Waferless Orthognathic Surgery with Customized Osteosynthesis and Surgical Guides: A Prospective Study

The purpose of this paper was to describe and to evaluate the accuracy of a protocol that involves CAD/CAM-generated cutting guides and customized titanium plates for waferless orthognathic surgery. Twenty-one patients consecutively treated between January 2021 and January 2023 were included. The pr...

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Bibliographic Details
Published inApplied sciences Vol. 14; no. 5; p. 1893
Main Authors Espino-Segura-Illa, Marc, Camps-Font, Octavi, Ferrer-Fuertes, Ada, Cuesta-González, Fran, Zubillaga-Rodríguez, Ignacio, Sieira-Gil, Ramón
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 01.02.2024
Subjects
Aesthetics
CAD-CAM systems
Comparative analysis
Computer programs
CT imaging
customized osteosynthesis plates
customized osteotomy guides
Dental occlusion
dentistry
Hospitals
Medical imaging
Observational studies
orthognathic surgery
Patients
Planning
Software
Surgery
Titanium
Tomography
Transplants & implants
virtual surgical planning
waferless maxillary surgery
Spain
Belgium
Germany
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Summary:The purpose of this paper was to describe and to evaluate the accuracy of a protocol that involves CAD/CAM-generated cutting guides and customized titanium plates for waferless orthognathic surgery. Twenty-one patients consecutively treated between January 2021 and January 2023 were included. The preoperative virtual surgical plan (VSP) was compared with the final position determined from the postoperative CT scan and STL files. An alignment algorithm was employed to adjust the skull position in areas unaffected by the surgery. Absolute and signed deviations were calculated across all three dimensions for each maxilla, mandible and chin landmark. The accuracy analysis revealed an overall deviation of 0.93 mm (95% confidence interval [95%CI]: 0.86 to 0.99), which was < 2 mm for all assessed landmarks (p < 0.05; one-sample t-test). The mandibular landmarks showed greater deviation than the maxillary ones (p < 0.001; independent-samples t-test). Considering the deviations along the three axes, statistically significant differences were identified (p < 0.001; one-way analysis of variance). The reported protocol provides evidence on the benefit of guided orthognathic surgery when performed using a defined VSP protocol, improving accuracy in the maxilla, mandible and chin position, considered both globally and as isolated variables.
ISSN:2076-3417
2076-3417
DOI:10.3390/app14051893