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How Accurate Is 3-Dimensional Computer-Assisted Planning for Segmental Maxillary Surgery?

Tae-Geon Kwon1, Michael Miloro2, Michael D Han3

  • 1Visiting Professor, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago College of Dentistry, Chicago, IL.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|May 29, 2020
PubMed
Summary

Computer-assisted planning (CAP) for segmental maxillary osteotomies demonstrates clinically acceptable 3D accuracy. Surgical discrepancies were within 2.0 mm for over 80% of cases, with movement magnitude influencing accuracy.

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Area of Science:

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

Background:

  • Segmental maxillary osteotomies are complex procedures.
  • Comprehensive 3D accuracy assessment of computer-assisted planning (CAP) for these surgeries is limited.
  • Understanding factors influencing surgical accuracy is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate the 3D accuracy of computer-assisted planning (CAP) in segmental maxillary osteotomies.
  • To identify factors associated with surgical discrepancies in these procedures.

Main Methods:

  • Retrospective analysis of cone-beam computed tomography (CBCT) scans from 63 patients undergoing segmental maxillary osteotomy with CAP.
  • Comparison of planned vs. actual maxillary movements in 3D coordinates (x, y, z).
  • Statistical analysis using correlation and regression to identify predictors of surgical discrepancy, with a 2.0 mm threshold for clinical acceptability.

Main Results:

  • Overall absolute mean differences (AMD) were 0.96 mm (transverse), 1.23 mm (vertical), and 1.16 mm (anteroposterior).
  • More than 80% of cases exhibited discrepancies within the 2.0 mm clinical acceptability threshold.
  • The magnitude of actual surgical movements was the primary predictor of surgical discrepancy (P < .01).

Conclusions:

  • 3D CAP provides clinically acceptable accuracy for segmental maxillary osteotomies, comparable to nonsegmental procedures.
  • While movement magnitude impacts accuracy, further investigation is needed to identify all sources of surgical discrepancies.