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Relapse tendency after BSSO surgery differs between 2D and 3D measurements: A validation study.

Yi Sun1, Lei Tian2, Heinz-Theo Luebbers3

  • 1OMFS-IMPATH Research Group, Department of Imaging and Pathology, (Head: Prof. Dr. Constantinus Politis), Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Constantinus Politis), University Hospitals Leuven, Leuven, Belgium.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|October 11, 2018
PubMed
Summary

Accurate positioning after bilateral sagittal split ramus osteotomy (BSSO) is crucial. This study found significant differences between 2D and 3D imaging in measuring skeletal changes, impacting relapse assessment in BSSO surgery.

Keywords:
2D cephalometry3D cephalometryBSSOOrthognathic surgeryRelapseValidation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Medical Imaging

Background:

  • Bilateral sagittal split ramus osteotomy (BSSO) corrects dento-skeletal deformities.
  • Accurate skeletal repositioning is vital for successful BSSO outcomes.
  • Postoperative monitoring of skeletal changes is essential for patient follow-up.

Purpose of the Study:

  • To compare 2D and 3D imaging methods for assessing mandibular position changes after BSSO.
  • To evaluate the accuracy and reliability of 2D versus 3D measurements in detecting skeletal relapse.
  • To examine the relationship between 2D and 3D analyses in monitoring BSSO surgical outcomes.

Main Methods:

  • Retrospective analysis of 24 patients undergoing BSSO surgery.
  • Postoperative cephalometric X-rays and cone-beam computed tomography (CBCT) scans at 6 weeks and 12 months.
  • Comparison of 2D and 3D measurements of mandibular position displacement at three key points.

Main Results:

  • Significant differences (>1 mm) between 2D and 3D measurements in both horizontal (14/24 patients) and vertical (16/24 patients) planes.
  • 2D measurements showed significantly different skeletal relapse compared to 3D measurements.
  • No clear relationship was found between 2D and 3D measurements regarding landmark direction or location.

Conclusions:

  • 2D cephalometric analysis may not accurately reflect true skeletal changes after BSSO compared to 3D CBCT.
  • Discrepancies between 2D and 3D measurements can impact the assessment of skeletal relapse and treatment outcomes.
  • 3D analysis is recommended for more precise monitoring of mandibular repositioning following BSSO surgery.