Splintless orthognathic surgery in edentulous patients-a pilot study

Area of Science:

• Oral and Maxillofacial Surgery
• Dental Implantology
• Computer-Aided Surgery

Background:

• Edentulous patients often require orthognathic surgery for functional and aesthetic rehabilitation.
• Traditional treatment protocols can be complex and may involve intraoperative splints.
• Advancements in digital planning and 3D printing offer potential for improved surgical predictability.

Purpose of the Study:

• To evaluate the accuracy and predictability of a novel splintless treatment protocol for orthognathic surgery in edentulous patients.
• To compare virtual surgical plans with actual postoperative outcomes.

Main Methods:

• Virtual surgical planning was performed for all cases.
• Computer-aided design (CAD) was used to create patient-specific osteotomy guides and titanium fixation implants.
• 3D printing technology was utilized for implant and guide fabrication.
• Postoperative outcomes were quantitatively compared against the virtual treatment plan.

Main Results:

• Mean maxillary translation discrepancy was 0.6mm.
• Mean rotational discrepancies for the maxilla were 1.9° (pitch), 0.1° (yaw), and 0.4° (roll).
• Mean mandibular translation discrepancy was 0.4mm.

Conclusions:

• The evaluated splintless treatment protocol demonstrates high accuracy and predictability in edentulous patients undergoing orthognathic surgery.
• This digital workflow, utilizing patient-specific implants and guides, offers a reliable alternative to traditional methods.