3-D facial reconstruction is revolutionizing the way Oral and Maxillofacial Surgery is performed.  This new technology allows a greater level of precision and accuracy in surgery.  In office cone beam ct scans decrease the cost of treatment as well as decreasing the amount of radiation exposure compared with traditional CT scans and conventional 2-D x-rays.  Dr. McGann uses the most advanced 3-D technology daily to provide improved surgical outcomes for his patients.   The in-office iCAT scanner offers improved patient convienience and efficiency in treatment planning as the images are instantly available for assessment.  Dr. McGann also uses  Anatomage In-Vivo software to  analyze the images. This software is the most advanced software available currently. Some areas that care is improved are:

Orthognatic/Jaw surgery:

3-D facial planning is used to look at the whole face instead of traditional 2-D cephlometric “normal” numbers increasing accuracy.  Improved visualization of facial anatomy improves esthetic outcomes. In addition the position of nerve structures can be better visualized and protected during surgery.  Facial asymmetries can be more accurately corrected.  Software is used to show predictions of treatment options.  Facial structures can be morphed to show possible facial appearances after surgery.  3D planning is opening the door to guided surgery and surgical splints being made from the planning data. Improved precision during surgery and better surgical outcomes are a result of this advanced technology.

Implant treatment:

3-D CT scans are the new standard of care in implant treatment.  The enhanced images are used to see both the height and width of bone available for implant placement, as well as the significant anatomic structures.  In addition the images do not have distortion as do conventional panoramic or dental x-rays which often lead to inaccurate measurements of the distance away from nerves and sinuses.  The technology allows safer and more predictable surgery by allowing Dr. McGann to plan and avoid vital anatomic structures with certanty.  This decreases the risks of nerve injury/numb lip, sinus perforation,  bleeding, damage to adjacent teeth and poor implant position which lead to decreased esthetic outcomes.  The images allow sophisticated planning of the cases and communication with restoring doctors. Surgical guides are created to accurately transfer the virtual planning to surgery.  Because of this technology smaller incisions can be used to decrease the pain and recovery time after surgery.  Smaller incisions also create more esthetic outcomes in treatment with decreased scars on the gum tissue.   CT guided surgery improves accuracy in position and angulation of implant placement. In addition the added information gives Dr. McGann the ability to more accurately assess the need for bone and soft tissue grafting procedures.  When these procedures are necessary they can be performed to produce the desired results with the least amount of patient discomfort.  The types of procedures performed can be tailored to the needs of the patient.   Unnecessary procedures can be avoided and efficient treatment can be delivered.  Safe,  accurate,   minimally invasive surgery with less pain is the reality of 3-D facial reconstruction. 

Tumor/Cancer Reconstruction

Unfortunately after surgery patients with cancer and tumors are often left with facial defects that need to be reconstructed.  3-D technology can accurately assess the defect or the proposed defect and allow for better reconstruction.  “Mirror image” 3-D models can be created before surgery which can be used to plan and bend reconstruction plates for immediate reconstruction of the defects created by surgery. Improved facial symmetry can be obtained.  Time can be saved during surgery by accurately planning the case.  This technology decreases the time the patient is under anesthesia.  In addition 3-D models can be used in conjunction with the maxillofacial prosthodontist to make teeth and facial prostheses to reconstruct other parts of the face.  Extraoral facial implants to restore contour and function can be planned and designed using 3-D technology.  In addition smaller implants similar to dental implants can be used to support prosthetic ears, noses, eyes and other facial structures.  Dr. McGann works with an advanced team to reconstruct faces.  Members of Dr. McGann’s  reconstructive team includes  Oral and Maxillofacial Prosthodontists, Oral and Maxillofacial Surgeons, Plastic surgeons,  and Ear Nose and Throat surgeons.

Sleep Apnea   

3-D technology shows the size of the airway without invasive tests.  The area of obstruction can more accurately be assessed and diagnosed.  One of the main reasons for failed sleep apnea surgery is that an inaccurate area of obstruction is treated.  With a 3-D cone beam CT scan the airway can accurately be assessed and surgical interventions can be tailored to the patient needs.  There are many options for improving the airway.  Jaw surgery can dramatically improve airway obstruction and is becoming a first line for management of this disease when CPAP is not tolerated or used. 

Cleft Lip and Palate

Patients with cleft lip and palate have complex surgical needs that are managed by a team of doctors.  Dr. McGann is part of the Rady Children’s Hospital Cleft and Craniofacial Team.  3-D analysis of these complex facial features are important to assess the size of the defect as well as to assess healing after surgery.  Being able to see the complex anatomy of cleft sites as well as the many impacted or malformed teeth is part of the modern management of cleft lip and palate.