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Computer-assisted orthognathic surgery: feasibility study using multiple CAD/CAM surgical splints.

Max J Zinser1, Robert A Mischkowski, Hermann F Sailer

  • 1Department of Cranio-Maxillo-Facial Surgery, University of Cologne, Germany. drmaxzinser@yahoo.de

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
|June 7, 2012
PubMed
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This study validates a virtual planning protocol using a patented 3-D surgical splint for orthognathic surgery. The method demonstrates clinically acceptable precision for skeletal movements, offering a reliable alternative to traditional 2-D planning.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Medical Imaging
  • Computer-Aided Surgery

Background:

  • Orthognathic surgery planning traditionally relies on 2-D methods.
  • Virtual planning offers potential for improved accuracy and predictability.
  • A patented 3-D surgical splint technique has been developed.

Purpose of the Study:

  • To demonstrate the feasibility and in vivo validity of a virtual planning protocol for orthognathic surgery.
  • To assess the accuracy of a novel 3-D surgical splint technique.

Main Methods:

  • The protocol involved CT/CBCT imaging, optical scanning, virtual planning, CAD/CAM splint fabrication, and intraoperative transfer.
  • Accuracy was validated in 8 adult class III patients undergoing bimaxillary osteotomies.

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  • Virtual plans were compared to postoperative results using image fusion and landmark analysis.

    • Main Results:

    • The virtual planning approach achieved clinically acceptable precision for maxillary (<0.23 mm) and condylar (<0.19 mm) positioning.
    • Marginal precision was noted for mandibular positioning (<0.33 mm).
    • Soft tissue prediction showed lower precision (<2.52 mm).

    Conclusions:

    • Virtual diagnosis and planning with a patented CAD/CAM surgical splint technique is a reliable method.
    • This approach may serve as an alternative to arbitrary splints and 2-D planning.
    • Further refinement may improve soft tissue prediction accuracy.