Answer To The Authors: 3D virtual surgical planning for positioning and orientation of the maxilla in orthognathic surgery: Methodological issues on accuracy and agreement

Tonin, Renata Hernandes; Filho, Liogi Iwaki; Yamashita, Amanda Lury; Ferraz, Flávio Wellington da Silva; Tolentino, Elen de Souza; Previdelli, Isolde Terezinha Santos; Brum, Beatriz Regina; Iwaki, Lílian Cristina Vessoni

doi:10.1111/ocr.12439

Cited by 2 publications

(4 citation statements)

References 1 publication

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“…Lastly, customized titanium plate shape and thickness can be designed preoperatively to endure soft tissue tension and mastication. 8,9,[15][16][17] x-, y-, z-axis measurements at 7 maxillary landmarks using superimposition software program of virtual surgery data and postoperative CBCT image confirmed an error <1 mm. Posterior landmarks exhibited relatively larger range of errors, possibly due to measurement errors which may occur during acquisition of STL file and superimposition with T1 and Tv.…”

Section: Discussionmentioning

confidence: 78%

“…Virtual surgery-based cutting guides and plates are used to shorten surgical time as well as increase accuracy of surgery. Lastly, customized titanium plate shape and thickness can be designed preoperatively to endure soft tissue tension and mastication 8,9,15–17 . x- , y- , z -axis measurements at 7 maxillary landmarks using superimposition software program of virtual surgery data and postoperative CBCT image confirmed an error <1 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Customized plate fabrication via 3D printing further allows design adjustments as well as change in thickness of plates to increase strength. Use of cutting guides prior to downfracture of the maxilla shortens surgical time, and utilization of intermediate wafers and customized plates double checks to make sure that the maxilla is repositioned to the predetermined position (especially vertical location) 6,9. The purpose of this study is to introduce maxillary total elongation surgery case using 3D Virtual Surgery, CAD/CAM and 3D printing technology, as well as analyze its surgical accuracy and efficacy.…”

mentioning

confidence: 99%

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Maxillary Total Elongation Surgery using 3D Virtual Surgery, CAD/CAM and 3D Printing Technology: Surgical Convenience and Accuracy

Ha¹,

Maeng

Baek

et al. 2022

Journal of Craniofacial Surgery

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After Le Fort I osteotomy was first performed by von Langernbeck in 1859, there has been many improvements since. Research on and development of Le Fort I osteotomy procedure has shown downward movement of the maxilla to exhibit lowest stability and accuracy. However, maxillary downgraft movement is necessary in orthognathic patients with insufficient vertical length of the maxilla, but fixation of the maxilla after elongation is often very inaccurate. In this study, the authors utilized 3D virtual surgery, CAD/CAM-assisted 3D printing technology to overcome such limitations of maxillary total elongation. In addition, accuracy at 7 different landmarks from superimposition of virtual simulation data and postoperative Cone-beam computed tomography (CBCT) data were measured. Although posterior maxilla exhibited bigger range of errors, an error of <1 mm was measured at all 7 landmarks. Operation time was greatly shortened with cutting guides and customized plates. Although this study is a single-case study, this study shows increased accuracy and efficacy from application of 3D virtual surgery, CAD/CAM, and 3D printing technology.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Maxillary Total Elongation Surgery using 3D Virtual Surgery, CAD/CAM and 3D Printing Technology: Surgical Convenience and Accuracy

Ha¹,

Maeng

Baek

et al. 2022

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

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“…They are especially applied to orthognathic surgery or hard tissue surgery for maxillofacial reconstruction, compensating for errors due to differences in the experience of the operator and finally leading to improvement in surgical accuracy. 12 Also, the use of 3D virtual surgery and CAD/CAM technology is very helpful for clinicians in the diagnosis and actual surgery of patients with trauma or congenital anomalies different from normal anatomical structures. [7][8][9] However, the application of 3D virtual surgery and CAD/CAM technology for facial aesthetic surgery such as malarplasty has not yet been commercialized.…”

Section: Discussionmentioning

confidence: 99%

Reduction Malarplasty Using Customized Surgical Stent Based on 3D Virtual Surgery, CAD/CAM, and 3D Printing Technology: Case Series

Jung

Choi

2021

Journal of Craniofacial Surgery

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The zygomatic bone is a structure that protrudes symmetrically on both sides of the midface and plays an important role in the overall aesthetic appearance of the face. Unlike Caucasians, the mesocephalic facial shape is predominant in Asians, and therefore, many people have a relatively laterally developed zygomatic bone. In Asians, when the zygomatic bone is excessively developed, it gives a strong and stubborn image, and aesthetically, many people want to reduce the zygomatic bone because they prefer an oval and slim face. To reduce the excessive zygomatic bone, a reduction malarplasty through an intraoral and preauricular approach has been performed. Although reducing the zygomatic bone is not a big problem in most cases of symmetric reduction malarplasty, it is not easy to produce surgical results as intended by the surgeon in asymmetric malar patients or patients requiring a three-dimensional (3D) change of zygoma. In addition, because of the mobility of the zygoma segment, it may be difficult to drill holes and fix plate after osteotomy. Moreover, these factors can increase the possibility of malunion or nonunion. In this study, cutting guides made with the aid of 3D virtual surgery, 3D printing, and customized titanium plates manufactured with the computer-aided design/computer-aided manufacturing technology are used for 8 patients to maximize the recovery of 3D symmetry and minimize complications through accurate fixation after surgery. During the surgical procedures, screw hole drilling and osteotomy were performed using a cutting guide, and then, the malar segment was fixed by matching the premade customized plates with the predrilled holes. As a result of checking the accuracy of the surgery by superimposing the postoperative 3D cone beam computed tomography image and virtual surgery data based on the skull base, the 2 images almost overlapped and no significant differences were observed, so it was confirmed that the operation was performed exactly as planned. When using the 3D technology, it is possible to perform a more accurate surgery in patients with asymmetry due to congenital anomalies or trauma as well as simple asymmetry, so it can be concluded that using the 3D technology can overcome the limitations and disadvantages of the conventional method as in the cases in this study. The accurate prediction of soft tissue is still insufficient, and further research is needed to overcome this limitation

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Answer To The Authors: 3D virtual surgical planning for positioning and orientation of the maxilla in orthognathic surgery: Methodological issues on accuracy and agreement

Cited by 2 publications

References 1 publication

Maxillary Total Elongation Surgery using 3D Virtual Surgery, CAD/CAM and 3D Printing Technology: Surgical Convenience and Accuracy

Maxillary Total Elongation Surgery using 3D Virtual Surgery, CAD/CAM and 3D Printing Technology: Surgical Convenience and Accuracy

Reduction Malarplasty Using Customized Surgical Stent Based on 3D Virtual Surgery, CAD/CAM, and 3D Printing Technology: Case Series

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