Surgery
			5.2.1	 Lack of Tactile Perception and Proprioception
			5.2.2	 Lack of Haptic Feedback
			5.2.3	 Complicated Procedures
			5.2.4	 Expensive
			5.2.5	 Large Size
			5.2.6	 Lack of Specific Instruments for Maxillofacial Surgery
	6	 Prospective of Robotics in the Head and Neck and Maxillofacial Region
	References
Brief Introduction to Artificial Intelligence and Machine Learning
	1	 Introduction
	2	 A Brief History of Artificial Intelligence
		2.1	 Artificial Intelligence and Medicine
		2.2	 Artificial Intelligence and Dentistry
	3	 How Does Machine Learning Work
		3.1	 The Learning Process
		3.2	 What Can We Do Using Machine Learning?
		3.3	 Data Collection and Preparation
			3.3.1	 Data Collection and Curation
			3.3.2	 De-identification
			3.3.3	 Resampling Medical Images
			3.3.4	 Data Labeling and Reference Standard
			3.3.5	 Dataset Sampling Strategies
			3.3.6	 Challenges of Small Datasets
		3.4	 Model Implementation
			3.4.1	 Machine Learning Models
				Linear Regression
				Logistic Regression
				Support Vector Machine
				Random Forest
				Cluster Analysis
			3.4.2	 Deep Learning Models
				Artificial Neural Networks
				Convolutional Neural Network (CNN)
				Recurrent Neural Networks (RNNs)
				Generative Adversarial Nets (GANs)
				Autoencoders (AE)
		3.5	 Requirements for Training the Model
			3.5.1	 Software Requirements
			3.5.2	 Hardware Requirements
		3.6	 Model Evaluation
	4	 Conclusion
	References
Application of Artificial Intelligence in Diagnosing Oral and Maxillofacial Lesions, Facial Corrective Surgeries, and Maxillofacial Reconstructive Procedures
	1	 Introduction
	2	 AI Applications in Recent Medicine
		2.1	 AI in Radiology
		2.2	 AI in Oncology
		2.3	 AI in Ophthalmology
		2.4	 AI in Cardiology
		2.5	 AI in Dermatology
	3	 AI in Dentistry and Oral and Maxillofacial Surgery
		3.1	 Implementation of AI for the Diagnosis of Maxillofacial Pathologic Conditions
			3.1.1	 Cystic Lesions
			3.1.2	 Cancerous Lesions
			3.1.3	 Bone and Joint Pathology
			3.1.4	 Developmental Abnormalities
			3.1.5	 Salivary Glands’ Pathology
			3.1.6	 Sinusitis
		3.2	 Implementation of AI for Oral and Maxillofacial Corrective Surgeries
			3.2.1	 Orthognathic Surgeries
			3.2.2	 Rhinoplasty
			3.2.3	 Facelift Surgeries (Rhytidectomy)
			3.2.4	 Otoplasty
			3.2.5	 Blepharoplasty
			3.2.6	 Hair Transplant
		3.3	 Implementation of AI for Oral and Maxillofacial Reconstructive Procedures
			3.3.1	 Dental Implants
			3.3.2	 Craniofacial Implants
			3.3.3	 Craniofacial Surgery
			3.3.4	 Craniosynostosis
			3.3.5	 Mandibular Reconstruction
	4	 Conclusion
	References
Future Trends of Using Artificial Intelligence in Oral and Maxillofacial Surgery
	1	 Introduction
	2	 Possible Future Applications
		2.1	 Precision Medicine
			2.1.1	 AI in Precision Medicine
		2.2	 Tissue Engineering
			2.2.1	 Degradation of the Scaffold
			2.2.2	 Bone Growth
			2.2.3	 In Vivo Bone Regeneration
		2.3	 3D Printing
			2.3.1	 Assessing Quality
			2.3.2	 Optimizing Printing Parameters
		2.4	 4D Printing
		2.5	 Robotic Surgery
	3	 Challenges
		3.1	 Black Box Nature
		3.2	 Generalizability
		3.3	 Algorithmic Bias
		3.4	 Adaptation
		3.5	 Ethical Issues
		3.6	 Cybersecurity Issues
		3.7	 Patients’ Rights and Autonomy
	References
Application of Bioprinting Technology in Oral and Maxillofacial Surgery
	1	 Introduction
	2	 Extrusion-Based Approach
		2.1	 Optimizing Printing Materials
		2.2	 Cell Viability Improvements
			2.2.1	 Printing Pressure and Nozzle Geometry
			2.2.2	 Fabrication Time, Extrusion Speed, and Material Characteristics
		2.3	 Crosslinking
	3	 Laser-Based Stereolithography (SLA) Bioprinting
		3.1	 Material
			3.1.1	 Photo-crosslinkable Polymer
			3.1.2	 Non-photo-crosslinkable Polymers + Photoinitiators
			3.1.3	 Irradiation
	4	 Inkjet Bioprinting
		4.1	 Thermal Inkjet Bioprinting
		4.2	 Piezoelectric Inkjet Bioprinting
		4.3	 Advantages and Disadvantages
	5	 Comparison of Bioprinting Methods
	References
Application of Bioreactors in Oral and Maxillofacial Surgery
	1	 Introduction
	2	 Bioreactors for Bone Tissue Engineering
		2.1	 Hydrodynamic-Based Shear-Loading Bioreactors
			2.1.1	 Spinner Flask Bioreactors
			2.1.2	 Rotating Bioreactors (Rotating Wall Vessel (RWV))
			2.1.3	 Perfusion-Based Bioreactors
		2.2	 Compression Bioreactors (Direct Mechanical Stress)
		2.3	 EMF-Based Bioreactors
		2.4	 Combined Bioreactors
			2.4.1	 Applications and Advancements
		2.5	 In Vivo Bioreactors
			2.5.1	 Surgical Strategies
				Flap Techniques
					Subcutaneous Pocket
					Muscular Pouch or Flap
					Periosteal Flap
				Vascular Techniques
					Axial Vascular Bundle (AVB) and Arteriovenous Loop (AV loop)
	References