Direct three-dimensional diagnosis of ex vivo facial fractures

Sirin Y., Yildirimturk S., Horasan S., Guven K.

Journal of Craniofacial Surgery, vol.30, no.5, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 5
  • Publication Date: 2019
  • Doi Number: 10.1097/scs.0000000000005445
  • Journal Name: Journal of Craniofacial Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes


The aim of the present study is to assess the reliability and accuracy of different 3-dimensional (3D) reconstruction algorithms in detecting undisplaced condylar, zygomatic arc, and orbital rim fractures based on cone-beam computed tomography data set. Twenty sheep heads were used in the present study. Sixty fractured and 60 nonfractured (control) zones were randomly allocated. Three groups consisting of nondisplaced fractures of condyle (CF, n = 20), orbital (OF, n = 20), and zygomatic arc (ZF, n = 20) were created by using a diamond cutting disc. Soft tissues were only dissected and no fractures were generated in the control group (n = 60). The 3D reconstructions were created by using multiplanar reconstruction (MPR), surface rendering (SR), volume rendering (VR), and maximum intensity projection (MIP) algorithms. Final 3D models were examined in Osirix software (Pixmeo SARL, Bernex, Switzerland) by 6 observers. Diagnostic accuracies of each algorithm were statistically compared by receiver operating characteristics (ROC) and area under the ROC curves (AUCs). For the detection of CF, AUC for VR algorithm was found to be statistically larger than that of MIP while AUCs for VR and MIP were larger than those of MPR and SR for OF detection. For the detection of ZF, AUCs for MPR and VR were significantly larger than those of MIP and SR (P< 0.05 for each). Within the limitations of this experimental study, it can be concluded that for maxillofacial surgeons, it is more likely to detect condylar, orbital, and zygomatic fractures by using VR algorithm in 3D reconstruction.