Medial Canthal Region as an External Reference Point in Orthognathic Surgery

Gil, José Nazareno; Campos, Felipe Eduardo Baires; Claus, Jonathas Daniel Paggi; Gil, Luiz Fernando; Marin, Charles; Freitas, Sérgio Fernando Torres de

doi:10.1016/j.joms.2010.07.023

Cited by 22 publications

(10 citation statements)

References 11 publications

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“…In two-jaw surgeries, the splint was used for correct assembly of the mandibulomaxillary complex according to correct occlusal relations in the first instance. Reorientation of this complex was then controlled with regard to the desired final position of the maxillary incisors by intraoperative landmark measurement, which has proved to be reliable for vertical and sagittal movements [8, 9]. A computer-assisted two-splint strategy as described by Choi et al [14], where the first splint is used for the positioning of the mobilized maxilla with respect to the mandible, would, in fact, require the use of positioning devices.…”

Section: Discussionmentioning

confidence: 99%

“…After mobilization, both jaws were assembled by wires using the final splint to achieve correct occlusal relations, and the whole complex was subsequently repositioned with respect to the planned position of the maxillary incisors. Control of vertical and sagittal dimensions was performed according to intra- and extraoral landmarks as described by Kretschmer et al [8] and Gil et al [9]. Retral condylar positioning was performed manually without positioning plates.…”

Section: Methodsmentioning

confidence: 99%

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RapidSplint: virtual splint generation for orthognathic surgery – results of a pilot series

Adolphs

Liu

Keeve

et al. 2014

Computer Aided Surgery

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BackgroundWithin the domain of craniomaxillofacial surgery, orthognathic surgery is a special field dedicated to the correction of dentofacial anomalies resulting from skeletal malocclusion. Generally, in such cases, an interdisciplinary orthodontic and surgical treatment approach is required. After initial orthodontic alignment of the dental arches, skeletal discrepancies of the jaws can be corrected by distinct surgical strategies and procedures in order to achieve correct occlusal relations, as well as facial balance and harmony within individualized treatment concepts. To transfer the preoperative surgical planning and reposition the mobilized dental arches with optimal occlusal relations, surgical splints are typically used. For this purpose, different strategies have been described which use one or more splints. Traditionally, these splints are manufactured by a dental technician based on patient-specific dental casts; however, computer-assisted technologies have gained increasing importance with respect to preoperative planning and its subsequent surgical transfer.Methods: In a pilot study of 10 patients undergoing orthognathic corrections by a one-splint strategy, two final occlusal splints were produced for each patient and compared with respect to their clinical usability. One splint was manufactured in the traditional way by a dental technician according to the preoperative surgical planning. After performing a CBCT scan of the patient’s dental casts, a second splint was designed virtually by an engineer and surgeon working together, according to the desired final occlusion. For this purpose, RapidSplint®, a custom-made software platform, was used. After post-processing and conversion of the datasets into .stl files, the splints were fabricated by the PolyJet procedure using photo polymerization. During surgery, both splints were inserted after mobilization of the dental arches then compared with respect to their clinical usability according to the occlusal fitting.ResultsUsing the workflow described above, virtual splints could be designed and manufactured for all patients in this pilot study. Eight of 10 virtual splints could be used clinically to achieve and maintain final occlusion after orthognathic surgery. In two cases virtual splints were not usable due to insufficient occlusal fitting, and even two of the traditional splints were not clinically usable. In five patients where both types of splints were available, their occlusal fitting was assessed as being equivalent, and in one case the virtual splint showed even better occlusal fitting than the traditional splint. In one case where no traditional splint was available, the virtual splint proved to be helpful in achieving the final occlusion.ConclusionsIn this pilot study it was demonstrated that clinically usable splints for orthognathic surgery can be produced by computer-assisted technology. Virtual splint design was realized by RapidSplint®, an in-house software platform which might contribute in future to shorten preoperative workflows fo...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

RapidSplint: virtual splint generation for orthognathic surgery – results of a pilot series

Adolphs

Liu

Keeve

et al. 2014

Computer Aided Surgery

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“…The medial canthus of the eye was selected as the reference point in this technique for iris disk placement. Various studies justify the use of the medial canthus region as a fixed reference point . The superioinferior visibility of the iris disk can be checked by measuring the distance from upper eyelid to lower eyelid with the same customized scale.…”

Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Orientation of Iris in an Ocular Prosthesis Using a Customized Scale

Gupta

Aparna

Balakrishnan

et al. 2013

Journal of Prosthodontics

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The success of an ocular prosthesis depends largely on the correct orientation of the iris disk. Various methods have been put forth to achieve this. This article emphasizes one such simplified method, wherein a customized scale has been used to orient the iris disk mediolaterally, superoinferiorly, and anteroposteriorly in an ocular prosthesis. A scleral wax pattern was fabricated. The customized scale was used to measure the dimension and orientation of the natural iris. These measurements were then transferred to the scleral wax pattern with the customized scale. An iris disk was fabricated using black crayon on the scleral wax pattern according to the measurements. The scleral wax pattern, including the iris disk, was then placed in the eye socket to verify its dimension and orientation. A prefabricated iris disk was modified according to the measured dimensions and transferred to the final scleral wax pattern. The transfer of these dimensions to the definitive prosthesis was achieved successfully, ultimately improving the patient's social and psychological well being.

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“…20 A metal ruler is used to measure the distance to the orthodontic archwire as it crosses the lateral incisor (see Figure 22.13). We prefer using the medial canthus as the fixed point.…”

Section: Techniquementioning

confidence: 99%