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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.
A new Maxillary Bone-Dental-Supported (MBDS) guide enhances surgical accuracy in orthognathic surgery. This innovative tool improves maxillary positioning and osteotomy precision, leading to more predictable and secure procedures.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- Orthodontics
Background:
- Orthognathic surgery corrects significant jaw discrepancies.
- Accurate osteotomy and maxillary positioning are critical for successful outcomes.
- Existing guides may have limitations in stability and precision.
Purpose of the Study:
- To evaluate the surgical accuracy of a novel Maxillary Bone-Dental-Supported (MBDS) guide.
- To assess the guide's efficacy in osteotomy and maxillary positioning during orthognathic procedures.
Main Methods:
- Customized MBDS guides were fabricated using CAD-CAM technology.
- Positional accuracy was assessed by superimposing pre- and post-treatment CT scans.
- Mean positional differences were calculated in three dimensions (X, Y, Z).
Main Results:
- The MBDS guide demonstrated high precision, with most discrepancies under 2 mm (99.24%).
- Mediolateral (X-axis) and vertical (Z-axis) movements showed minimal mean differences (e.g., 0.34 mm at incisor, 0.50 mm vertically).
- Skeletal landmarks like the SNA point exhibited very small average discrepancies (e.g., 0.10 mm on X-axis).
Conclusions:
- The MBDS guide, with its dual osseous and dental support, enhances maxillary positional stability.
- The guide provides superior control of the vertical axis during surgery.
- Utilizing an osteotomy guide increases the predictability and safety of orthognathic surgical procedures.
