Treatment Planning for Surgical Cases

SureSmile is an orthodontic treatment planning system and is not intended to be used to plan surgery. The surgical case planning features described in this section allow you to capture planned surgical movements and use them in conjunction with orthodontic treatment planning for the ultimate purpose of arch-wire design. A best practice is to consult with the oral surgeon throughout this process.

Typically you use the SureSmile surgical case planning features to create two plans and corresponding wires.

First, you create a post-surgical setup to plan the patient’s results, including both dental and skeletal movements.

SureSmile gives you the ability to indicate the number and placement of cuts and to indicate the skeletal corrections interactively in 3D or by entering “global" displacement values for each bone segment independently.

SureSmile automatically constructs a new archform based on the planned bone position, from which you can plan the post-surgical dental setup.

After you approve the post-surgical setup, SureSmile automatically calculates the starting point for a pre-surgical setup by removing all bone segment movements while retaining all dental corrections from the post-surgical setup.

Next, you create a pre-surgical setup, at which time you can then adjust the tooth positions to allow room for the osteotomy cuts or to accommodate other considerations. You also have the option to skip this pre-surgical setup and instead use a pre-surgical simulation, which allows you to bypass the Digital Lab and order your pre-surgical wires directly.

Since the pre-surgical setup automatically incorporates all dental movement from the post-surgical setup minus the skeletal movement of the surgical segments, you do not have to manually deduct movement. You can model all of the movements planned for a multi-piece surgery.

The suggested workflow in the table below is described in detail in the topics in this section.

Step	Procedure
1	Review and approve the therapeutic model
2	Create Post-Surgery simulations or setup Select either or both of the surgery options in the Special Instructions section of the MACROS form to activate the Surgery tab. Use the Surgery tab for skeletal movements. Use MACROS or the simulation to specify the planned dental movements. Submit the setup.
3	Review/approve the Post-Surgery setup (review with oral surgeon if possible).
4	Create pre-surgical simulations) or setup (minus the surgical movements) and adjust as needed for osteotomy cuts or interferences.
5	Order pre-surgical wires.
6	Order Post-Surgical wires.