Comprehensive virtual orthognathic planning concept in surgery-first patients

Area of Science:

• Orthodontics and Oral and Maxillofacial Surgery
• Digital Dentistry
• Computer-Aided Surgical Planning

Background:

• The surgery-first approach in orthognathic surgery is gaining traction due to reduced treatment duration and increased patient satisfaction.
• Eliminating presurgical orthodontic decompensation is a key benefit of the surgery-first concept.

Purpose of the Study:

• To present a novel, fully virtual interdisciplinary planning pathway for a surgery-first orthognathic setting.
• To demonstrate the application of 3D-printed guides and custom implants for precise Le Fort I osteotomy.
• To validate a CAD/CAM-based stereolithographic splint for mandibular repositioning.

Main Methods:

• Utilized cone-beam computed tomography and dental scans processed with OnyxCeph3TM software.
• Conducted computer-aided surgical simulation for 3D maxillary and mandibular movement planning.
• Designed custom surgical guides and implants using Geomagic Freeform Plus software.
• Fabricated a 3D-printed CAD/CAM splint for accurate mandibular repositioning.

Main Results:

• Successfully established and applied a comprehensive virtual interdisciplinary orthognathic workflow.
• Achieved a high level of accuracy in surgery-first patients with diverse dentofacial anomalies.
• Demonstrated the efficacy of 3D-printed cutting guides and custom implants for Le Fort I osteotomy.

Conclusions:

• The novel fully computer-based pathway significantly improves orthognathic surgery outcomes.
• This virtual planning concept has high potential to reduce overall treatment time in orthognathic patient management.
• The interdisciplinary workflow enhances precision and efficiency in surgery-first orthognathic procedures.