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Abstract
Background
Today virtual surgical planning (VSP) is a standard method in maxillofacial corrective surgery and is the key to reach satisfactory esthetic outcomes. The purpose of this study was to evaluate usability of three established virtual surgical planning software applications by comparing feasibility, time consumption, and costs in a standardized workflow for a modified intraoral quadrangular Le Fort II osteotomy (IQLFIIO).
Results
A cross-sectional study was performed based on retrospective and re-planned data of patients with midfacial deficiency treated by modified IQLFIIO, using three software applications: IPS Case Designer ®, Dolphin Imaging ®, and ProPlan CMF ®. Feasibility: All evaluated steps of the VSP procedure could be successfully performed in all three evaluated applications. In all software packages, it was possible to design the surgical splints with CAD/CAM technology. Working time: The mean value of time needed was IPS Case Designer ®, 36.5 min; Dolphin Imaging ®, 33.6 min; ProPlan CMF ®, 45.5 min. We found statistical significant difference between ProPlan CMF ® and Dolphin Imaging ® (p value, 0.02). Costs: Asset costs for acquiring the software, license fee, license possibilities, paying for support services, and service contracts were evaluated and are found in similar ranges.
Conclusion
All three tested software applications are usable for virtual planning of an IQLFIIO and splint production by CAD/CAM technology. Successful movement of bone segments and overlaying soft tissues proved feasibility. Time consumption and costs were found in similar ranges.
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Details

1 Medical University of Vienna, University Clinic of Cranio- and Maxillofacial Surgery, Vienna, Austria (GRID:grid.22937.3d) (ISNI:0000 0000 9259 8492)
2 University of Applied Sciences FH Campus Wien, Vienna, Austria (GRID:grid.452084.f) (ISNI:0000 0001 1018 1376)
3 Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Vienna, Austria (GRID:grid.22937.3d) (ISNI:0000 0000 9259 8492)