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Oral and maxillofacial surgery in 3D.

Ramus is a workspace for dentists and surgeons: explain a treatment at the chair, plan it on real CT-derived anatomy, and learn each operation step by step.

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Free for macOS and Windows, with two packages for Linux.

The Ramus window. On the left the list of modules and layers, in the middle a 3D lower jaw with a handpiece drilling at the first molar, on the right the implant panel with length, diameter and the distance to the nerve canal.

Show the patient what you will do.

Explain to patient has 23 topics, from a wisdom tooth to a Le Fort I. You talk and the model shows it.

  1. A few cards in plain words.

    Each topic has 3 to 5 cards. A card says one thing, such as “The gum is opened and folded aside”, and plays that part of the animation.

    Explain to patient, wisdom tooth removal. The 3D skull with an instrument at the lower wisdom tooth, and the card Uncovering the tooth, 3 of 5, with Back, Pause and Next.

  2. The risks, ticked as you talk.

    Next and Back move through the cards. The risks are a list, and you tick each one when you have discussed it. Afterwards has the aftercare.

    Explain to patient, upper jaw correction, Le Fort I. The skull with the cut line above the upper teeth, the tabs Explanation, Risks and Afterwards, and the card Moving to the planned position, 3 of 4.

  3. Draw on it. Print one page.

    Draw on the 3D view with the pen, or place an arrow or a circle. The handout is one A4 page. Your drawing and the explanation are on it, and so are the risks you ticked.

    The same view closer: under the model the toolbar with the pen, compare, pointer, picture, handout, tooth chart, hide and full screen tools.

Tap a tooth. The model follows.

The FDI chart and the 3D arch show the same teeth. Mark 36 as missing in one and it is gone in the other.

3D view of the lower left jaw. The first molar is missing: between the premolar and the second molar the gum has closed over the site.
The chart here is a drawing. The picture is the model with tooth 36 marked missing.

Cases stay on this device.

A case is stored on the device you work on and nowhere else. The chart and the plans belong to it.

One file, and a passcode if you want.

Export a case as one file when it has to move. Set a passcode and the stored cases are locked.

Plan with the nerve in view.

Import an STL, PLY, OBJ or GLB scan and align it to the model with three points.

A translucent skull in the planning view. The nerves run through it in yellow and the sinuses are blue.
An implant handpiece with a pilot drill at the site of the lower left first molar. The nerve canal below is shown in yellow and labelled Inferior alveolar nerve.

The distance, while you move the implant.

Ramus measures from the implant to the nerve canal and to the sinus floor as you place it. It checks the neighbouring teeth too. In this picture the apex is 4.3 mm from the canal.

The marker turns amber under 3 mm and red under 2 mm.

One tracing, six analyses.

SteinerRickettsMcNamaraJarabakWitsTweed

Trace a cephalogram on your own image and read it in any of the six. Orthognathic planning moves the jaw segments and lists each movement in millimetres.

34 operations, each on a timeline.

Every procedure is an animation you can stop anywhere. Drag the timeline back two seconds and watch the cut again.

A Le Fort I seen from below on a dark stage. Two retractors hold the soft tissue, the upper jaw is cut free, and both dental arches are in view.

Stop at any second.

A round bur opens a small window in the bone over the root apex.

Apicoectomy at second 5. The gum flap over the upper front tooth is raised and a round bur opens the bone over the root tip.
0:05. A round bur opens a small window in the bone over the root apex.
Apicoectomy at second 9. The window in the bone is open and an instrument reaches the root tip.
0:09. Four seconds later the window is 4 to 5 mm wide, right over the apex.
Apicoectomy at second 31. The instruments are gone and the flap is still raised, ready to be closed.
0:31. The work at the root end is done. The flap goes back and is sutured.
0:05

Apicoectomy of an upper incisor, 36 seconds. Three pictures of it are here; in Ramus the timeline is continuous.

Instruments touch what they cut.

A test measures every instrument against the bone and the teeth along its path. The bur meets the bone where the window opens, and the forceps close on the tooth.

In hands-on mode you hold the instrument yourself. Drag a saw and it cuts where you drag.

  • Le Fort I after the down-fracture: the upper jaw is lowered and the cut bone is open. Le Fort I
  • Sagittal split: a saw at the inside of the ramus, the nerve canal shown in yellow. Sagittal split
  • Genioplasty: a saw at the chin, the planned cut drawn on the bone. Genioplasty
  • Third molar surgery: a bur and a retractor at the lower wisdom tooth, the lingual nerve labelled. Third molar
  • Extraction: forceps closed on an upper incisor. Extraction
  • Sinus lift: an instrument at the window in the side of the upper jaw, the sinus shown translucent. Sinus lift
  • Nerve block: a syringe with its needle path to the nerve on the inside of the lower jaw. Nerve block
  • Fracture plating: a plate and a screwdriver at the lower border of the jaw. Fracture plating

Also in the set: SARPE, implant placement, apicoectomy, arthrocentesis, cyst surgery, biopsy. Eleven of the 34 are nerve blocks.

86 cards. Each one names its source.

Every number on a card comes with its source. One search field finds the card.

  • Local anaesthesia 5
  • Nerve block atlas 11
  • Antibiotics 4
  • Analgesia 4
  • Anticoagulation 6
  • Medically compromised 6
  • Emergencies 8
  • Classifications 18
  • Timelines 3
  • Materials 6
  • Post-operative instructions 9
  • Differential diagnosis 5
  • Cephalometric norms 1
The local anaesthetic calculator. Articaine 4 % with epinephrine, adult, 70 kg: maximum dose 490 mg, which is 12.2 ml or 7 cartridges of 1.7 ml. Below it the limit used and its source.

The maximum dose for this patient.

Pick the anaesthetic and the age group, then enter the weight. The calculator gives the dose in milligrams and in whole cartridges, and it says which limit it used.

Emergencies in large type.

Seven emergency cards, each a short list of numbered steps. Anaphylaxis starts with “Stop treatment. Call for help.”

The emergency card Anaphylaxis in large type with its first three numbered steps.
The atlas skull with the chewing muscles in red, nerves in yellow and vessels in red and blue.

Nine courses. 307 questions.

Each course keeps your progress. A question you miss comes back after 10 minutes, then after 1, 3, 7 and 21 days.

  • Anatomy38
  • Local anaesthesia37
  • Exodontia34
  • Dentoalveolar surgery34
  • Implantology33
  • Trauma32
  • Orthognathic surgery35
  • Temporomandibular joint30
  • Oral pathology34

Exam mode sets 10, 20 or 40 questions against a clock.

Patient data stays on the device.

Ramus has no account and no analytics. It works offline. A case leaves the device only when you export it.

Facts.

Systems
macOS on Apple silicon and Intel. Windows, 64-bit. Linux as AppImage and as deb package. Ramus also runs in a browser.
Languages
German and English.
Anatomy
Real CT-derived anatomy from BodyParts3D, © The Database Center for Life Science, licensed under CC Attribution-Share Alike 2.1 Japan. Nerve and vessel courses after Z-Anatomy, CC BY-SA 4.0. The jaw opens and closes.
Explain
23 patient topics with drawing tools and a one-page A4 handout.
Procedures
34 animated procedures, 11 of them nerve blocks.
Reference
86 cards in 13 categories, each card naming its source.
Learn
307 questions in 9 courses. Exam mode and spaced review.
Scans
STL, PLY, OBJ, GLB. Aligned with three points.
Cephalometry
Steiner, Ricketts, McNamara, Jarabak, Wits, Tweed.
Data
Stored on the device, with no account and no analytics. Works offline. A case exports as one file, and a passcode can lock it.
Price
Free.
Use
Teaching and planning aid. Not a medical device and not for diagnosis.

Download Ramus.

Free installers for the desktop.

The download buttons need JavaScript. With it off, the installers are on the GitHub releases page of 0xBakeer/ramus.

Ramus is a teaching and planning aid. It is not a medical device and not for diagnosis.

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