Efficacy and Cost of Maxillary Patient-Specific Implants in Orthognathic Surgery: A Review of Three Patient Cases

• Published in: Permanente journal Vol. 26; no. 1; pp. 137 - 142
• Main Authors: Sun, Ho-Hyun Brian, Fallah, Heshaam
• Format: Journal Article
• Language: English
• Published: United States The Permanente Federation 05.04.2022
• Subjects: Case Reports; Humans; Orthognathic Surgical Procedures - economics; Orthognathic Surgical Procedures - methods; Osteotomy, Le Fort - methods; Prostheses and Implants - economics
• ISSN: 1552-5775; 1552-5767; 1552-5775
• DOI: 10.7812/TPP/21.054

Patient-specific implants (PSIs) are accurate, efficient alternatives to traditional plate fixation. They are well-suited for use in procedures that require the utmost accuracy, stability, and efficiency. Although PSIs have demonstrated such qualities in craniomaxillofacial reconstruction, they have so far found limited utilization elsewhere. We explored the departmental protocol for Lefort 1 PSI orthognathic surgery at a high-volume, tertiary referral center. Three cases were selected that matched predetermined criteria, which included treatment by the same surgical team, concurrent Lefort 1 osteotomy and bilateral sagittal split osteotomy, Angle's type 3 malocclusion, lack of interdental osteotomies, and American Society of Anesthesiologists classification 2 or less without metabolic or osseous diseases. The operative outcomes from these patients were then compared to similar cases also meeting the same criteria and conducted within the same time period. The use of PSI in Lefort 1 osteotomy is associated with anatomically sound designs that could contribute to postoperative stability of the jaws. They also have not shown increased rates of complications such as infection, dehiscence, or relapse at 6 weeks postoperatively but may in fact decrease the operative duration. These findings are consistent with the results gleaned from literature on the use of PSI in craniomaxillofacial reconstruction.