Computer-assisted orthognathic surgery: clinical evaluation of a mandibular condyle repositioning system

Area of Science:

• Oral and Maxillofacial Surgery
• Orthognathic Surgery
• Computer-Assisted Surgery

Background:

• Orthognathic surgery aims to correct jaw discrepancies.
• Accurate mandibular condyle positioning is crucial for surgical outcomes.
• Traditional methods may lead to suboptimal occlusion and temporomandibular dysfunction.

Purpose of the Study:

• To evaluate a novel 3D optical localization method for mandibular condyle positioning during orthognathic surgery.
• To compare the outcomes of computer-assisted positioning with standard techniques.

Main Methods:

• Three groups of patients undergoing orthognathic surgery were compared: empirical repositioning (control), computer-assisted sagittal positioning, and computer-assisted 3D positioning with bone grafting.
• Outcomes assessed included postoperative occlusion, skeletal stability, temporomandibular dysfunction (TMD), and mandibular motion recovery.
• Follow-up assessments were conducted at 1, 3, 6, and 12 months.

Main Results:

• The empirical group showed poor occlusion (45%), relapse (5/11), worsened TMD (45%), and limited motion recovery (63.37%).
• The computer-assisted sagittal group achieved good occlusion, with minimal relapse and TMD, but limited motion recovery (62.65%).
• The computer-assisted 3D graft group demonstrated excellent occlusion, no relapse or TMD, and superior motion recovery (77.58%).

Conclusions:

• Accurate sagittal repositioning is vital for achieving good occlusion and skeletal stability in orthognathic surgery.
• Minimizing condylar torque is essential for improving functional outcomes, particularly mandibular motion recovery.
• Computer-assisted 3D positioning offers significant advantages in orthognathic surgery outcomes.