Positionnement condylien lors de la chirurgie orthognathique mandibulaire

Benateau, Hervé; Chatellier, Anne; Leprovost, N.; Ghezal, S.; Compère, J F; Veyssière, A.

doi:10.1016/j.revsto.2014.06.003

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…-Le positionnement manuel dit « empirique » : le chirurgien aligne les bords basilaires en repoussant le segment proximal condylien en haut et en arrière pour une chirurgie de classe II. Les bords basilaires sont alignés sans exercer de contraintes sur le segment proximal pour une chirurgie de classe III [70]. -Le positionnement par méthodes instrumentales : le dispositif le plus répandu correspond à une plaque d'ostéosynthèse temporaire allant du bord antérieur du ramus au cintre maxillo-zygomatique homolatéral.…”

Section: Planification Virtuelle Et Positionnement Condylienunclassified

“…-Le positionnement par méthodes instrumentales : le dispositif le plus répandu correspond à une plaque d'ostéosynthèse temporaire allant du bord antérieur du ramus au cintre maxillo-zygomatique homolatéral. Celle-ci permet le repérage de la position habituelle du condyle avant de réaliser l'ostéotomie mandibulaire, puis de la restituer au moment de l'ostéosynthèse [70]. -Le positionnement par méthodes radiologiques : une échographie per opératoire permet d'identifier les malpositions discales après l'ostéosynthèse [71].…”

Section: Planification Virtuelle Et Positionnement Condylienunclassified

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Current status of surgical planning and transfer methods in orthognathic surgery

Pascal

Majoufre

Bondaz

et al. 2018

Journal of Stomatology, Oral and Maxillofacial Surgery

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Section: Planification Virtuelle Et Positionnement Condylienunclassified

Current status of surgical planning and transfer methods in orthognathic surgery

Pascal

Majoufre

Bondaz

et al. 2018

Journal of Stomatology, Oral and Maxillofacial Surgery

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“…Dissection training is constrained and cannot offer condylar repositioning training because it may introduce damage to tissues which influences their anatomical position [ 10 ]. Despite of none scientific evidence supported the routine use of condyle positioning devices to prevent TMJ disorders [ 11 – 14 ], computer-assisted navigation could be considered as an educational tool to control the learning curve for condylar positioning among condylar positioning devices available to help surgeons in condylar repositioning [ 12 ]. Bettega et al [ 15 , 16 ] have developed a condylar positioning system (CPS) based on navigation and underlined the benefits of using CPS routinely for clinical and educational purposes.…”

Section: Introductionmentioning

confidence: 99%

Computer-assisted teaching of bilateral sagittal split osteotomy: Learning curve for condylar positioning

Savoldelli¹,

Chamorey

Bettega

2018

PLoS ONE

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Bilateral sagittal split osteotomy (BSSO) is a widely-performed procedure in orthognathic surgery for the correction of dentofacial deformity. Condylar positioning is a critical step during BSSO to maximize functional and morphological results. The unsuitable positioning of condyles represents one of the causative mechanisms that may induce temporomandibular joint noxious effects after BSSO. Repositioning devices can assist surgeons in maintaining the preoperative condylar position; however, empirical repositioning methods based on experience gained are still commonly used. Trainee learning curves are difficult to assess. The aim of this study was to evaluate the relevance of computer-assisted surgery in the acquisition of condylar positioning skills. Forty-eight patients underwent BSSO performed by six maxillofacial trainees (four junior residents and two senior experienced residents). A condyle positioning system (CPS) was used by a senior surgeon to record a condylar position score during the procedure. Firstly, scores were recorded when the trainee manually positioned the condyle without access to the CPS score (phase 1) and then when the trainee positioned the condyle and performed osteosynthesis with visual access to the CPS score (phase 2). Six parameters describing condylar three-dimensional motions were assessed: translational motion from top to bottom (TB), back to front (BF), and left to right (LR), axial rotation (AR), sagittal rotation (SR), frontal rotation (FR), and a total score (TS). There were no significant differences between junior and senior residents in condyle positioning without access to the CPS. Condyles were significantly better positioned during phase 2 with access to the CPS (p<0.001). Over time, use of the CPS (phase 2) produced significantly quicker improvements in scores (p = 0.042). For those teaching surgeries to trainees, computer-assisted devices can potentially result in more rapid learning curves than traditional “observations-imitation” models. Use of a CPS by trainees facilitated condylar repositioning that resulted in an accurate occlusal result and avoidance of adverse effects on the temporomandibular joint.

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Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy

Blasio

Anghinoni

Blasio

2017

Case Reports in Dentistry

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In maxillofacial surgery, every patient presents special problems requiring careful evaluation. Conventional methods to study the deformities are still reliable, but the advent of tridimensional (3D) imaging, especially computed tomography (CT) scan and laser scanning of casts, created the opportunity to better understanding the skeletal support and the soft tissue structures. Nowadays, virtual technologies are increasingly employed in maxillofacial surgery and demonstrated precision and reliability. However, in complex surgical procedures, these new technologies are still controversial. Especially in the less frequent cases of three-part maxillary surgery, the experience is limited, and scientific literature cannot give a clear support. This paper presents the case of a young patient affected by a complex long face dentofacial deformity treated by a bimaxillary surgery with three-part segmentation of the maxilla. The operator performed the surgical study completely with a virtual workflow. Pre- and postoperative CT scan and optical scanning of plaster models were collected and compared. Every postoperatory maxillary piece was superimposed with the presurgical one, and the differences were examined in a color-coded map. Only mild differences were found near the osteotomy lines, when the bony surface and the teeth demonstrated an excellent coincidence.

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Positionnement condylien lors de la chirurgie orthognathique mandibulaire

Cited by 3 publications

References 15 publications

Current status of surgical planning and transfer methods in orthognathic surgery

Current status of surgical planning and transfer methods in orthognathic surgery

Computer-assisted teaching of bilateral sagittal split osteotomy: Learning curve for condylar positioning

Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy

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