Beta-tricalcium phosphate patient-specific gap implants in bilateral sagittal split osteotomy: an innovative treatment method to enhance the mandibular border contour. Part 1: concept and workflow.

Antegonial notching can occur after bilateral sagittal split osteotomy (BSSO) and may lead to unpleasant aesthetic outcomes in both young and older patients. This clinical study presents a new concept to potentially overcome this problem and describes the workflow. Beta-tricalcium phosphate patient-specific gap implants (β-TCP gap-PSIs) are biocompatible and resorbable bone grafts that are placed in the space of the osteotomy gap during orthognathic procedures; they are virtually planned and printed in 3D.

The Accuracy of Three-Dimensional Soft Tissue Simulation in Orthognathic Surgery-A Systematic Review.

Three-dimensional soft tissue simulation has become a popular tool in the process of virtual orthognathic surgery planning and patient-surgeon communication. To apply 3D soft tissue simulation software in routine clinical practice, both qualitative and quantitative validation of its accuracy are required. The objective of this study was to systematically review the literature on the accuracy of 3D soft tissue simulation in orthognathic surgery.

Mandibular autorotation: a critical virtual parameter in clinical decision-making regarding maxilla-first versus mandible-first sequence.

Large degrees of mandibular autorotation during intermediate splint design are prone to transfer error and decrease accuracy. The purpose of this study was to evaluate the amount of mandibular autorotation necessary to design intermediate splints for maxilla- and mandible-first sequences using virtual planning software, to help the clinical decision-making regarding the most adequate sequence for each patient. The influence of specific orthognathic movements (different vertical and sagittal changes at the Le Fort I level, cant correction) and the type of maxillofacial deformity (skeletal Class II, III, anterior open bite) were evaluated to identify those that would require higher levels of autorotation for each sequence.

Resistance and Stress Analysis of 3D Plate and Locking Plate Fixation in Bilateral Sagittal Split Osteotomy: A Comparative Finite Element Study.

Aim: This study evaluates the biomechanical properties of 3D plates and compares it with locking plates, in both set back and advancement models of bilateral sagittal split osteotomy (BSSO) using finite element model analysis.

Design: A stereolithography model of mandibular structure was imported to hypermesh to create 3D solid finite model. A BSSO was simulated on hemimandibular model and advancement and setback simulations were carried out for a distance of 4, 6, and 8 mm each.