Accuracy and reliability of three-dimensional computer-assisted planning for orthognathic surgery

Kwon, Tae-Geon

doi:10.1186/s40902-018-0154-4

Cited by 10 publications

(8 citation statements)

References 6 publications

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“…Moreover, the ICP algorithm can quantify how strongly the obtained data deviate from the reference data; it does not, however, analyze the rotation/translation around the Cartesian axes ( x , y , and z ) of the repositioned skeletal segments; therefore, it does not show in which direction the error occurred [ 24 , 26 , 27 , 28 ]. Other factors that negatively affect the homogeneity of the sample and the assessment are the manual selection of ROI [ 14 ], CBTC resolution limits [ 29 ], overlay due to plates on the obtained postoperative CBCT mesh, the presence of metal in the area with subsequent surface rendering errors, and finally, the skills possessed by the operator [ 5 , 30 ]. The entire digitalized orthognathic surgical plan can be accurately transferred into the operative room by creating devices, such as splints or custom-made cutting guides and plates, with a computer-aided design and manufacturing process (CAD/CAM) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Over time, orthognathic surgery has taken advantage of technological evolution. Nowadays, it is possible to perform computer-assisted surgical programming and transfer the planning to the operating room through devices designed and manufactured with computer assistance (CAD/CAM technologies) [ 4 , 5 ]. To date, for the diagnosis of dentofacial dysmorphosis, we have been relying almost entirely on reference points, planes, and angles, all landmarks identified on cephalometric images.…”

Section: Introductionmentioning

confidence: 99%

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Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery

Cassoni

Manganiello

Barbera

et al. 2022

IJERPH

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Purpose: This retrospective study aims to compare the accuracy of two different CAD/CAM systems in orthognathic surgery. The novelty of this work lies in the method of evaluating the accuracy, i.e., using an Iterative Closest Point (ICP) algorithm, which matches a pair of 2D or 3D point clouds with unknown dependencies of the transition from scan s(k) to scan s(k+1). Methods: The study population was composed of ten patients who presented to the Maxillofacial Surgery Department of the University “Sapienza” of Rome for the evaluation and management of skeletal malocclusions. The patients were divided into two groups, depending on the technique used: group 1: splintless group (custom-made cutting guide and plates); group 2: splint group (using a 3D-printed splint). STL files were imported into Geomagic® Control X™ software, which allows for comparison and analysis using an ICP algorithm. The RMSE parameter (3D error) was used to calculate the accuracy. In addition, data were compared in two different patient subgroups. The first subgroup only underwent a monobloc Le Fort I osteotomy (p-value = 0.02), and the second subgroup underwent a Le Fort I osteotomy associated with a segmental osteotomy of the maxilla (p-value = 0.23). Results: Group 1 showed a 3D error of 1.22 mm ± SD 0.456, while group 2 showed a 3D error of 1.63 mm ± SD 0.303. These results have allowed us to compare the accuracy of the two CAD/CAM systems (p-value = 0.09). Conclusions: The ICP algorithm provided a reproducible method of comparison. The splintless method would seem more accurate (p-value = 0.02) in transferring the surgical programming into the operating room when only a Le Fort I osteotomy is to be performed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery

Cassoni

Manganiello

Barbera

et al. 2022

IJERPH

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“…Minor errors in each step accumulate and could lead to accuracy errors [ 17 ]. Kwon also reported that computer-assisted 3D virtual model surgery and 3D-printed intermediate occlusal splint were useful but not completely accurate; random errors are inevitable [ 27 ]. This is because the humans’ masticatory movement is a mutually complex interaction between the nervous and musculoskeletal systems [ 28 ] while the osteotomy guide is based on static occlusal and skeletal relationships only.…”

Section: Discussionmentioning

confidence: 99%

Correction of Condylar Displacement of the Mandible Using Early Screw Removal following Patient-Customized Orthognathic Surgery

Jang

Byun

Cho

et al. 2021

JCM

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Objective: Orthognathic surgery (OGS) is a surgical intervention that corrects dentofacial deformities through the movement of maxillary and mandibular segments to achieve adequate masticatory function, joint health, and facial harmony. However, some patients present with occlusal discrepancies, condylar sag, and/or temporomandibular disorders after OGS. Various methods have been employed to solve these problems after surgery. This study aimed to evaluate the effectiveness of early screw removal in patients with occlusal discrepancies after OGS using three-dimensional cone-beam computed tomography (CBCT). Methods: In 44 patients with dentofacial deformities, patient-customized OGSs with customized plates were performed to correct facial deformities using customized guides with computer-aided surgical simulation. Of the 44 patients, eight patients complained of occlusal discrepancies and temporomandibular disorders after OGS. These eight patients underwent screw removal under local anesthesia around four weeks. The temporomandibular joint spaces at three time points (pre-surgical, post-surgical, and after screw removal) in the sagittal and coronal planes were compared using CBCT. Results: Eight patients showed an increase in joint space on CBCT images immediately after surgery (T1), but after early screw removal (T2), these spaces almost returned to their pre-surgical state, and the temporomandibular joint problem disappeared. Conclusions: The removal of screws located in the distal segment under local anesthesia between three and four weeks post-surgically may be a treatment option for patients with post-OGS occlusal discrepancies, condylar sag, and/or temporomandibular disorder.

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“…These three-dimensional (3D) printed surgical guides are used for the resection of the mandible, and to shape the free bone flap [4][5][6]. The advantages of CAS are reduction of the operative time and aesthetic and functional results through anatomical reconstructions [7,8]. Additionally, it has been reported that CAS can more safely and accurately resect the mandibular malignancies with VSP performed using various imaging modalities, such as CT and MRI simultaneously [9].…”

Section: Introductionmentioning

confidence: 99%

Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

et al. 2020

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This study aimed to present and evaluate alternative lesion-specific mandibulectomy methods for preserving the mandibular anatomical structures as compared with the conventional virtual surgical plan. Fifteen patients who received segmental mandibulectomy were included in this study, and the following parameters were evaluated: (1) the disease-free bone margin, (2) the volume and surface between the tailor-made resection simulation and conventional resection simulation, and (3) the preserved mandibular anatomical structures. In all 15 patients, disease-free bone margins were confirmed by histopathology. Volumes of conventional resection simulation and tail-made resection simulation were 49,468.66 ± 14,007.96 mm 3 and 52,610.01 ± 13,755.33 mm 3 and the surfaces were 20,927.38 ± 4471.70 mm 2 and 22,356.49 ± 4185.73 mm 2 , respectively; these were statistically significant (both, p < 0.001). Mandibular dentition was partially preserved in six patients. Twelve of the 15 patients had changes in defect classification with preservation of the mandibular inferior border. In conclusion, alternative lesion-specific mandibulectomy was a less invasive method for effectively removing mandibular lesions while preserving the important anatomical structures of the mandible.

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Accuracy and reliability of three-dimensional computer-assisted planning for orthognathic surgery

Cited by 10 publications

References 6 publications

Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery

Three-Dimensional Comparison of the Maxillary Surfaces through ICP-Type Algorithm: Accuracy Evaluation of CAD/CAM Technologies in Orthognathic Surgery

Correction of Condylar Displacement of the Mandible Using Early Screw Removal following Patient-Customized Orthognathic Surgery

Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

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