Stokbro K, Aagaard E, Torkov P, Bell R B, Thygesen T
Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
Int J Oral Maxillofac Surg. 2014 Aug;43(8):957-65. doi: 10.1016/j.ijom.2014.03.011. Epub 2014 Apr 16.
Numerous publications regarding virtual surgical planning protocols have been published, most reporting only one or two case reports to emphasize the hands-on planning. None have systematically reviewed the data published from clinical trials. This systematic review analyzes the precision and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more than five patients, comparing the virtual surgical plan with the actual surgical outcome. Search terms revealed a total of 428 titles, out of which only seven articles were included, with a combined sample size of 149 patients. Data were presented in three different ways: intra-class correlation coefficient, 3D surface area with a difference <2mm, and linear and angular differences in three dimensions. Success criteria were set at 2mm mean difference in six articles; 125 of the 133 patients included in these articles were regarded as having had a successful outcome. Due to differences in the presentation of data, meta-analysis was not possible. Virtual planning appears to be an accurate and reproducible method for orthognathic treatment planning. A more uniform presentation of the data is necessary to allow the performance of a meta-analysis. Currently, the software system most often used for 3D virtual planning in clinical trials is SimPlant (Materialise). More independent clinical trials are needed to further validate the precision of virtual planning.
关于虚拟手术规划方案的众多出版物已经发表，大多数仅报告一两个病例报告以强调实际操作规划。没有一篇系统性综述分析过临床试验中发表的数据。本系统性综述分析了正颌手术的三维（3D）虚拟手术规划与临床试验中报告的正颌手术后实际手术结果相比的精确性和准确性。对当前文献进行了系统性检索，以找出样本量超过五名患者的临床试验，将虚拟手术规划与实际手术结果进行比较。检索词共显示428个标题，其中仅纳入了7篇文章，合并样本量为149名患者。数据以三种不同方式呈现：组内相关系数、差异<2mm的3D表面积以及三维线性和角度差异。六篇文章将成功标准设定为平均差异2mm；这些文章纳入的133名患者中有125名被视为手术成功。由于数据呈现方式不同，无法进行荟萃分析。虚拟规划似乎是一种用于正颌治疗规划的准确且可重复的方法。需要更统一的数据呈现方式以进行荟萃分析。目前，临床试验中最常用于3D虚拟规划的软件系统是SimPlant（Materialise）。需要更多独立的临床试验来进一步验证虚拟规划的精确性。
