The Accuracy of Maxillary Position Using a Computer-Aided Design/Computer-Aided Manufacturing Intermediate Splint Derived Via Surgical Simulation in Bimaxillary Orthognathic Surgery

Yamaguchi, Yoshihiro; Yamauchi, Kensuke; Suzuki, Hisayoshi; Saito, S.; Nogami, Shinnosuke; Takahashi, Tsuneo

doi:10.1097/scs.0000000000006305

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…32 Recent advances in 3D computer-aided design/computeraided manufacturing technology has enabled clinicians to fabricate surgical wafers and simulate surgical movements 33 as well as the validation of maxilla stability after orthognathic surgery. 34 Simulation surgery and 3D computer-aided design/computer-aided manufacturing splints 35 and condyle positioning jigs 15 have been developed for such stabilization during orthognathic surgery. Lee et al, 22 developed a type of computer-assisted surgery protocol for managing the proximal segment while treating complex maxilla-facial deformities.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry

Kim

Jha

Choi

et al. 2022

Journal of Craniofacial Surgery

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: This study was performed to evaluate condylar position and angulation after asymmetric mandibular setback between a conventional (CA) and surgery-first approach (SFA) using three-dimensional analysis. The condylar positions of 30 patients with skeletal Class III malocclusion and facial asymmetry who underwent 1-jaw (sagittal split ramus osteotomy) or 2-jaw orthognathic surgery (Le Fort I osteotomy and sagittal split ramus osteotomy) with CA (n = 18) or SFA (n = 12) from 2 university hospitals were studied. The three-dimensional assessment of condylar changes was performed using computed tomography images at the initial time point (T0) and at least 6 months after surgery (T1). Segmentation of condyles and cranial base assessment from cone-beam computed tomography images were performed using ITK-SNAP software (version 3.4.0). Condylar position and angulation changes were calculated using 3D Slicer software (version 4.10.2), and statistical analysis was performed. No significant translational or rotational condylar changes were observed between the deviated and non-deviated sides in each group or between the CA and SFA groups except yaw (p = 0.014). Linear mixed-model analysis and multi-variate analysis showed no significant difference between the CA and SFA groups. Surgery-first approach might not be associated with more harmful effects on the condylar position and angulation changes as compared with CA.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry

Kim

Jha

Choi

et al. 2022

Journal of Craniofacial Surgery

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“…Multiple studies have used voxel-based matching to superimpose the preoperative and postoperative cone beam computed tomography (CBCT) scans for assessing surgical accuracy and for identifying factors that may influence or affect the feasibility of 3D VSP [ 4 , 5 ]. Recent studies reported that the accuracy of maxillary positioning in non-cleft patients using a computer-aided design/computer-aided manufacturing (CAD/CAM) splint derived from 3D VSP is within the range of 1 to 2 mm [ 6 , 7 ]. Studies with similar study design involving cleft patients demonstrated that the surgical accuracy of maxillary positioning varied between 1.48 and 2.75 mm [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Is there a difference in surgical accuracy following bimaxillary surgery between cleft and non-cleft patients?

Beek,

Visser,

Chen

et al. 2024

Clin Oral Invest

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Objectives To assess the surgical accuracy of 3D virtually planned orthognathic surgery among patients with and without cleft. Materials and methods This retrospective cohort study included cleft and non-cleft patients with class III malocclusion who underwent bimaxillary surgery. CBCT scans were acquired before and immediately after surgery. 3D virtual surgical planning (VSP) was performed using CBCT and digitalized dentition data. All orthognathic surgeries were performed by the same surgeons using interocclusal splints. The primary outcome variable was surgical accuracy, defined as the difference between the planned and surgically achieved maxillary movements, quantified in six degrees of freedom. Analysis of covariance was used to test for intergroup differences in surgical accuracy after correcting for differences in the magnitude of planned surgical maxillary movements. Results Twenty-eight cleft and 33 non-cleft patients were enrolled, with mean ages of 18.5 and 25.4 years, respectively (P=0.01). No significant gender difference was present between the groups (P=0.10). After adjustment for small differences in surgical movements, no significant differences in surgical accuracy were observed between cleft and non-cleft patients. Conclusion The present study demonstrates that high surgical accuracy in maxillary movements can be achieved in both cleft and non-cleft patients using VSP and interocclusal splints. Clinical relevance Orthognathic cases with cleft can be performed with 3D VSP to obtain a satisfactory surgical accuracy.

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“…3 In this way, a more precise surgical method than the conventional one is achieved. 4 Despite the precision with which skeletal surgeries are performed today, the evidence regarding the reaction of soft tissues to the skeletal movement of orthognathic or orthofacial surgery varies widely. [5][6][7][8] Conversely, the literature shows limited information about the relationship between hard and soft tissues in the 3D analysis, rendering the process at the soft tissue level unpredictable.…”

mentioning

confidence: 99%

“…This flow includes: (1) image acquisition of bone hard tissues with cone beam computed tomography (CBCT), (2) image acquisition of dental hard tissues and occlusion with an intraoral scanner, (3) reconstruction of soft tissues using 3D photographs, (4) video of functional movements, (5) image superimposition, (6) virtual planning and treatment, and (7) design and printing of surgical and cutting guides 3 . In this way, a more precise surgical method than the conventional one is achieved 4 …”

mentioning

confidence: 99%

Photographic Parameters in Three-Dimensional Facial Image Acquisition. A Scoping Review

Muñoz,

Brito,

Olate

2024

Journal of Craniofacial Surgery

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Objective: Orthognathic surgery is a viable and reproducible treatment for facial deformities. Despite the precision of the skeletal planning of surgical procedures, there is little information about the relations between hard and soft tissues in three-dimensional (3D) analysis, resulting in unpredictable soft tissue outcomes. Three-dimensional photography is a viable tool for soft tissue analysis because it is easy to use, has wide availability, low cost, and is harmless. This review aims to establish parameters for acquiring consistent and reproducible 3D facial images. Methods: A scoping review was conducted across PubMed, SCOPUS, Scientific Electronic Library Online (SciELO), and Web of Science databases, adhering to “Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews” guidelines. Articles presenting 3D facial photographs in the diagnostic phase were considered. Results: A total of 79 articles were identified, of which 29 were selected for analysis. Conclusion: The predominant use of automated systems like 3dMD and VECTRA M3 was noted. User positioning has highest agreement among authors. Noteworthy aspects include the importance of proper lighting, facial expression, and dental positioning, with observed discrepancies and inconsistencies among authors. Finally, the authors proposed a 3D image acquisition protocol based on this research findings.

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The Accuracy of Maxillary Position Using a Computer-Aided Design/Computer-Aided Manufacturing Intermediate Splint Derived Via Surgical Simulation in Bimaxillary Orthognathic Surgery

Cited by 8 publications

References 24 publications

Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry

Three-Dimensional Changes in the Mandibular Proximal Segment After Using a Surgery-First Approach in Patients With Class III Malocclusion and Facial Asymmetry

Is there a difference in surgical accuracy following bimaxillary surgery between cleft and non-cleft patients?

Photographic Parameters in Three-Dimensional Facial Image Acquisition. A Scoping Review

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