Development of a Statistical Shape Model of the Zygomatic-Maxillary Complex as Input to Plate Design Optimization

Introduction. Preformed osteosynthesis plates to treat zygomatic fractures could aid surgical outcome. The aim of this study was to develop a statistical shape model of the zygomatic maxillary complex (ZMC) to assist in the development of preformed 3D osteosynthesis plates. Methodology. A statistical shape model (SSM) was built using 53 CT scans of patients sustained and surgically treated for a unilateral ZMC fracture. The unaffected side was used to build the SSM. The new element in the build was the development of a reference template of the bony area of interest that could be mapped to all individual meshes using initial correspondence mapping. After that only the region of interest, as set by the template, was used to capture the variation of the ZMC. Results. The SSM performed sufficiently on accuracy (RMSE 0.3 mm) and compactness (14 principle components covered 90% of variance). The largest variations (up to 4,5 mm) occur in the teeth area, the zygomatic arch and the medical side of the inferior orbital rim; and smaller variations (