Background The elaboration of a precise pre-surgical plan is essential during surgical treatment of dentofacial deformities. The aim of this study was to evaluate the accuracy of computer-aided simulation compared with the actual surgical outcome, following orthognathic surgery reported in clinical trials. Methods Our search was performed in PubMed, EMBASE, Cochrane Library and SciELO for articles published in the last decade. A total of 392 articles identified were assessed independently and in a blinded manner using eligibility criteria, out of which only twelve articles were selected for inclusion in our research. Data were presented using intra-class correlation coefficient, and linear and angular differences in three planes. Results The comparison of the accuracy analyses of the examined method has shown an average translation (< 2 mm) in the maxilla and also in the mandible (in three planes). The accuracy values for pitch, yaw, and roll (°) were (< 2.75, < 1.7 and < 1.1) for the maxilla, respectively, and (< 2.75, < 1.8, < 1.1) for the mandible. Cone-beam computed tomography (CBCT) with intra-oral scans of the dental casts is the most used imaging protocols for virtual orthognathic planning. Furthermore, calculation of the linear and angular differences between the virtual plan and postoperative outcomes was the most frequented method used for accuracy assessment (10 out of 12 studies) and a difference less than 2 mm/° was considered acceptable and accurate. When comparing this technique with the classical planning, virtual planning appears to be more accurate, especially in terms of frontal symmetry. Conclusion Virtual planning seems to be an accurate and reproducible method for orthognathic treatment planning. However, more clinical trials are needed to clearly determine the accuracy and validation of the virtual planning in orthognathic surgery.

Facial soft tissue esthetics is a priority in orthodontic treatment, and emerging of the digital technologies can offer new methods to help the orthodontist toward an esthetic outcome. This prospective study aimed to assess the soft tissue changes of the face after six months of retention following Rapid Maxillary Expansion (RME). The sample consisted of 25 patients (13 females, 12 males, mean age: 11.6 years) who presented with unilateral or bilateral posterior crossbite requiring RME, which was performed with a Hyrax expander. 3D facial images were obtained before treatment (T0) and at the end of a six-month retention period after the treatment (T1) using a structured-light 3D handheld scanner. Linear and angular measurements were performed and 3D deviation analyses were done for six morphological regions of the face. Significant changes in various areas of the nasal and the upper lip regions were observed. Based on the results of the study and within the limitations of the study, RME with a Hyrax expander results in significant morphological changes of the face after a six-month retention period.

CBCT/ CT Cone beam/ computed tomography CFAs Craniofacial anomalies OMSs Oral and maxillofacial surgeons AAOMS Association of oral and maxillofacial surgeons MCA Multiple congenital abnormalities CL/P Cleft lip and palate CO Central occlusion CR Central relation RME Rapid maxillary expansion 2D Two-dimensional 3D Three-dimensional 4D Four-dimensional MRI Magnetic resonance imaging TMJ Temporomandibular joint CMM Coordinate measurement machines LED Light emitting diode STL Stereolithography ICC Interclass correlation coefficient ADRL Average distances between the reciprocal landmarks BSSRO Bilateral sagittal split ramus osteotomy MSS Mandibular setback surgery Skeletal and dental consideration in the transverse dimensionMaxillary transverse deficiency may be one of the most pervasive skeletal problems in the craniofacial region (7). The transverse dimension is often interrelated with the sagittal and vertical dimensions. However, the transverse dimension relates primarily to the posterior occlusion, and any discrepancy is usually manifest as a unilateral or bilateral crossbite of the buccal occlusion. Conservative correction of the maxillary transverse deficiency 1.3.2.1 Unilateral posterior crossbite in cleft lip and palateMaxillary skeletal asymmetry in unilateral complete clefts of the lip and palate may also be reflected in a unilateral posterior crossbite, which may be expanded with a quad helix type of appliance or rapid maxillary expansion (RME) in the mixed dentition. The cleft maxilla does not have a midpalatal suture, instead, there is a midpalatal cleft covered with repaired and scarred palatal tissues limiting the rate and amount of expansion. The force provided by these appliances allows the soft tissue of the palate to stretch and adapt to the increasing maxillary width. This type premolars. This may be accomplished with a hyrax type appliance screw (Figure 3, A). The patient Surgical correction of the craniofacial deformities:According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), orthognathic surgery is the surgical correction of abnormalities of the mandible, maxilla, or both.The underlying abnormality may be present at birth or may become evident as the patient grows IndicationsGiven the relationship between facial skeletal deformities and masticatory dysfunction as well as the limitations of non-surgical therapies to correct these discrepancies. The measurement of these discrepancies must consider dental compensations relating to the malocclusion and the underlying skeletal deformity. Orthognathic surgery should be considered medically appropriate in the following circumstances (11):A. Anteroposterior discrepancies: established norm=2mm 1. Maxillary/mandibular incisor relationship  Horizontal overjet of +5mm or more  Horizontal overjet of zero to a negative value 2. Maxillary/mandibular anteroposterior molar relationship discrepancy of 4mm or more (norm 0 to 1mm) 3. These values represent two or more standard deviation from published norms 1.6.2.2 Intraoral Scanning W...

Az ortognath műtétek tervezésénél a lágyrészek adaptációjának és kontúrjainak figyelembe vétele kiemelt fontosságú.Prospektív tanulmányunk célja a skeletalis III. osztályú páciensek bimaxilláris műtétje után, az arc különböző morfológiairégióiban bekövetkezett lágyrész-változások átfogó értékelésének elvégzése kézi háromdimenziós strukturált fényszkennerrel.Vizsgálati mintánk 12 olyan páciensből állt (6 férfi és 6 nő, átlagéletkoruk 22 ± 2,17 év), akiknek a skeletalisIII. osztályú eltérése átfogó kezelésük második lépéseként bimaxilláris osteotomiát igényelt. Háromdimenziós arcképeketkészítettünk egy héttel a műtét előtt (T0) és 6 hónappal a műtét után (T1) kézi 3D strukturált fényszkennerrel. A képekenlineáris és szögméréseket végeztünk és hasonlítottunk össze, illetve elkészítettük az arc 7 morfológiai régiójánakháromdimenziós deviációs elemzését. Statisztikailag szignifikáns növekedést találtunk az orr- és az orralap szélességében,az orrcsúcs szögében, a felső ajak magasságában és az alsó ajak szögében. Ezzel szemben az alsó ajak magasságaés az inter-labialis szög értéke szignifikánsan csökkent. A skleletalis III. osztályú betegek bimaxilláris műtétjeután különböző mértékű háromdimenziós lágyrész változásokat figyeltünk meg a faciális régiók többségében, melyekközül jelentősebbek voltak a középarc, az orr és a felső ajak változásai. Ezekkel a várható változásokkal a kezelésekmegtervezésénél számolni kell.