Three-dimensional planning accuracy and follow-up protocol in orthognathic surgery: a validation study

Abstract

The purpose of the study was to propose and validate a three-dimensional (3D) tool for the assessment of orthognathic surgery planning accuracy and postoperative follow-up. A total of 15 patients (four male, 11 female; mean age 29.6 years) with skeletal class II and III, who underwent bimaxillary surgery were recruited for the study. All patients had preoperative computed tomography (CT), and cone-beam computerized tomography (CBCT) scans 1-6 weeks and 6 months postoperatively. The data was exported to a customized stepwise module developed in Amira software resulting in the accuracy being presented as translational and rotational differences between the planning and the actual outcome. To evaluate the reliability of the proposed method, intra-class correlation coefficient (ICC) was applied at a 95% confidence interval on the translational and rotational output of two observers. The inter- and intra-observer reliability were found to be high (ICC range: 0.94-0.98) with mean variability of less than 0.4mm and 0.7° for translational and rotational movements for both planning accuracy and follow-up protocols. The study provides a reliable, quantitative and time-efficient method for evaluating the accuracy of virtual surgical planning and postoperative follow-up.

Validation of the OrthoGnathicAnalyser 2.0—3D accuracy assessment tool for bimaxillary surgery and genioplasty

“…degrees, and corresponding high ICCs (>0.92). The current results of the maxilla were comparable to the results described in literature, with an inter-observer and intra-observer ICC of >0.97 and >0.98, for translation and rotation respectively [11,17]. Stokbro and Thygesen used VBM for measuring the movements of the maxilla and found high ICC values similar to this current study [18].…”

Planificación, resultados y anatomía de la vía aérea superior en síndrome de apnea/hipopnea obstructiva del sueño tras avance bimaxilar: 20 casos

“…Sin embargo, pensamos que es más confiable un TC médico helicoidal en pacientes SAHS, ganando más resolución de tejidos blandos y posiblemente mayor precisión en la segmentación de VAS también, a costa de más exposición a radiación. Estas cirugías tienen un gran impacto en la salud y aspectos psicosociales por la cosmética implícita, por lo que CBCT/TC se consideran no solo para planificar, sino también para el análisis cefalométrico inicial y el control postoperatorio, logrando una evaluación integral 3D 16 . Nosotros realizamos el primer control con TC en pacientes SAHS, pero no el estudio inicial o controles sucesivos.…”

“…However, we believe it is still more reliable a helical medical CT in OSAHS patients, gaining more soft tissue resolution and possibly more precision in UA segmentation too, at the cost of more radiation exposure. These surgeries have great impact on health and psychosocial aspects because of implicit aesthetics, so CBCT/CT is sometimes considered not only for planning, but also for the initial cephalometric analysis and post-operative control, achieving an entirely 3D evaluation 16 . We perform the first control with CT in OSAHS patients, but not the initial study or successive reviews.…”

Assessment of pharyngeal airway in unilateral adult cleft lip and palate patients using Three-dimensional methods

“…Technological advances in imaging have led to accurate three-dimensional (3D), high resolution digital records of hard and soft tissues. Several imaging technologies, such as spiral or helical computed tomography (CT) and dental cone-beam computed tomography (CBCT), are widely acting as diagnostic and research instruments in orthodontics and craniofacial surgeries (10,11) . There is an increasing agreement on the reliability of CBCT 3D assessment of the pharyngeal airway volume (12,13,14,15) .…”