Accuracy of patient-specific implants and additive-manufactured surgical splints in orthognathic surgery — A three-dimensional retrospective study

Rückschloß, Thomas; Ristow, Oliver; Müller, Michael; Kühle, Reinald; Zingler, Sebastian; Engel, Michael; Hoffmann, Jürgen; Freudlsperger, Christian

doi:10.1016/j.jcms.2019.02.011

Cited by 43 publications

(39 citation statements)

References 47 publications

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“…To our knowledge, this is the first study evaluating the aesthetic outcome of a patient collective with midfacial deficiency that was treated by IQLFII surgery. Individualized surgical treatment planning has become the gold standard in orthognathic surgery, where tools for virtual surgical planning, such as prefabricated cutting guides and customized plates facilitate and improve surgical treatment [9][10][11][12] . However, surgical planning, devoid of profile analyses, poses the risk that infraorbital deficits are underdiagnosed and neglected.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy

Cede

Gráf

Zeitlinger

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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In this study we compared the aesthetic outcome of (1) Le Fort I (LFI) osteotomy and (2) intraoral quadrangular Le Fort II (IQLFII) osteotomy for surgical correction of skeletal class III dysgnathia involving midfacial deficiency. The aim was to investigate whether laypersons see differences in facial changes that occur due to variations of the osteotomy cuts. The patient collectives consisted of 23 patients in each group. Pre-and postoperative photographs were presented in a random sequence to 40 layperson raters. The rating procedure was conducted with a four-point Likert scale. Assessed characteristics were 'attractiveness' ('Attraktivität'), 'likeability' ('Sympathie'), 'intelligence' ('Intelligenz'), 'aggressiveness' ('Aggressivität') and 'dominance' ('Dominanz'). For preoperative photographs we found a significant difference for 'likeability' with lower ratings for the IQLFII group; all other criteria were rated similarly. For the IQLFII group we found a significantly larger shift from lower to higher ratings for 'attractiveness' and 'likeability' and a significantly larger shift from higher to lower ratings for 'aggressiveness' and 'dominance' than for the LF I group. Our study shows that lay raters detect significant differences between the two surgical groups. Thus, IQLFII osteotomy, when indicated, represents a favourable alternative to conventional LFI osteotomy, if patients desire the expectable change in recognition by their social circle.

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Section: Discussionmentioning

confidence: 99%

Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy

Cede

Gráf

Zeitlinger

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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“…Several studies have investigated the quality of the actual implant position compared with a pre-planned position [12][13][14][15][16][17][18][19][20][21][22] . For computer-aided implant placement, either static methods with templates or dynamic systems with intraoperative navigation can be used.…”

Section: Discussionmentioning

confidence: 99%

“…The hypothesis was that virtual planning improves the placement of Epiplating titanium plates at areas of higher bone stock. Several studies have assessed the spatial and angular accuracy of implant placement [12][13][14][15][16][17][18][19][20][21][22] , but this requires reference to an existing surgical plan and is not appropriate for assessing intuitively placed implants. Therefore, a method of evaluating implant placement was developed using a scoring system based on the underlying bone thickness, without reference to a surgical plan.…”

mentioning

confidence: 99%

Topographic bone thickness maps to evaluate the intuitive placement of titanium miniplates for nasal prostheses

Zaoui

Jung

Wimmer

et al. 2020

International Journal of Oral and Maxillofacial Surgery

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“…To replace this method, several approaches such as intraoperative navigation, templatebased maxillary repositioning, and patient-specific implants (PSI) have been introduced [6][7][8]. These methods enable independent repositioning of the maxilla without the help of mandibular autorotation, therefore, the possibility of an intraoperative error inherent in the intermediate splint can be reduced [9,10] and there is no need for error-prone and time-consuming laboratory procedures for fabrication of the intermediate splint. Even though various attempts have been made for orthognathic surgery using intraoperative navigation [11][12][13], it is still challenging to reposition the maxilla to the target position through intraoperative guidance, and to fine-tune the position of the maxilla.…”

Section: Introductionmentioning

confidence: 99%

“…It is also difficult to hold the maxilla stably in the internal fixation procedures, including drilling holes and applying a plate [12]. For template-based surgery or PSI, several clinical studies have been conducted to assess the surgical accuracy and the results of these studies showed high accuracy compared to the results of surgery using traditional methods [9,10,14]. However, in the template-based surgery or PSI, a relatively long laboratory time is required to fabricate surgical tools, and there is no leeway to change maxillary positioning perioperatively, when soft tissue response is different from the preoperative prediction or there are errors in the preoperative evaluation and surgical plan [9,10,15].…”

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

Han

Woo

et al. 2021

JCM

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Several methods enabling independent repositioning of the maxilla have been introduced to reduce intraoperative errors inherent in the intermediate splint. However, the accuracy is still to be improved and a different approach without time-consuming laboratory process is needed, which can allow perioperative modification of unoptimized maxillary position. The purpose of this study is to assess the feasibility and accuracy of a robot arm combined with intraoperative image-guided navigation in orthognathic surgery. The experiments were performed on 12 full skull phantom models. After Le Fort I osteotomy, the maxillary segment was repositioned to a different target position using a robot arm and image-guided navigation and stabilized. Using the navigation and the postoperative computed tomography (CT) images, the achieved maxillary position was compared with the planned position. Although the maxilla showed mild displacement during the fixation, the mean absolute deviations from the target position were 0.16 mm, 0.18 mm, and 0.20 mm in medio-lateral, antero-posterior, and supero-inferior directions, respectively, in the intraoperative navigation. Compared with the target position using postoperative CT, the achieved maxillary position had a mean absolute deviation of less than 0.5 mm for all dimensions and the mean root mean square deviation was 0.79 mm. The results of this study suggest that the robot arm combined with the intraoperative image-guided navigation may have great potential for surgical plan transfer with the accurate repositioning of the maxilla in the orthognathic surgery.

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Accuracy of patient-specific implants and additive-manufactured surgical splints in orthognathic surgery — A three-dimensional retrospective study

Cited by 43 publications

References 47 publications

Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy

Evaluation of facial aesthetics by laypersons in patients undergoing intraoral quadrangular Le Fort II osteotomy compared with conventional Le Fort I osteotomy

Topographic bone thickness maps to evaluate the intuitive placement of titanium miniplates for nasal prostheses

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

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