Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome.

J Clin Med Res

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand.

Published: May 2018

Background: The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS.

Methods: Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method.

Results: The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria.

Conclusion: In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862091PMC
http://dx.doi.org/10.14740/jocmr3372wDOI Listing

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