Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation.

This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy and transverse expansion. Furthermore, only a few have evaluated the precision and accuracy of genioplasty in placement of the chin segment. The virtual surgical plan was compared with the postsurgical outcome by using three linear and three rotational measurements. The influence of maxillary segmentation was analyzed in both superior and inferior maxillary repositioning. In addition, transverse surgical expansion was compared with the postsurgical expansion obtained. An overall, high degree of linear accuracy between planned and postsurgical outcomes was found, but with a large standard deviation. Rotational difference showed an increase in pitch, mainly affecting the maxilla. Segmentation had no significant influence on maxillary placement. However, a posterior movement was observed in inferior maxillary repositioning. A lack of transverse expansion was observed in the segmented maxilla independent of the degree of expansion.

[1]  O Donatsky,et al.  Computerized cephalometric evaluation of orthognathic surgical precision and stability in relation to maxillary superior repositioning combined with mandibular advancement or setback. , 1997, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[2]  J. Gateno,et al.  A comparison of 3 methods of face-bow transfer recording: implications for orthognathic surgery. , 2001, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  Joachim E Zöller,et al.  Computer-assisted orthognathic surgery: feasibility study using multiple CAD/CAM surgical splints. , 2012, Oral surgery, oral medicine, oral pathology and oral radiology.

[4]  Mitchel Seruya,et al.  Outcomes in Computer-Assisted Surgical Simulation for Orthognathic Surgery , 2012, The Journal of craniofacial surgery.

[5]  H. Obwegeser,et al.  The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. , 1957, Oral surgery, oral medicine, and oral pathology.

[6]  K. Ueki,et al.  Assessment of bone healing after Le Fort I osteotomy with 3-dimensional computed tomography. , 2011, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[7]  T. Turvey,et al.  The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension , 2007, Head & face medicine.

[8]  Jaime Gateno,et al.  Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. , 2013, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  Jaime Gateno,et al.  Accuracy of the computer-aided surgical simulation (CASS) system in the treatment of patients with complex craniomaxillofacial deformity: A pilot study. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[10]  John B Ludlow,et al.  Accuracy of measurements of mandibular anatomy in cone beam computed tomography images. , 2007, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[11]  Filip Schutyser,et al.  Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  E Ellis,et al.  Accuracy of model surgery: evaluation of an old technique and introduction of a new one. , 1990, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  R. Moreira,et al.  Skeletal stability after inferior maxillary repositioning without interpositional graft. , 2012, International journal of oral and maxillofacial surgery.

[14]  G. Baciut,et al.  Transverse stability of 3-piece Le Fort I osteotomies. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[15]  H. Obwegeser,et al.  The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. II. Operating methods for microgenia and distoclusion. , 1957, Oral surgery, oral medicine, and oral pathology.

[16]  L. Wolford,et al.  Modification of the mandibular ramus sagittal split osteotomy. , 1987, Oral surgery, oral medicine, and oral pathology.

[17]  Bell Wh Le Forte I osteotomy for correction of maxillary deformities. , 1975 .

[18]  T. Turvey Maxillary expansion: a surgical technique based on surgical-orthodontic treatment objectives and anatomical considerations. , 1985, Journal of maxillofacial surgery.

[19]  Brandon Burke,et al.  Observer reliability of three-dimensional cephalometric landmark identification on cone-beam computerized tomography. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[20]  G. Swennen,et al.  Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. , 2009, International journal of oral and maxillofacial surgery.

[21]  S. Brooks,et al.  Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. , 2006, Dento maxillo facial radiology.

[22]  W H Bell,et al.  Surgical-orthodontic expansion of the maxilla. , 1976, American journal of orthodontics.

[23]  Lutz Ritter,et al.  A paradigm shift in orthognathic surgery? A comparison of navigation, computer-aided designed/computer-aided manufactured splints, and "classic" intermaxillary splints to surgical transfer of virtual orthognathic planning. , 2013, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[24]  E. Ellis,et al.  Sequencing bimaxillary surgery: mandible first. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[25]  P. Stoelinga,et al.  Surgical orthodontic treatment of anterior skeletal open bite using small plate internal fixation. One to five year follow-up. , 1991, International journal of oral and maxillofacial surgery.

[26]  Sean P Edwards,et al.  Computer-assisted craniomaxillofacial surgery. , 2010, Oral and maxillofacial surgery clinics of North America.

[27]  J C Barbenel,et al.  Errors in orthognathic surgery planning: the effect of inaccurate study model orientation. , 2010, International journal of oral and maxillofacial surgery.

[28]  G. Baciut,et al.  Stability of Le Fort I osteotomy in bimaxillary osteotomies: single-piece versus 3-piece maxilla. , 2010, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[29]  T. Turvey,et al.  Orthognathic surgery: a hierarchy of stability. , 1996, The International journal of adult orthodontics and orthognathic surgery.

[30]  K. Moos,et al.  How accurate is model planning for orthognathic surgery? , 2008, International journal of oral and maxillofacial surgery.

[31]  Beat Hammer,et al.  An evaluation of face-bow transfer for the planning of orthognathic surgery. , 2012, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[32]  L. Wolford,et al.  Orthognathic and TMJ surgery: postsurgical patient management. , 2011, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[33]  D. B. Tuinzing,et al.  Stability of transverse maxillary dental arch dimensions following orthodontic-surgical correction of anterior open bites. , 1998, The International journal of adult orthodontics and orthognathic surgery.

[34]  Ulrich Wolf,et al.  Cone-beam computed tomography for routine orthodontic treatment planning: a radiation dose evaluation. , 2008, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[35]  A. Rosenberg,et al.  Palatal surgical splint for transverse stability of Le Fort I osteotomies: a technical note. , 1996, International journal of oral and maxillofacial surgery.

[36]  W. Proffit,et al.  Stability of surgical maxillary expansion. , 1992, The International journal of adult orthodontics and orthognathic surgery.

[37]  O Donatsky,et al.  Computerized cephalometric orthognathic surgical simulation, prediction and postoperative evaluation of precision. , 1992, International journal of oral and maxillofacial surgery.

[38]  L. Kaban,et al.  Occlusal cant in the frontal plane as a reflection of facial asymmetry. , 1997, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[39]  K Stokbro,et al.  Virtual planning in orthognathic surgery. , 2014, International journal of oral and maxillofacial surgery.

[40]  E Ellis,et al.  Accuracy of face-bow transfer: effect on surgical prediction and postsurgical result. , 1992, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[41]  Anne Marie Kuijpers-Jagtman,et al.  Digital three-dimensional image fusion processes for planning and evaluating orthodontics and orthognathic surgery. A systematic review. , 2011, International journal of oral and maxillofacial surgery.