Accuracy of orthognathic surgery using 3D computer-assisted surgical simulation
Online veröffentlicht: 20. Juli 2021
Seitenbereich: 17 - 26
Eingereicht: 01. Mai 2017
Akzeptiert: 01. Sept. 2017
DOI: https://doi.org/10.21307/aoj-2020-055
© 2018 Richard Lee et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
To evaluate the accuracy of maxilla and mandibular repositioning during two-jaw orthognathic surgery using computerassisted surgical simulation (CASS)
Materials and methods
Fifteen patients who underwent two-jaw orthognathic surgery using CASS (VSP,® Orthognathics by 3D Systems) were evaluated to assess the accuracy of the simulation. Translational and rotational discrepancies of the centroids of the maxilla and mandible and the translational discrepancy of the dental midline between the planned and actual outcomes were reported using the root mean square error (RMSE). The number of cases that exceeded limits set for clinical significance, the direction of the error in relation to the direction of planned movement and the differences between segmental and non-segmental procedures were evaluated as secondary outcomes
Results
The largest translational RMSE was 1.53 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. The largest rotational RMSE was 1.9° about the x-axis in the maxilla and 1.16° about the x- and y-axes in the mandible. The largest RMSE for the dental midline was 1.6 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. A tendency for insufficient advancement of the maxilla was noted
Conclusions
CASS is an efficient and accurate way to develop the surgical plan and transfer the plan to the patient intraoperatively. While CASS is accurate on a population level, there remains the potential for clinically significant errors to occur on an individual basis
Conclusion
The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review