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Surgical Accuracy of Maxillomandibular Clockwise Rotation Using Computer-Aided Surgical Planning in Skeletal Class
Nam-Ki Lee1, Bingshuang Zou2, Pil-Young Yun3,4
1Department of Orthodontics, Seoul National University Bundang Hospital, Seongnam, South Korea.
The Journal of Craniofacial Surgery
|July 3, 2025
Summary
Computer-aided surgical planning (CASP) demonstrated high accuracy in bimaxillary surgery for class III malocclusion. This method aids clinicians in achieving predictable and precise surgical outcomes, minimizing deviations from the plan.
Area of Science:
- Orthognathic Surgery
- 3D Imaging
- Surgical Planning
Background:
- Skeletal class III malocclusion often requires complex bimaxillary surgery.
- Computer-aided surgical planning (CASP) offers a virtual environment for precise treatment design.
- Evaluating the accuracy of CASP in real surgical outcomes is crucial for clinical adoption.
Purpose of the Study:
- To assess the 3-dimensional (3D) surgical accuracy of CASP by comparing virtual surgical movements with actual surgical outcomes.
- To quantify discrepancies in maxillary and mandibular landmark positions after bimaxillary surgery guided by CASP.
Main Methods:
- Retrospective analysis of 20 adult patients with skeletal class III malocclusion undergoing bimaxillary surgery.
- Comparison of pre-operative CASP virtual movements with post-operative Cone-Beam Computed Tomography (CBCT) data.
- Statistical analysis (paired t test/Wilcoxon signed-rank test) of 3D landmark coordinate differences.
Main Results:
- Maxillary landmark discrepancies ranged from 0.02 to 0.68 mm; posterior nasal spine impaction was less than planned (3.47 vs 4.15 mm, P<0.05).
- Mandibular landmark discrepancies ranged from 0.06 to 1.16 mm; superior movement was less than planned.
- Condylar position and lateral ramal inclinations showed no significant changes between planned and actual outcomes.
Conclusions:
- CASP provides a predictable framework for achieving accurate surgical results in class III malocclusion treatment.
- Minor deviations observed in maxillary and mandibular movements highlight areas for potential refinement in surgical execution.
- CASP application enhances surgical precision and predictability in complex orthognathic procedures.
