Accuracy of Maxillary Repositioning Using Customized Maxillary Bone-Dental-Supported Guides

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Biomedical Engineering

Background:

• Dentofacial deformities require precise surgical correction.
• Accurate maxillary repositioning is crucial for functional and aesthetic outcomes.
• Computer-aided design and computer-aided manufacturing (CAD/CAM) technologies have advanced surgical planning.

Purpose of the Study:

• To compare the accuracy of maxillary repositioning using customized bone-dental-supported guides versus intermediate CAD/CAM splints.
• To evaluate the effectiveness of surgical guides in transferring 3D simulation plans to actual surgical results.

Main Methods:

• Retrospective cohort study involving patients with dentofacial deformities.
• Computed tomography scans were analyzed before and 3 months after surgery.
• Differences between planned and actual postoperative maxillary positions were measured for 3 landmarks using simulation software.
• Two groups were compared: customized guides (n=22) and intermediate CAD/CAM splints (n=22).

Main Results:

• Smaller discrepancies between planned and actual maxillary positions were observed in the customized guide group (Group A) across all 3 axes and 3 landmarks.
• Intermediate CAD/CAM splints (Group B) showed significantly larger discrepancies on all 3 axes compared to customized guides.
• Customized guides demonstrated higher accuracy in achieving the planned surgical outcome.

Conclusions:

• Customized maxillary bone-dental-supported guides are more effective than intermediate CAD/CAM splints for accurate maxillary repositioning.
• These guides enhance the precision of transferring 3D surgical simulations to clinical practice.
• The findings suggest improved predictability and outcomes in orthognathic surgery using customized guides.