PMID- 29742139 OWN - NLM STAT- MEDLINE DCOM- 20180802 LR - 20181114 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 13 IP - 5 DP - 2018 TI - A novel soft tissue prediction methodology for orthognathic surgery based on probabilistic finite element modelling. PG - e0197209 LID - 10.1371/journal.pone.0197209 [doi] LID - e0197209 AB - Repositioning of the maxilla in orthognathic surgery is carried out for functional and aesthetic purposes. Pre-surgical planning tools can predict 3D facial appearance by computing the response of the soft tissue to the changes to the underlying skeleton. The clinical use of commercial prediction software remains controversial, likely due to the deterministic nature of these computational predictions. A novel probabilistic finite element model (FEM) for the prediction of postoperative facial soft tissues is proposed in this paper. A probabilistic FEM was developed and validated on a cohort of eight patients who underwent maxillary repositioning and had pre- and postoperative cone beam computed tomography (CBCT) scans taken. Firstly, a variables correlation assessed various modelling parameters. Secondly, a design of experiments (DOE) provided a range of potential outcomes based on uniformly distributed input parameters, followed by an optimisation. Lastly, the second DOE iteration provided optimised predictions with a probability range. A range of 3D predictions was obtained using the probabilistic FEM and validated using reconstructed soft tissue surfaces from the postoperative CBCT data. The predictions in the nose and upper lip areas accurately include the true postoperative position, whereas the prediction under-estimates the position of the cheeks and lower lip. A probabilistic FEM has been developed and validated for the prediction of the facial appearance following orthognathic surgery. This method shows how inaccuracies in the modelling and uncertainties in executing surgical planning influence the soft tissue prediction and it provides a range of predictions including a minimum and maximum, which may be helpful for patients in understanding the impact of surgery on the face. FAU - Knoops, Paul G M AU - Knoops PGM AUID- ORCID: 0000-0002-4772-8408 AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. FAU - Borghi, Alessandro AU - Borghi A AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. FAU - Ruggiero, Federica AU - Ruggiero F AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. AD - Oral and Maxillofacial Surgery Unit, St Orsola-Malpighi University Hospital, Bologna, Italy. FAU - Badiali, Giovanni AU - Badiali G AD - Oral and Maxillofacial Surgery Unit, St Orsola-Malpighi University Hospital, Bologna, Italy. FAU - Bianchi, Alberto AU - Bianchi A AD - Oral and Maxillofacial Surgery Unit, St Orsola-Malpighi University Hospital, Bologna, Italy. FAU - Marchetti, Claudio AU - Marchetti C AD - Oral and Maxillofacial Surgery Unit, St Orsola-Malpighi University Hospital, Bologna, Italy. FAU - Rodriguez-Florez, Naiara AU - Rodriguez-Florez N AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. AD - Department of Biomedical Engineering, Mondragon University, Mondragon, Spain. FAU - Breakey, Richard W F AU - Breakey RWF AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. FAU - Jeelani, Owase AU - Jeelani O AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. FAU - Dunaway, David J AU - Dunaway DJ AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. FAU - Schievano, Silvia AU - Schievano S AD - UCL Great Ormond Street Institute of Child Health, London, United Kingdom. AD - Craniofacial Unit, Great Ormond Street Hospital for Children, London, United Kingdom. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180509 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Adolescent MH - Adult MH - Cephalometry MH - Cone-Beam Computed Tomography MH - Face/physiopathology/*surgery MH - Female MH - Finite Element Analysis MH - Humans MH - Image Processing, Computer-Assisted/methods MH - Lip/physiopathology/surgery MH - Male MH - Mandible/physiopathology/*surgery MH - Maxilla/physiopathology/*surgery MH - Nose/physiopathology/surgery MH - *Orthognathic Surgery MH - Software PMC - PMC5942840 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2018/05/10 06:00 MHDA- 2018/08/03 06:00 PMCR- 2018/05/09 CRDT- 2018/05/10 06:00 PHST- 2018/01/10 00:00 [received] PHST- 2018/04/27 00:00 [accepted] PHST- 2018/05/10 06:00 [entrez] PHST- 2018/05/10 06:00 [pubmed] PHST- 2018/08/03 06:00 [medline] PHST- 2018/05/09 00:00 [pmc-release] AID - PONE-D-18-00953 [pii] AID - 10.1371/journal.pone.0197209 [doi] PST - epublish SO - PLoS One. 2018 May 9;13(5):e0197209. doi: 10.1371/journal.pone.0197209. eCollection 2018.