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Virtual Analysis of Segmental Bimaxillary Surgery: A Validation Study.

Michael Boelstoft Holte1, Alexandru Diaconu2, Janne Ingerslev3

  • 1Associate Professor and Head of 3D-Laboratory, University Hospital of Southern Denmark, Department of Oral and Maxillofacial Surgery & University of Southern Denmark, Faculty of Health Sciences, Department of Regional Health Research, Esbjerg Denmark.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|July 10, 2021
PubMed
Summary

This study introduces an automated virtual surgical analysis (VSA) for assessing segmental bimaxillary surgery outcomes. The validated VSA demonstrates excellent reliability in measuring surgical accuracy and postoperative results.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthodontics
  • Medical Imaging

Background:

  • Three-dimensional (3D) assessment of orthognathic surgery is challenging due to time constraints and manual landmark identification.
  • Current methods often lack precision for segmental osteotomies, limiting accurate outcome evaluation.

Purpose of the Study:

  • To propose and validate an automated approach for the 3D assessment of segmental bimaxillary surgery.
  • To evaluate the accuracy and postoperative outcomes of this novel virtual surgical analysis (VSA) method.

Main Methods:

  • A semi-automatic virtual surgical analysis (VSA) was developed and validated using pre- and postoperative cone-beam computerized tomography (CBCT) scans.
  • Accuracy was quantified by 3D translational and rotational differences between planned and actual bone segment movements.
  • Reliability was assessed using intra-class correlation coefficients (ICC) and observer measurements against a clinical threshold.

Main Results:

  • The study included 10 subjects undergoing segmental bimaxillary surgery (3-piece Le Fort I, bilateral sagittal split osteotomy, genioplasty).
  • Excellent intra- and inter-observer reliability was achieved, with ICC values ranging from 0.96 to 1.00.
  • Mean absolute differences in measurements were significantly lower than the hypothesized clinical thresholds (p < .001).

Conclusions:

  • The validated virtual surgical analysis (VSA) offers excellent reliability for quantitative assessment.
  • This automated approach accurately evaluates the postoperative outcomes and precision of segmental bimaxillary surgery.