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Updated: Nov 26, 2025
Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
A new model of customized maxillary guide for orthognathic surgery: Precision analysis
Nayara Cristina Monteiro Carneiro1, Douglas Voss Oliveira2, Flávio Henrique Real3
1Oral and Maxillofacial Surgery - João de Barros Barreto University Hospital, Augusto Corrêa, 01, Guamá. CEP, 66075-110, Belém, PA, Brazil; Msc and PhD Student in Oral and Maxillofacial Surgery - Federal University of Pará, Augusto Corrêa, 01, Guamá. CEP, 66075-110, Belém, PA, Brazil.
Purpose:
To evaluate the surgical accuracy of a new Maxillary Bone-Dental-Supported guide (MBDS) for osteotomy and maxillary positioning in orthognathic surgeries.
Materials And Methods:
The customized MBDS were prototyped through CAD-CAM technology (computer-aided design and manufacturing). The planning image (CT0) was superimposed on the computed tomography scan post-treatment (CT1) and the mean of positional differences between them were obtained tridimensionally at the axes: mediolateral (X), anteroposterior (Y) and vertical (Z).
Results:
Eleven patients were selected according to the inclusion and exclusion criteria. The mediolateral movement showed the best precision, with a greater mean difference of 0.34 mm at the CI point (central incisor) and less than 0.02 mm at the RM point (right molar). In the vertical direction, the largest mean discrepancy found was 0.50 mm and on the y-axis, anteroposterior, was 0.74 mm, as well as two at the CI point. The skeletal SNA point, on the other hand, showed the smallest average discrepancies: 0.10 mm (x-axis), 0.03 mm (y-axis) and 0 mm (z-axis). Overall, 99.24% of the discrepancies found were less than 2 mm.
Conclusion:
Our results suggests that the double support, osseous and dental, present in that new guide, favored the positional stability of the maxilla and promoted better control of its vertical axis. Furthermore, the function of an osteotomy guide increases the predictability and security of the surgical procedure.
