Virtual Analysis of Segmental Bimaxillary Surgery: A Validation Study

Holte, Michael Boelstoft; Diaconu, Alexandru; Ingerslev, Janne; Thorn, Jens Jørgen; Pinholt, Else Marie

doi:10.1016/j.joms.2021.06.003

Cited by 22 publications

(30 citation statements)

References 34 publications

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“…This limitation also applies to segmental osteotomies (2-piece-maxilla, Delaire-Joos, Zisser) as well as distractions and LeFort II or III surgeries. Measuring the accuracy of those surgical procedures CT or CBCT protocols with a reference to the cranial base are necessary where voxel-based registrations are preferred [ 35 , 36 , 37 , 38 ].…”

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

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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.

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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

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show abstract

“…This study is a continuation of the validation study by Holte et al 1 In this previous work, a semi-automated three-dimensional (3D) approach for virtual surgical analysis (VSA) of the accuracy of segmental bimaxillary surgery was proposed and validated. The approach was solely validated on postoperative cone beam computed tomography (CBCT) scans acquired immediately (2 weeks) after surgery.…”

Section: Introductionmentioning

confidence: 93%

“…The approach was solely validated on postoperative cone beam computed tomography (CBCT) scans acquired immediately (2 weeks) after surgery. The purpose of the present study was to expand and validate the semi-automated VSA approach proposed by Holte et al 1 for 3D assessment of the long-term (2-year) postoperative stability of orthognathic surgery. Due to bone remodelling and resorption, long-term assessment is inherently more difficult than short-term assessment from CBCT scans acquired immediately after surgery.…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review on protocols to assess the outcomes of orthognathic surgery, showed that voxel-based superimposition protocols presented the highest accuracy and reproducibility, and protocols that used automated processes and involved only one software were the most efficient. 25 A versatile and semi-automated approach using VBR for virtual 3D assessment of the accuracy of segmental bimaxillary surgery, including segmental osteotomies, such as the threepiece Le Fort I osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty, was proposed and validated by Holte et al 1 The VSA approach is semi-automated as it solely requires user input for VBR, comprising pre-alignment and selection of the volume of interest (VOI). The strength of the method by Holte et al was proven in the validation, which showed excellent intra-and inter-observer reliability (intra-class correlation coefficient (ICC) > 0.96) and low mean absolute difference of repeated intraand inter-observer translational (< 0.20 mm) and rotational (< 0.63°) measurements of all individual bone segments.…”

Section: Introductionmentioning

confidence: 99%

“…The strength of the method by Holte et al was proven in the validation, which showed excellent intra-and inter-observer reliability (intra-class correlation coefficient (ICC) > 0.96) and low mean absolute difference of repeated intraand inter-observer translational (< 0.20 mm) and rotational (< 0.63°) measurements of all individual bone segments. 1 However, its applicability and validity for 3D assessment of longterm postoperative stability of segmental bimaxillary surgery is not yet proven. Mutual image information of long-term postoperative CBCT scans used for the registration of the individual bone segments is less similar due to bone remodelling processes and the continuous post-surgical orthodontic treatment.…”

Section: Introductionmentioning

confidence: 99%

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