Accuracy of Maxillary Positioning During Orthognathic Surgery: A Comparison of Web-based 3-Dimensional Virtual Surgical Planning and Actual Outcomes

Abstract

Purpose: To determine the accuracy of planned maxillary positioning by virtual surgery by comparing planned and actual postoperative outcomes. Materials and Methods: Twenty patients who underwent 2-jaw orthognathic surgery performed by a single surgeon from May 2017 to December 2020 were the subjects of this retrospective study. The coordinates of reference points in horizontal, sagittal, and coronal planes as determined by virtual surgery were compared with those of actual surgical outcomes. The reference points used were as follows: #16 mesiobuccal cusp tip (#16), #26 mesiobuccal cusp tip (#26), and #11 mesial tip (U1); anterior nasal spine; and posterior nasal spine. Three-dimensional linear distances between the reference point on which virtual surgery was performed and the reference point after the actual operation was calculated. Results: Of the 20 patients, there were 11 males and 9 females of average age 20.65±2.41 years. Three-dimensional printed wafers had high accuracy with a maximum difference of 0.3 mm. No significant difference was observed in horizontal or coronal planes for any reference point, but a significant difference was observed in the sagittal plane. However, positional differences between planned and actual reference points were all <1 mm. Conclusions: Virtual surgical planning and 3-dimensional printed wafer achieved excellent maxillary positioning accuracies after orthognathic surgery.

Three-Dimensional Plotted Calcium Phosphate Scaffolds for Bone Defect Augmentation—A New Method for Regeneration

“…Thus, in the worst case a total workflow error of 0.75 mm is possible. However, the clinical impact of this error is questionable as the scaffold is inserted by a surgeon and a positioning error of less than 1 mm can be considered as sufficient [ 33 ]. Moreover, the scaffold was fixed tightly to the adjacent bone by a fixation screw enabling a close bone-scaffold-contact and, thus, a sufficient healing.…”