Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates

Wong, Agnes M-L; Goonewardene, Mithran S.; Allan, Brent; Mian, Ajmal; Rea, Alethea

doi:10.1016/j.ijom.2020.08.009

Cited by 28 publications

(24 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is hardly any information on how the postoperative occlusion was set. Manual placement of the plaster casts with subsequent scanning and incorporation into the CT data set still seems to be a standard procedure [ 28 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

In Vivo Accuracy of a New Digital Planning System in Terms of Jaw Relation, Extent of Surgical Movements and the Hierarchy of Stability in Orthognathic Surgery

Stamm

Andriyuk

Kleinheinz

et al. 2022

JPM

View full text Add to dashboard Cite

This retrospective cohort study compares the virtual planned and postoperative jaw positions in patients undergoing orthognathic surgery. Surgery was virtually planned with the Digital Münster Model Surgery system (DMMS). Primary outcome: Spatial difference in the maxillo-mandibulo relation between virtual planning and postoperative result. Secondary outcome: Possible relationship between the measured differences and surgical movements as well as the postoperative stability according to Proffit. Ninety female and sixty-one male patients were included in the study. The average translation errors were 0.54 ± 0.50 mm (anteroposterior), 0.37 ± 0.33 mm (mediolateral), and 0.33 ± 0.28 mm (superoinferior). Orientation errors were 0.86 ± 0.79 degrees (yaw), 0.54 ± 0.48 degrees (roll), and 0.90 ± 0.72 degrees (pitch). The surgical procedures do not differ with respect to their error sizes. Maxilla forward and class II maxilla up with mandible forward are the most precise procedures. Most significant differences were found in the anteroposterior direction, whereby the extent of the surgical movement has no effect on the magnitude of the error. The process of planning with the DMMS followed by surgery is highly accurate and shows error values well below the clinically accepted limit of two millimeters in translation and four degrees in rotation.

show abstract

Section: Discussionmentioning

confidence: 99%

In Vivo Accuracy of a New Digital Planning System in Terms of Jaw Relation, Extent of Surgical Movements and the Hierarchy of Stability in Orthognathic Surgery

Stamm

Andriyuk

Kleinheinz

et al. 2022

JPM

View full text Add to dashboard Cite

show abstract

“…In the comparison of maxillary repositioning between PSI and interocclusal splint by Ruckschloss et al [10], PSI group showed the discrepancies of 0.51 mm in left/right positioning, 0.39 mm in anterior/posterior positioning, and 0.44 mm in up/down positioning. Recently, Wong et al [14] also assessed the accuracy of maxillary repositioning using customized titanium guides and PSI, and they reported the overall root mean error of 0.38 mm in the transverse dimension, 0.64 mm in the anteroposterior dimension, and 0.55 mm in the vertical dimension.…”

Section: Discussionmentioning

confidence: 99%

“…It is also difficult to hold the maxilla stably in the internal fixation procedures, including drilling holes and applying a plate [12]. For template-based surgery or PSI, several clinical studies have been conducted to assess the surgical accuracy and the results of these studies showed high accuracy compared to the results of surgery using traditional methods [9,10,14]. However, in the template-based surgery or PSI, a relatively long laboratory time is required to fabricate surgical tools, and there is no leeway to change maxillary positioning perioperatively, when soft tissue response is different from the preoperative prediction or there are errors in the preoperative evaluation and surgical plan [9,10,15].…”

Section: Introductionmentioning

confidence: 99%

“…However, in the template-based surgery or PSI, a relatively long laboratory time is required to fabricate surgical tools, and there is no leeway to change maxillary positioning perioperatively, when soft tissue response is different from the preoperative prediction or there are errors in the preoperative evaluation and surgical plan [9,10,15]. In addition, excessive exposure of operation field is needed to place templates or PSI [14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

Han

Woo

et al. 2021

JCM

View full text Add to dashboard Cite

Several methods enabling independent repositioning of the maxilla have been introduced to reduce intraoperative errors inherent in the intermediate splint. However, the accuracy is still to be improved and a different approach without time-consuming laboratory process is needed, which can allow perioperative modification of unoptimized maxillary position. The purpose of this study is to assess the feasibility and accuracy of a robot arm combined with intraoperative image-guided navigation in orthognathic surgery. The experiments were performed on 12 full skull phantom models. After Le Fort I osteotomy, the maxillary segment was repositioned to a different target position using a robot arm and image-guided navigation and stabilized. Using the navigation and the postoperative computed tomography (CT) images, the achieved maxillary position was compared with the planned position. Although the maxilla showed mild displacement during the fixation, the mean absolute deviations from the target position were 0.16 mm, 0.18 mm, and 0.20 mm in medio-lateral, antero-posterior, and supero-inferior directions, respectively, in the intraoperative navigation. Compared with the target position using postoperative CT, the achieved maxillary position had a mean absolute deviation of less than 0.5 mm for all dimensions and the mean root mean square deviation was 0.79 mm. The results of this study suggest that the robot arm combined with the intraoperative image-guided navigation may have great potential for surgical plan transfer with the accurate repositioning of the maxilla in the orthognathic surgery.

show abstract

“…Recent advances in surgical planning using computer-aided design to manufacture (CAD/CAM) customized xation plates represents a valuable improvement in mandibular reconstructive surgery [24].…”

Section: Discussionmentioning

confidence: 99%

Thirty-eight-year Follow-up of the First Patient of Mandibular Reconstruction with Free Vascularized Fibula Flap

Puricelli

Chem

2021

Preprint

View full text Add to dashboard Cite

Background: The mandible is responsible for vital functions of the stomatognathic system, and its loss results in functional and aesthetic impairment. Mandibular reconstruction with free fibula flap is considered the gold standard for mandibular reconstruction.Case presentation: We describe here the 38-year follow-up of the patient who was the first case of mandibular reconstruction with free fibula flap reported in the literature. The original report describes a 27-year-old woman who had undergone extensive mandibulectomy due to an osteosarcoma. A microvascularized fibula flap was used for mandibular reconstruction in 1983. Two years later, a vestibulo-lingual sulcoplasty with skin graft was performed to allow the construction of a total dental prosthesis. Fifteen years after the initial treatment, an autologous iliac crest graft was placed in the fibula flap, aimed at increasing bone thickness and height for rehabilitation with implant supported prosthesis. In 2015, a rib graft was positioned in the mental region, enhancing the support to the soft tissues of the face and improving the oral function. A recent review of the patient shows well-balanced facial morphology and optimal functional results of the procedure. Conclusions: The fibula flap method, described in 1975 and first reported for mandibular reconstruction in 1985, continues to be applied as originally described, especially where soft tissue damage is not extensive. Its use in reconstructive surgery was expanded by advancements in surgery and techniques such as virtual surgical planning. However, there is still a lack of evidence related to the long-term evaluation of outcomes. The present work represents the longest-term follow-up of a patient undergoing mandibular reconstruction with free vascularized fibula flap, presenting results showing that, even after 38 years, the procedure continues to provide excellent results.

show abstract

Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates

Cited by 28 publications

References 34 publications

In Vivo Accuracy of a New Digital Planning System in Terms of Jaw Relation, Extent of Surgical Movements and the Hierarchy of Stability in Orthognathic Surgery

In Vivo Accuracy of a New Digital Planning System in Terms of Jaw Relation, Extent of Surgical Movements and the Hierarchy of Stability in Orthognathic Surgery

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

Thirty-eight-year Follow-up of the First Patient of Mandibular Reconstruction with Free Vascularized Fibula Flap

Contact Info

Product

Resources

About