A Novel Orthognathic Surgery With a Half-Millimeter Accuracy for the Maxillary Positioning Using Prebent Plates and Computer-Aided Design and Manufacturing Osteotomy Guide.


Journal

The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410

Informations de publication

Date de publication:
01 Oct 2023
Historique:
received: 06 03 2023
accepted: 19 03 2023
medline: 9 10 2023
pubmed: 30 5 2023
entrez: 30 5 2023
Statut: ppublish

Résumé

This retrospective study aimed to assess the accuracy of prebent plates and computer-aided design and manufacturing osteotomy guide for orthognathic surgery. The prebent plates correspondent to the planning model were scanned with a 3-dimensional printed model for guide design and used for fixation. Forty-two patients who underwent bimaxillary orthognathic surgery using computer-aided design and manufacturing intermediate splint with the guide (guided group: 20 patients) or with conventional fixation under straight locking miniplates (SLMs) technique (SLM group: 20 patients) were analyzed. A deviation of the maxilla between the planned and postoperative positions was evaluated using computed tomography, which was taken 2 weeks before and 4 days after the surgery. The surgery time and the infraorbital nerve paranesthesia were also evaluated. The mean deviations in the mediolateral ( x ), anteroposterior ( y ), and vertical directions ( z ) were 0.25, 0.50, and 0.37 mm, respectively, in the guided group, while that in the SLM group were 0.57, 0.52, and 0.82 mm, respectively. There were significant differences in x and z coordinates ( P <0.001). No significant difference in the surgery duration and paranesthesia was seen, suggesting the present method offers a half-millimeter accuracy for the maxillary repositioning without increasing the risk of extending surgery duration and nerve complication.

Identifiants

pubmed: 37253149
doi: 10.1097/SCS.0000000000009409
pii: 00001665-990000000-00768
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2087-2091

Informations de copyright

Copyright © 2023 by Mutaz B. Habal, MD.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

Bai S, Shang H, Liu Y, et al. Computer-aided design and computer-aided manufacturing locating guides accompanied with prebent titanium plates in orthognathic surgery. J Oral Maxillofac Surg 2012;70:2419–2426
Heufelder M, Wilde F, Pietzka S, et al. Clinical accuracy of waferless maxillary positioning using customized surgical guides and patient specific osteosynthesis in bimaxillary orthognathic surgery. J Craniomaxillofac Surg 2017;45:1578–1585
Li B, Wei H, Jiang T, et al. Randomized clinical trial of the accuracy of patient-specific implants versus CAD/CAM splints in orthognathic surgery. Plast Reconstr Surg 2021;148:1101–1110
Li B, Zhang L, Sun H, et al. A novel method of computer aided orthognathic surgery using individual CAD/CAM templates: a combination of osteotomy and repositioning guides. Br J Oral Maxillofac Surg 2013;51:e239–e244
Li K, Li J, Du W, et al. Computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates improve surgical accuracy of skeletal class III malocclusion. Plast Reconstr Surg 2020;145:963e–974e
Wong A, Goonewardene MS, Allan BP, et al. Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates. Int J Oral Maxillofac Surg 2021;50:494–500
Ellis E 3rd. Bimaxillary surgery using an intermediate splint to position the maxilla. J Oral Maxillofac Surg 1999;57:53–56
Iwai T, Omura S, Honda K, et al. An accurate bimaxillary repositioning technique using straight locking miniplates for the mandible-first approach in bimaxillary orthognathic surgery. Odontology 2017;105:122–126
Omura S, Kimizuka S, Iwai T, et al. An accurate maxillary superior repositioning technique without intraoperative measurement in bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 2012;41:949–951
Pietzka S, Mascha F, Winter K, et al. Clinical accuracy of 3D-planned maxillary positioning using CAD/CAM-generated splints in combination with temporary mandibular fixation in bimaxillary orthognathic surgery. Craniomaxillofac Trauma Reconstr 2020;13:290–299
Araújo MM, Lauria A, Mendes MB, et al. Analysis of residual stress and hardness in regions of pre-manufactured and manual bends in fixation plates for maxillary advancement. Oral Maxillofac Surg 2015;19:369–373
Liu L-N, Li J-Y, Li K-H, et al. Deformation assessment of the manually pre-bent titanium miniplates in orthognathic surgery with finite element analysis. J Craniofac Surg 2021;32:883–887
Costa F, Robiony M, Toro C, et al. Condylar positioning devices for orthognathic surgery: a literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:179–190
Takasu H, Hirota M, Yamashita Y, et al. Straight locking miniplate technique achieves submillimeter accuracy of condylar positional change during bimaxillary orthognathic surgery for patients with skeletal class III malocclusion. J Oral Maxillofac Surg 2020;78:1834.e1–1834.e9

Auteurs

Yosuke Yamashita (Y)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Haruki Imai (H)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Hikaru Takasu (H)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Susumu Omura (S)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Koichi Fujita (K)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Toshinori Iwai (T)

Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa Prefecture, Japan.

Makoto Hirota (M)

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center.

Kenji Mitsudo (K)

Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa Prefecture, Japan.

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