Realistic Facial Three-Dimensional Reconstruction from CT Images and 2D Photographic Images for Surgical-Orthognathic Planning

Abstract

Featured Application: The development of this co-registration method that combines CBCT with photographic images and subsequent realistic image reconstruction can be used during the orthognathic surgical planning stage. Therefore, both orthodontists and maxillofacial surgeons will obtain more realistic and precise result predictions, allowing them to better clarify the patient’s surgical prognosis. Orthognathic surgery is a procedure used to correct intermaxillary discrepancies, thus promoting significant improvements in chewing and breathing. During the surgical planning stage, orthodontists often use two-dimensional imaging techniques. The assessment is based on CBCT images and dental cast models to overcome these limitations; however, the evaluation of soft tissues remains complex. The aim of the present study was to develop a co-registration method of CBCT and photo images that would result in realistic facial image reconstruction. CBCT images were three-dimensionally rendered, and the soft tissues were subsequently segmented resulting in the cranial external surface. A co-registration between the obtained surface and a frontal photo of the subject was then carried out. From this mapping, a photorealistic model capable of replicating the features of the face was generated. To assess the quality of this procedure, seven orthodontists were asked to fill in a survey on the models obtained. The survey results showed that orthodontists consider the three-dimensional model obtained to be realistic and of high quality. This process can automatically obtain a three-dimensional model from CBCT images, which in turn may enhance the predictability of surgical-orthognathic planning.