Computer assisted oral and maxillofacial surgery - a review and an assessment of technology

Advances in the basic scientific research within the field of computer assi sted oral and maxillofacial surgery have enabled us to introduce features o f these techniques into routine clinical practice. In order to simulate com plex surgery with the aid of a computer, the diagnostic image data and espe cially various imaging modalities including computer tomography (CT), magne tic resonance imaging (MRI) and Ultrasound (US) must be arranged in relatio n to each other, thus enabling a rapid switching between the various modali ties as well as the viewing of superimposed images. Segmenting techniques f or the reconstruction of three-dimensional representations of soft and hard tissues are required. We must develop ergonomic and user friendly interact ive methods for the surgeon, thus allowing for a precise and fast entry of the planned surgical procedure in the planning and simulation phase. During the surgical phase, instrument navigation tools offer the surgeon interact ive support through operation guidance and control of potential dangers. Th is feature is already available today and within this article me present a review of the development of this rapidly evolving technique. Future intrao perative assistance takes the form of such passive tools for the support of intraoperative orientation as well as so-called 'tracking systems' (semi-a ctive systems) which accompany and support the surgeons' work. The final fo rm are robots which execute specific steps completely autonomously. The tec hniques of virtual reality and computer assisted surgery are increasingly i mportant in their medical applications. Many applications are still being d eveloped or are still in the form of a prototype. It is already clear, howe ver, that developments in this area will have a considerable effect on a su rgeon's routine work.