Tran Ngoc Hieu, Tantidhnazet Syrina, Raocharernporn Somchart, Kiattavornchareon Sirichai, Pairuchvej Verasak, Wongsirichat Natthamet
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand.
Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand; Natthamet Wongsirichat, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, 6 Yothi Street Rachathewee District, Bangkok 10400, Thailand. Email:
J Clin Med Res. 2018 May;10(5):429-436. doi: 10.14740/jocmr3372w. Epub 2018 Mar 16.
The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS.
Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method.
The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria.
In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS.
在过去十年中，计算机辅助规划在正颌外科手术（OGS）中的益处已得到广泛记录。本研究旨在评估手术优先的正颌外科手术中三维（3D）虚拟规划的准确性。
纳入15例接受手术优先双颌正颌外科手术的III类骨性错牙合患者。使用锥形束计算机断层扫描数据和扫描牙模的立体光刻技术重建复合颅骨模型。使用Simplant O&O软件模拟手术过程，并使用3D打印夹板将虚拟计划转移到手术室。评估虚拟计划与术后结果之间的3D测量差异，并使用均方根偏差（RMSD）和Bland-Altman方法报告准确性。
虚拟规划成功转移至手术中。总体平均线性差异为0.88毫米（上颌为0.79毫米，下颌为1毫米），总体平均角度差异为1.16°。RMSD范围为0.86至1.46毫米和1.27°至1.45°，在可接受的临床标准范围内。
在本研究中，虚拟手术规划和3D打印手术夹板有助于诊断和治疗规划，并在手术优先的正颌外科手术中提供了准确的结果。
