Has this experience with PSI convinced you consistently to use this technology in supramellular osteotomies, or will you continue with a traditional freehand technique? And for institutions that do not have access to weight-bearing CT, PSI technology, and 3D printing capabilities, is it still possible to achieve the excellent outcomes that you report in this publication?

that's indeed a very pertinent question professor easily during my training i was lucky to still be trained during the supermodel osteotomies freehandly amongst others by professor beat hinterman from switzerland and one of his quotes was and i quote this in in german so that it is real his quote and he said that It was Chirurgie ist ein Kunst and must ein Kunst bleiben.

So this means that surgery is an art and it must remain an art.

But during the same time, I was introduced to the weight bearing CT and its possibilities where I got acquainted with computer aided design software.

and i actually used the happy marriage between both the imaging device and and the software skills and that i combined so that we could use it to generate the psis for the super molar osteotomies correction and for now on it has become um or standard of choice for supermalar osteotomies.

Because, of course, once you get used to the convenience of the PSI, it gets a bit difficult or you reduce some of your freehand skills.

But on the other hand, the inframalular osteotomies, they still remain freehandly.

If I or others less experienced than you were to use this technology, and we do not have your expertise in the planning process, how would we best identify the appropriate anatomic landmarks? And are providers able to work with the engineering team during the planning phase? Or is the system able to learn and suggest optimal anatomic landmarks to use for planning?