Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Oral and maxillofacial radiologyComputer-assisted orthognathic surgery: feasibility study using multiple CAD/CAM surgical splints
Section snippets
Computer-Assisted Orthognathic Surgery: Virtual Planning and CAD/CAM Surgical Splints
We have developed and patented (WO 2008/031562) a computer-assisted design and manufacture (CAD/CAM) technique for the fabrication of multiple surgical splints for orthognathic surgery.31 The benefits of this technique are that it allows direct operative transfer of virtual surgical plans, and is easy to use, relatively inexpensive, and clinically efficient. The workflow process consists of 4 stages as described in the following paragraphs.
Sample
This was a prospective observational design approved by the Ethics Committee of the Medical Faculty of the University of Cologne (approval no. 05-111). Subjects were recruited from patients who attended the University Clinic in Cologne. All patients were provided with informed consent. The inclusion criteria were (1) adult patients, (2) skeletal class III, (3) dental class III combined with an open bite or vertical maxillary extrusion, and (4) consented to bimaxillary surgeries. The exclusion
Results
Both mean intra- (0.91) and interobserver (0.92) ICC reliabilities were high. All correlations were highly significant (P < .0001).
Table IV shows the angular measurement differences between virtual planning position (T0) and postoperative surgical result (T1) in relation to various reference planes. The inclination of the angles between the maxillary and occlusal planes between the FHP and the midfacial plane showed no significant differences (ΔT1 – T0). Although mean angular differences for
Discussion
In this article, we presented a computer-assisted orthognathic surgery protocol incorporating a patented CAD/CAM 3-splint concept. We showed that this approach provided clinically acceptable precise transfer of preoperative planning to the surgical environment for the maxilla (<0.23 mm) and the condyles (<0.05°, <0.18 mm), comparing favorably with reported variations within conventional clinical orthognathic protocols incorporating lateral cephalometry, facebow transfer to a semiadjustable
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