Skip to main content
Erschienen in: Aesthetic Plastic Surgery 6/2017

21.06.2017 | Original Article

The Application of 3D Printing Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities

verfasst von: Yanju Xiao, Xiumei Sun, Lin Wang, Yaoyao Zhang, Kai Chen, Guomin Wu

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Because of the limitation of specific preoperative design and surgical templates, orthognathic surgery and mandibular contour osteoplasty are generally performed in two stages. Three-dimensional printing technology has improved the accuracy of the surgery and results in good surgical predictability easily. This study aims to confirm the effectiveness, feasibility and precision of simultaneous mandibular contour osteoplasty and orthognathic surgery with the assistance of 3D printing technology.

Methods

Ten patients, who were diagnosed with mandibular hypertrophy and bimaxillary deformities, were included in the study. In addition to conventional orthognathic surgery, mandibular angle ostectomy, mandibular outer cortex grinding or mandibular border ostectomy was designed for mandibular hypertrophy. Optimal osteotomy lines and simulated surgeries were designed according the 3D printing model of the mandible. Then, surgical templates were made on the 3D printing model. No muscle excision was performed in any patient. Preoperative, predicted and postoperative measurements were taken, including the gonial angle (Ar–Go–Me) and the mandibular width (Go–Go).

Results

All the patients had a reposeful postoperative recovery, with no indication of obvious infection, facial paralysis, osteonecrosis or bone displacement. The gonial angle was improved from 110.3° ± 11.1 to 121.3° ± 2.9, and the mandibular width was improved from 117.5 mm ± 6.8 to 111.9 mm ± 4.2. The discrepancies between simulation and postoperation of the left gonial angle, the right gonial angle and the mandibular width were 0.56° ± 0.22, 0.65° ± 0.3 and 0.49 mm ± 0.43, respectively.

Conclusions

The results of our study illustrated the predictability, feasibility and reliability of simultaneous mandibular contour osteoplasty and orthognathic surgery with the assistance of 3D printing technology. Our technique could achieve functional improvement and an aesthetic profile at the same time.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
1.
Zurück zum Zitat Terajima M, Nakasima A, Aoki Y, Goto TK, Tokumori K, Mori N, Hoshino Y (2009) A 3-dimensional method for analyzing the morphology of patients with maxillofacial deformities. Am J Orthod Dentofacial Orthop 136(6):857–867CrossRefPubMed Terajima M, Nakasima A, Aoki Y, Goto TK, Tokumori K, Mori N, Hoshino Y (2009) A 3-dimensional method for analyzing the morphology of patients with maxillofacial deformities. Am J Orthod Dentofacial Orthop 136(6):857–867CrossRefPubMed
2.
Zurück zum Zitat Lonic D, Lo LJ (2016) Three-dimensional simulation of orthognathic surgery-surgeon’s perspective. J Formos Med Assoc 115(6):387–388CrossRefPubMed Lonic D, Lo LJ (2016) Three-dimensional simulation of orthognathic surgery-surgeon’s perspective. J Formos Med Assoc 115(6):387–388CrossRefPubMed
3.
Zurück zum Zitat Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016) Functional needs of subjects with dentofacial deformities: a study using the index of orthognathic functional treatment need (IOFTN). J Plast Reconstr Aesthet Surg 69(6):796–801CrossRefPubMed Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016) Functional needs of subjects with dentofacial deformities: a study using the index of orthognathic functional treatment need (IOFTN). J Plast Reconstr Aesthet Surg 69(6):796–801CrossRefPubMed
4.
Zurück zum Zitat Tian KY, Li QQ, Liu XJ, Wang XX, Li ZL, Wang X (2016) Evaluation of therapeutic effect of virtual design for correcting facial asymmetry of skeletal Class III deformity. Zhonghua Kou Qiang Yi Xue Za Zhi 51(10):594–599PubMed Tian KY, Li QQ, Liu XJ, Wang XX, Li ZL, Wang X (2016) Evaluation of therapeutic effect of virtual design for correcting facial asymmetry of skeletal Class III deformity. Zhonghua Kou Qiang Yi Xue Za Zhi 51(10):594–599PubMed
5.
Zurück zum Zitat Cousley RR, Turner MJ (2014) Digital model planning and computerized fabrication of orthognathic surgery wafers. J Orthod 41(1):38–45CrossRefPubMed Cousley RR, Turner MJ (2014) Digital model planning and computerized fabrication of orthognathic surgery wafers. J Orthod 41(1):38–45CrossRefPubMed
6.
Zurück zum Zitat Suojanen J, Leikola J, Stoor P (2017) The use of patient-specific implants in orthognathic surgery: a series of 30 mandible sagittal split osteotomy patients. J Craniomaxillofac Surg 44(12):1913–1916CrossRef Suojanen J, Leikola J, Stoor P (2017) The use of patient-specific implants in orthognathic surgery: a series of 30 mandible sagittal split osteotomy patients. J Craniomaxillofac Surg 44(12):1913–1916CrossRef
7.
Zurück zum Zitat Wang L, Tian D, Sun X, Xiao Y, Chen L, Wu G (2017) The precise repositioning instrument for genioplasty and a three-dimensional printing technique for treatment of complex facial asymmetry. Aesth Plast Surg. doi:10.1007/s00266-017-0875-2 Wang L, Tian D, Sun X, Xiao Y, Chen L, Wu G (2017) The precise repositioning instrument for genioplasty and a three-dimensional printing technique for treatment of complex facial asymmetry. Aesth Plast Surg. doi:10.​1007/​s00266-017-0875-2
8.
Zurück zum Zitat Hernandez-Alfaro F, Guijarro-Martinez R (2013) New protocol for three-dimensional surgical planning and CAD/CAM splint generation in orthognathic surgery: an in vitro and in vivo study. J Oral Maxillofac Surg 42:1547–1556CrossRef Hernandez-Alfaro F, Guijarro-Martinez R (2013) New protocol for three-dimensional surgical planning and CAD/CAM splint generation in orthognathic surgery: an in vitro and in vivo study. J Oral Maxillofac Surg 42:1547–1556CrossRef
9.
Zurück zum Zitat Lee YC, Sohn HB, Kim SK, Bae OY, Lee JH (2015) A novel method for the management of proximal segment using computer assisted simulation surgery: correct condyle head positioning and better proximal segment placement. Maxillofac Plast Reconstr Surg 37(1):21CrossRefPubMedPubMedCentral Lee YC, Sohn HB, Kim SK, Bae OY, Lee JH (2015) A novel method for the management of proximal segment using computer assisted simulation surgery: correct condyle head positioning and better proximal segment placement. Maxillofac Plast Reconstr Surg 37(1):21CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Gateno J, Xia JJ, Teichgraeber JF (2011) New 3-dimensional cephalometric analysis for orthognathic surgery. J Oral Maxillofac Surg 69(3):606–622CrossRefPubMedPubMedCentral Gateno J, Xia JJ, Teichgraeber JF (2011) New 3-dimensional cephalometric analysis for orthognathic surgery. J Oral Maxillofac Surg 69(3):606–622CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Popat H, Richmond S, Marshall D, Rosin P (2012) Three-dimensional assessment of functional change following class 3 orthognathic correction—a preliminary report. J Cranio maxillofac Surg 40:36–42CrossRef Popat H, Richmond S, Marshall D, Rosin P (2012) Three-dimensional assessment of functional change following class 3 orthognathic correction—a preliminary report. J Cranio maxillofac Surg 40:36–42CrossRef
13.
Zurück zum Zitat Ye N, Long H, Zhu S (2015) The accuracy of computer image-guided template for mandibular angle ostectomy. Aesthet Plast Surg 39:117CrossRef Ye N, Long H, Zhu S (2015) The accuracy of computer image-guided template for mandibular angle ostectomy. Aesthet Plast Surg 39:117CrossRef
14.
Zurück zum Zitat Zhao M, ZWu G (2017) The appropriative retractors for genioplasty. J Craniofac Surg 28(1):252–253CrossRefPubMed Zhao M, ZWu G (2017) The appropriative retractors for genioplasty. J Craniofac Surg 28(1):252–253CrossRefPubMed
15.
Zurück zum Zitat Kim CH, Lee JH, Cho JY, Kim KW (2007) Skeletal stability after simultaneous mandibular angle resection and sagittal split ramus osteotomy for correction of mandible prognathism. J Oral Maxillofac Surg 65:192CrossRefPubMed Kim CH, Lee JH, Cho JY, Kim KW (2007) Skeletal stability after simultaneous mandibular angle resection and sagittal split ramus osteotomy for correction of mandible prognathism. J Oral Maxillofac Surg 65:192CrossRefPubMed
16.
Zurück zum Zitat Hsu SSP, Gateno J, Bell RB, Hirsch DL, Markiewicz MR, Teichgraeber JF, Zhou XB, Xia JJ (2013) Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 71(1):128–142CrossRefPubMed Hsu SSP, Gateno J, Bell RB, Hirsch DL, Markiewicz MR, Teichgraeber JF, Zhou XB, Xia JJ (2013) Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 71(1):128–142CrossRefPubMed
17.
Zurück zum Zitat Tucker S, Cevidanes LHS, Styner M, Kim H, Reyes M, Proffit W, Turvey T (2010) Comparison of actual surgical outcomes and 3-dimensional surgical simulations. J Oral Maxillofac Surg 61(10):2412–2421CrossRef Tucker S, Cevidanes LHS, Styner M, Kim H, Reyes M, Proffit W, Turvey T (2010) Comparison of actual surgical outcomes and 3-dimensional surgical simulations. J Oral Maxillofac Surg 61(10):2412–2421CrossRef
18.
Zurück zum Zitat Marmulla R, Wo¨rtche R, Mu¨hling J, Hassfeld S (2005) Geometric accuracy of the NewTom 9000 cone beam CT. Dentomaxillofac Radiol 34:28–31CrossRefPubMed Marmulla R, Wo¨rtche R, Mu¨hling J, Hassfeld S (2005) Geometric accuracy of the NewTom 9000 cone beam CT. Dentomaxillofac Radiol 34:28–31CrossRefPubMed
19.
Zurück zum Zitat Maloney K, Bastidas J, Freeman K, Olson TR, Kraut RA (2011) Cone beam computed tomography and SimPlant materialize dental software versus direct measurement of the width and height of the posterior mandible: an anatomic study. J Oral Maxillofac Surg 69:1923–1929CrossRefPubMed Maloney K, Bastidas J, Freeman K, Olson TR, Kraut RA (2011) Cone beam computed tomography and SimPlant materialize dental software versus direct measurement of the width and height of the posterior mandible: an anatomic study. J Oral Maxillofac Surg 69:1923–1929CrossRefPubMed
20.
Zurück zum Zitat Sun XM, Wu GM (2015) The precise repositioning instrument for genioplasty. J Craniofac Surg 26(8):2417CrossRefPubMed Sun XM, Wu GM (2015) The precise repositioning instrument for genioplasty. J Craniofac Surg 26(8):2417CrossRefPubMed
21.
Zurück zum Zitat Mao XB, Wang T, Yang DK, Zang GM (2011) The dynamics of blood supply of animal experimental study for simultaneous mandibular sagittal split osteotomy and mandibular angle plasty. J Chongqing Med Univ 6(36):718–720 Mao XB, Wang T, Yang DK, Zang GM (2011) The dynamics of blood supply of animal experimental study for simultaneous mandibular sagittal split osteotomy and mandibular angle plasty. J Chongqing Med Univ 6(36):718–720
22.
Zurück zum Zitat Anderson J Greg, Laney Thomas J (2002) Combined orthognathic and facial aesthetic surgery with case reports. J Tenn Dent Assoc 82(3):52PubMed Anderson J Greg, Laney Thomas J (2002) Combined orthognathic and facial aesthetic surgery with case reports. J Tenn Dent Assoc 82(3):52PubMed
23.
Zurück zum Zitat RaffainiM Pisani C (2015) Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction. Int J Oral Maxillofac Surg 44(3):362–370CrossRef RaffainiM Pisani C (2015) Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction. Int J Oral Maxillofac Surg 44(3):362–370CrossRef
24.
Zurück zum Zitat Trawitzki LV, Dantas RO, Mello-Filho FV, Elias-Júnior J (2006) Effect of treatment of dentofacial deformity on masseter muscle thickness. Arch Oral Biol 51(12):1086–1092CrossRefPubMed Trawitzki LV, Dantas RO, Mello-Filho FV, Elias-Júnior J (2006) Effect of treatment of dentofacial deformity on masseter muscle thickness. Arch Oral Biol 51(12):1086–1092CrossRefPubMed
25.
Zurück zum Zitat Lee ST, Mori Y, Minami K, An CH, Park JW, Kwon TG (2013) Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness? J Oral Maxillofac Surg 71(9):1577–1587CrossRefPubMed Lee ST, Mori Y, Minami K, An CH, Park JW, Kwon TG (2013) Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness? J Oral Maxillofac Surg 71(9):1577–1587CrossRefPubMed
26.
Zurück zum Zitat Sarver DM, Rousso DR (2004) Plastic surgery combined with orthodontic and orthognathic procedures. Am J Orthod Dentofacial Orthop 126(3):305–307CrossRefPubMed Sarver DM, Rousso DR (2004) Plastic surgery combined with orthodontic and orthognathic procedures. Am J Orthod Dentofacial Orthop 126(3):305–307CrossRefPubMed
Metadaten
Titel
The Application of 3D Printing Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities
verfasst von
Yanju Xiao
Xiumei Sun
Lin Wang
Yaoyao Zhang
Kai Chen
Guomin Wu
Publikationsdatum
21.06.2017
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 6/2017
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-017-0914-z

Weitere Artikel der Ausgabe 6/2017

Aesthetic Plastic Surgery 6/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.