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Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery

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Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in twojaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/ amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher’s exact and Kruskal–Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

Abstract

Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in twojaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/ amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher’s exact and Kruskal–Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

참고문헌 (24)

  1. Jacobson R, "The predictability of maxillary repositioning in LeFort I orthognathic surgery", Am J Orthod Dentofacial Orthop, 122, pp.142~154 (2002)
  2. Semaan S, "Accuracy of a LeFort I maxillary osteotomy", Angle Orthod, 75, pp.964~973 (2005)
  3. Gil JN, "Predictability of maxillary repositioning during bimaxillary surgery : accuracy of a new technique", Int J Oral Maxillofac Surg, 36, pp.296~300 (2007)
  4. Choi JY, "Surgical accuracy of maxillary repositioning according to type of surgical movement in two-jaw surgery", Angle Orthod, 79, pp.306~311 (2009)
  5. Stokbro K, "Surgical accuracy of three-dimensional virtual planning : a pilot study of bimaxillary orthognathic procedures including maxillary segmentation", Int J Oral Maxillofac Surg, 45, pp.8~18 (2016)
  6. Gaber RM, "A systematic review to uncover a universal protocol for accuracy assessment of 3-dimensional virtually planned orthognathic surgery", J Oral Maxillofac Surg, 75, pp.2430~2440 (2017)
  7. Song KG, "Comparison of the accuracy of the three-dimensional virtual method and the conventional manual method for model surgery and intermediate wafer fabrication", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 107, pp.13~21 (2009)
  8. De Riu G, "Accuracy of computer-assisted orthognathic surgery", J Craniomaxillofac Surg, 46, pp.293~298 (2018)
  9. Cho HJ, "A three-dimensional cephalometric analysis", J Clin Orthod, 43, pp.235~252 (2009)
  10. Metzger MC, "Manufacturing splints for orthognathic surgery using a threedimensional printer", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 105, pp.e1~e7 (2008)
  11. Aboul-Hosn Centenero S, "3D planning in orthognathic surgery : CAD", CAM surgical splints and prediction of the soft and hard tissues results-our experience in 16 cases, 2012, pp.40, 162~168
  12. Hernández-Alfaro F, "New protocol for three-dimensional surgical planning and CAD", CAM splint generation in orthognathic surgery : an in vitro and in vivo study, 2013, pp.42, 1547~1556
  13. Stokbro K, "Virtual planning in orthognathic surgery", Int J Oral Maxillofac Surg, 43, pp.957~965 (2014)
  14. Baan F, "A new 3D tool for assessing the accuracy of bimaxillary surgery : the OrthoGnathicAnalyser", PLoS One, 11, pp.e0149625~ (2016)
  15. Shaheen E, "Three-dimensional printed final occlusal splint for orthognathic surgery : design and validation", Int J Oral Maxillofac Surg, 46, pp.67~71 (2017)
  16. Van den Bempt M, "Toward a higher accuracy in orthognathic surgery by using intraoperative computer navigation, 3D surgical guides, and", or customized osteosynthesis plates: a systematic review, 2018, pp.46, 2108~2119
  17. Tankersley AC, "Comparison of the planned versus actual jaw movement using splint-based virtual surgical planning : how close are we at achieving the planned outcomes", J Oral Maxillofac Surg, 77, pp.1675~1680 (2019)
  18. Lin HH, "Three-dimensional computer-assisted surgical simulation and intraoperative navigation in orthognathic surgery : a literature review", J Formos Med Assoc, 114, pp.300~307 (2015)
  19. Mangano FG, "Accuracy of 6 desktop 3D printers in dentistry : a comparative in vitro study", Eur J Prosthodont Restor Dent, 28, pp.75~85 (2020)
  20. Choi JH, "A new method for superimposition of CBCT volumes", J Clin Orthod, 44, pp.303~312 (2010)
  21. Gkantidis N, "Evaluation of 3-dimensional superimposition techniques on various skeletal structures of the head using surface models", PLoS One, 10, pp.e0118810~ (2015)
  22. Tucker S, "Comparison of actual surgical outcomes and 3-dimensional surgical simulations", J Oral Maxillofac Surg, 68, pp.2412~2421 (2010)
  23. Hsu SS, "Accuracy of a computeraided surgical simulation protocol for orthognathic surgery : a prospective multicenter study", J Oral Maxillofac Surg, 71, pp.128~142 (2013)
  24. Shehab MF, "A novel design of a computer-generated splint for vertical repositioning of the maxilla after Le Fort I osteotomy", Oral Surg Oral Med Oral Pathol Oral Radiol, 115, pp.e16~e25 (2013)

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