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A learning curve in 3D virtual surgical planned orthognathic surgery
Dirk-Melle Beek1, Frank Baan2, Jeroen Liebregts1
1Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein 10, 6500, HB, Nijmegen, the Netherlands.
Clinical Oral Investigations
|April 21, 2023
Summary
Surgical accuracy in 3D virtual surgical planned orthognathic surgery improved annually, indicating a learning curve. Posterior impaction and large movements may require extra care for optimal outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthognathic Surgery
- Medical Imaging
Background:
- 3D virtual surgical planning (VSP) is increasingly used in orthognathic surgery.
- Assessing surgical accuracy and identifying factors influencing it is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the surgical accuracy of 3D VSP in orthognathic surgery.
- To investigate the impact of posterior impaction and movement magnitude on surgical accuracy and identify a learning curve.
Main Methods:
- Prospective cohort study of 124 patients undergoing bimaxillary surgery (2016-2020).
- 3D VSP using CBCT and digital dentition data.
- Voxel-based matching of pre- and postoperative CBCT to quantify maxillary movements in six degrees of freedom.
Main Results:
- Surgical accuracy significantly increased annually from 2016 to 2020 for vertical translations and yaw rotations.
- Overall surgical accuracy improved across all six degrees of freedom over the study period.
- An unfavorable learning curve was noted with posterior impaction and larger planned movements.
Conclusions:
- A significant annual increase in surgical accuracy supports the existence of a learning curve in 3D VSP orthognathic surgery.
- Careful planning and execution are recommended for cases involving maxillary posterior impaction or large magnitude jaw movements to ensure satisfactory surgical accuracy.
