Reconstruction of the craniofacial skeleton is extremely challenging even to the most experienced surgeon. Some of the critical factors that contribute to the complexity include anatomy, presence of vital structures adjacent to the affected part, uniqueness of each defect and chances of infection. In any craniofacial reconstruction whether secondary to trauma, ablative tumor resection, infection and congenital/developmental deformities, restoration of aesthetics and function is the primary goal and calls for precise pre-surgical planning and execution of the plan. Auto grafts are the gold standard for craniofacial skeletal reconstruction. However their use is limited by the availability of suitable donor site especially for large defects, additional expensive surgeries, tissue harvesting problems, donor site morbidity with an additional patient discomfort, chances of infection at both the recipient and donor sites, increased surgical time, resorption of the graft requiring secondary surgeries and the need for additionally skilled surgical team, which has led to the search of alloplastic material that would be suitable without the inherent problems. Craniofacial defects also have complex anatomical shapes that is hard to achieve intraoperatively by carving harvested bone from the donor site. Hence it would be very useful for the surgeon to be aided by standard practice and proven methods in engineering wherein, the design and performance of the reconstructed implants/prosthesis can be predicted with accuracy and precision.

Surgeons have adapted to enhanced visualization techniques for close to two decades and even today this is an advancing field. Advantages of virtual reality can be totally beneficial only when transferred to the clinical scenario, i.e., the operatory to achieve expected results. Development of computer assisted design (CAD) and computer assisted manufacturing (CAM) systems that adapt to the surgeons needs has resulted in a gamut of the armamentarium for computer assisted surgery. Such systems specifically focus on enhanced visualization tools – 3D modeling or better termed as virtual reality and gives the surgeon the ability for precise preoperative planning and perform virtual osteotomies resections and design patient specific implants preoperatively. These virtual models can be imported into an intraoperative navigation system for precise placement of bone segments, implants and hardware. Advances in manufacturing technology and material science has led to the possibility of turning such virtual model or design into reality as physical replica models, surgical guides or cutting jigs or splints for intraoperative use and patient specific implants.