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Updated: Nov 3, 2025
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Three dimensional assessment of segmented Le Fort I osteotomy planning and follow-up: A validation study
Oliver da Costa Senior1, Lukas Vaes1, Delphine Mulier1
1OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, E91, Leuven 3000, Belgium.
Objectives:
The planning accuracy and stability during follow-up of segmented Le Fort I osteotomy, often evaluated using 2D cephalometry and dental cast analysis, is controversial. The aim of this study is to develop and validate a 3D semi-automatic, voxel-based registration assessment protocol to evaluate planning accuracy and stability of segmented Le Fort I osteotomy with individualization of the maxillary segments.
Methods:
Preoperative, immediate postoperative and six months postoperative CBCT images were used to evaluate accuracy and stability of the individual segments in 20 patients (13 female; 7 male) who underwent segmented Le Fort I osteotomy. Three translational (left/right, intrusion/extrusion, anterior/posterior) and three rotational (pitch, roll, yaw) dimensions were calculated for each maxillary segment by means of a user-friendly module. Inter- and intra-observer Inter Class Coefficient (ICC) and mean absolute difference (MAD) were calculated.
Results:
The inter- and intra-observer reliability ICC varied between 0.93 and 0.99 for the translational and rotational accuracy and stability assessments, indicating excellent reliability. The MAD ranged between 0.21 mm and 0.32 mm for the translational error and between 0.6° and 0.9° for the rotational dimension.
Conclusions:
The 3D assessment protocol for accuracy of segmented Le Fort I planning and short-term follow-up, proved to have high reliability with only a small margin of error.
Clinical Significance:
The proposed 3D assessment protocol allows future in-depth analysis of segmented Le Fort I osteotomy and might implicate future improvement where necessary.
