How accurate are patient-specific osteotomy guides and fixation plates in orthognathic surgery?
Purpose: This study evaluates the accuracy of orthognathic surgical movements completed with patient-specific osteotomy guides and fixation plates and provides an example of the use of volumetric analysis to evaluate post-surgical results. Materials and methods: Utilizing three-dimensional (3D) over...
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| Main Authors: | , , |
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| Format: | Book |
| Published: |
Elsevier,
2021-07-01T00:00:00Z.
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| Online Access: | Connect to this object online. |
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| Summary: | Purpose: This study evaluates the accuracy of orthognathic surgical movements completed with patient-specific osteotomy guides and fixation plates and provides an example of the use of volumetric analysis to evaluate post-surgical results. Materials and methods: Utilizing three-dimensional (3D) overlay and anthropometric points, the pre-operative virtual surgical plan (VSP) was compared to the post-operative computed tomography (CT) scan. The average deviation in the movements between each patient's scans was calculated; additionally, volumetric analysis consisted of overlapping the virtually planned jaws with the surgically obtained maxilla and mandible, allowing accuracy to be calculated as a percentage and provide visualization of where errors occurred. Results: 9 orthognathic surgeries were completed using patient-specific guides and plates. In the anterior-posterior and left-right planes, the maxilla was under-corrected 0.79 mm and 0.01 mm respectively, whereas it was over-corrected in the superior-inferior plane by 0.15 mm; this corresponded with an average maxillary volume overlap of 82.59%. In the left-right and superior-inferior planes, the mandible was under-corrected 1.40 mm and 0.36 mm respectively, whereas it was over-corrected in the left-right plane by 0.10 mm; this corresponded with an average mandibular volume overlap of 77.52%. The volume overlap difference between the maxilla and mandible was not significant. Conclusion: Patient-specific guides and plates in orthognathic surgery can achieve acceptable results when measured by traditional cephalometric point analysis. Our protocol demonstrates the use of pre- and post-surgical CT scans to compare and evaluate surgical outcome as a percentage of positional volumetric accuracy as well as pinpoint the sources of error. |
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| Item Description: | 2667-1476 10.1016/j.adoms.2021.100124 |