On the feasibility of minimally invasive Le Fort I with patient-specific implants: Proof of concept

• Published in: Journal of stomatology, oral and maxillofacial surgery Vol. 125; no. 3; p. 101844
• Main Authors: Hernández-Alfaro, Federico, Saavedra, Oscar, Duran-Vallès, Francesc, Valls-Ontañón, Adaia
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.06.2024
• Subjects: Adult; Anatomic Landmarks; Computer simulation; Dental Implantation, Endosseous - instrumentation; Dental Implantation, Endosseous - methods; Dental Implants; Feasibility Studies; Female; Humans; Imaging, Three-Dimensional - methods; Le Fort osteotomy; Male; Minimally invasive surgery; Minimally Invasive Surgical Procedures - instrumentation; Minimally Invasive Surgical Procedures - methods; Orthognathic surgery; Osteotomy, Le Fort - instrumentation; Osteotomy, Le Fort - methods; Patient specific modeling; Proof of Concept Study; Orthognathic surgery; Patient specific modeling; Minimally invasive surgery; Le Fort osteotomy; Computer simulation
• ISSN: 2468-7855; 2468-7855
• DOI: 10.1016/j.jormas.2024.101844

A novel approach to Le Fort I osteotomy is presented, integrating patient-specific implants (PSIs), osteosynthesis and cutting guides within a minimally invasive surgical framework, and the accuracy of the procedure is assessed through 3D voxel-based superimposition. The technique was applied in 5 cases. Differences between the surgical plan and final outcome were evaluated as follows: a 2-mm color scale was established to assess the anterior surfaces of the maxilla, mandible and chin, as well as the condylar surfaces. Measurements were made at 8 specific landmarks, and all of them showed a mean difference of less than 1 mm. In conclusion, the described protocol allows for minimally invasive Le Fort I osteotomy using PSIs. Besides, although the accuracy of the results may be limited by the small sample size, the findings are consistent with those reported in the literature. A prospective comparative study is needed to obtain statistically significant results and draw meaningful conclusions.