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The Accuracy of Three-Dimensional Soft Tissue Simulation in Orthognathic Surgery-A Systematic Review.
Anna Olejnik1,2, Laurence Verstraete3, Tomas-Marijn Croonenborghs1
1Division of Maxillofacial Surgery, Department of Surgery, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium.
Journal of Imaging
|May 24, 2024
Summary
This systematic review found that 3D soft tissue simulation accuracy in orthognathic surgery varies, with errors ranging from 0.27 mm to 2.9 mm. Specific facial areas show higher inaccuracy depending on the surgical procedure.
Area of Science:
- Oral and Maxillofacial Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Three-dimensional (3D) soft tissue simulation is integral to virtual orthognathic surgery planning and patient communication.
- Accurate validation of 3D soft tissue simulation software is crucial for its routine clinical adoption.
Purpose of the Study:
- To systematically review and analyze the existing literature on the accuracy of 3D soft tissue simulation in orthognathic surgery.
- To identify areas of highest inaccuracy and propose guidelines for future accuracy assessments.
Main Methods:
- A comprehensive literature search was conducted across Web of Science, PubMed, Cochrane, and Embase databases.
- The systematic review followed PRISMA guidelines, including 40 selected articles.
- Risk of bias was assessed using the Quadas-2 tool.
Main Results:
- Reported mean errors for 3D soft tissue simulations across the entire face ranged from 0.27 mm to 2.9 mm.
- Largest errors were observed in the lip and chin regions for various orthognathic procedures (Le Fort I, bilateral sagittal split osteotomy, bimaxillary osteotomy).
- Paranasal regions also showed significant inaccuracy, particularly after Le Fort I osteotomies.
Conclusions:
- The accuracy of 3D soft tissue simulation in orthognathic surgery is variable, with specific anatomical regions exhibiting higher error rates.
- Inconsistencies in study designs and analysis methods limit direct comparisons.
- Standardized guidelines are proposed to improve future evaluations of 3D soft tissue simulation accuracy in orthognathic surgery.
