Accuracy Evaluation of Virtual Surgical Planning (VSP) in Orthognathic Surgery: Comparison Between CAD/CAM Fabricated Surgical Splint and CAD/CAM Cutting Guides with PSI

Pucci, R.; Priore, Paolo; Manganiello, Luigi; Cassoni, Andrea; Valentini, Virginia

doi:10.1016/j.joms.2019.06.020

Cited by 5 publications

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“…"Custom-made" solutions that have been developed ensure high precision in repositioning but require very high costs of realization and a long manufacturing time. The cost of the "custom-made" titanium plates, adapted for internal fixing, is expected at thousands of euros (almost 10 times more than the standard plates) [38]. These solutions are very expensive because they require the sintering of metallic powder according to rapid (additive) manufacturing techniques.…”

Section: Discussionmentioning

confidence: 99%

Computer Aided Orthognathic Surgery: A General Method for Designing and Manufacturing Personalized Cutting/Repositioning Templates

et al. 2022

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Orthognathic surgery allows broad-spectrum deformity correction involving both aesthetic and functional aspects on the TMJ (temporo-mandibular joint) and on the facial skull district. The combination of Reverse Engineering (RE), Virtual Surgery Planning (VSP), Computer Aided Design (CAD), Additive Manufacturing (AM), and 3D visualization allows surgeons to plan, virtually, manipulations and the translation of the human parts in the operating room. This work’s aim was to define a methodology, in the form of a workflow, for surgery planning and for designing and manufacturing templates for orthognathic surgery. Along the workflow, the error chain was checked and the maximum error in virtual planning was evaluated. The three-dimensional reconstruction of the mandibular shape and bone fragment movements after segmentation allow complete planning of the surgery and, following the proposed method, the introduction of both the innovative evaluation of the transversal intercondylar distance variation after mandibular arch advancement/set and the possibility of use of standard plates to plan and realize a customized surgery. The procedure was adopted in one clinical case on a patient affected by a class III malocclusion with an associated open bite and right deviation of the mandible with expected good results. Compared with the methods from most recent literature, the presented method introduces two elements of novelty and improves surgery results by optimizing costs and operating time. A new era of collaboration among surgeons and engineer has begun and is now bringing several benefits in personalized surgery.

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Section: Discussionmentioning

confidence: 99%

Computer Aided Orthognathic Surgery: A General Method for Designing and Manufacturing Personalized Cutting/Repositioning Templates

et al. 2022

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“…1 The application of contemporary 3D-VSP may range from computer-aided surgical simulation (CASS) to computer-aided design/computer-aided manufacture (CAD/CAM) of surgical splints, through to construction of patient specific implants (PSI). [2][3][4] Early adoption of 3D-VSP technologies in orthognathic surgery has been primarily in teaching hospitals where issues relating to cost, access, and case selection, are readily addressed. Early pioneers rapidly fine-tuned the process to minimize potential errors during 3D-VSP and reported on their learning curve and outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…The benefits of 3D‐VSP in orthognathic surgery are being increasingly reported. Within the current literature, it is evident that 3D‐VSP improves accuracy of surgical movements, reduces operating time, and increases patient satisfaction 3,8–13 . The outcome of orthognathic surgery is generally accepted to be clinically accurate if landmark locations are within 2 mm and 2° of their intended position 14…”

Section: Introductionmentioning

confidence: 99%

“…Within the current literature, it is evident that 3D-VSP improves accuracy of surgical movements, reduces operating time, and increases patient satisfaction. 3,[8][9][10][11][12][13] The outcome of orthognathic surgery is generally accepted to be clinically accurate if landmark locations are within 2 mm and 2 of their intended position. 14 Globally, the cost of PSI with customized cutting guides and plates is still prohibitive for most routine orthognathic cases outside teaching institutions.…”

Section: Introductionmentioning

confidence: 99%

“…The last decade has accelerated the paradigm shift in planning and execution of orthognathic surgery, from conventional two‐dimensional (2D) to three‐dimensional (3D) virtual surgical planning (VSP) 1 . The application of contemporary 3D‐VSP may range from computer‐aided surgical simulation (CASS) to computer‐aided design/computer‐aided manufacture (CAD/CAM) of surgical splints, through to construction of patient specific implants (PSI) 2–4 …”

Section: Introductionmentioning

confidence: 99%

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Surgical accuracy of CAD/CAM splints using virtual surgical planning in orthognathic surgery: policy implications for healthcare in Australia

Delpachitra,

Bordbar

2023

ANZ Journal of Surgery

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BackgroundThis study examines post‐surgical outcomes of maxillary position using virtual surgical planning (VSP) with computer designed and manufactured surgical splints, without the use of costly patient specific implants (PSI), in the treatment of routine nonsyndromic orthognathic patients. The cost of these personalized medical devices and their impact in the setting of cranio‐maxillofacial surgery is currently under review by The Department of Health and Aged Care in Australia.MethodsThis is a single‐centre retrospective analysis of 49 patients who underwent bimaxillary orthognathic surgery by a single surgeon at Epworth Richmond Hospital (Victoria, Australia) over a period spanning 2016 to 2020. Patients were included in the study provided their surgery was facilitated using VSP with manufacture of computer designed occlusal splints.ResultsUse of computer designed and manufactured splints were highly reliable in reproducing the virtual surgical plan, when using palatal plane, upper incisor angulation, and anterior upper facial height.ConclusionUse of computer designed and manufactured splints provide a method of leveraging the accuracy of VSP methods, without the additional costs associated with PSI. These findings may assist in appropriate resource allocation and case stratification in patients undergoing orthognathic surgery.

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The Emergence of Advance Technologies and Industrial Revolutions

Nokhbatolfoghahaei

Khojasteh

2023

Emerging Technologies in Oral and Maxillofacial Surgery

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Accuracy Evaluation of Virtual Surgical Planning (VSP) in Orthognathic Surgery: Comparison Between CAD/CAM Fabricated Surgical Splint and CAD/CAM Cutting Guides with PSI

Cited by 5 publications

References 0 publications

Computer Aided Orthognathic Surgery: A General Method for Designing and Manufacturing Personalized Cutting/Repositioning Templates

Computer Aided Orthognathic Surgery: A General Method for Designing and Manufacturing Personalized Cutting/Repositioning Templates

Surgical accuracy of CAD/CAM splints using virtual surgical planning in orthognathic surgery: policy implications for healthcare in Australia

The Emergence of Advance Technologies and Industrial Revolutions

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