Department of Craniofacial Orthodontics, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
J Formos Med Assoc. 2020 Mar;119(3):701-711. doi: 10.1016/j.jfma.2019.09.017. Epub 2019 Oct 22.
This study is aimed for measuring the accuracy of simulation and prediction of our CASNOS protocol in adult patients treated with 2-jaw orthognathic surgery.
Adult patients with skeletal Class III malocclusions requiring 2-jaw orthognathic surgery were enrolled in the study. Three-dimensional imaging data of 1-month pre-surgical (T1) and 6-month post-surgical (T2) CT were compared to assess accuracy of CASNOS planning. The accuracy of CASNOS protocol was evaluated by calculating the differences in the positions of selected landmarks between simulated surgical and post-surgical 3D images parameters, including ANB, A-Nv, Pog-Nv, and the positions of selected landmarks (ANS, Point A, Point B, Pog) changes in horizontal (x-axis) and vertical (y-axis) directions. Overall geographical discrepancy of planning was assessed by superimposing the color mapping of T1 and T2 imaging.
Thirty adult patients with a mean age of 20.6 ± 1.5 years (female/male = 18/12) were enrolled. The geographical changes of overall superimposition between the planned and post-surgical imaging was 0.60 ± 0.19 mm (range: 0.42-1.08 mm). The discrepancies between simulated and post-surgical ANB, A-Nv, Pog-Nv were 1.16 ± 0.36°, 1.25 ± 0.33 mm, 1.19 ± 0.35 mm, respectively. The deviations between simulated and post-surgical Point A and Point B positions were within 1 mm in horizontal and vertical directions.
The application of the pre-designed bony guiding splints of CASNOS protocol can allow surgeons to treat patients with craniofacial deformities precisely. CASNOS provides a novel approach for orthodontists and surgeons accurately remedying the patients with complex craniofacial discrepancies.
本研究旨在测量我们的 CASNOS 方案在接受双颌正颌手术治疗的成年患者中的模拟和预测准确性。
纳入需要双颌正颌手术的骨骼 III 类错颌畸形的成年患者。比较术前 1 个月（T1）和术后 6 个月（T2）CT 的三维成像数据，以评估 CASNOS 计划的准确性。通过计算模拟手术和术后 3D 图像参数（包括 ANB、A-Nv、Pog-Nv 和选定标志点的位置）之间的差异来评估 CASNOS 方案的准确性，这些参数包括所选标志点在水平（x 轴）和垂直（y 轴）方向上的位置变化。通过叠加 T1 和 T2 成像的彩色映射来评估规划的整体地理差异。
纳入了 30 名平均年龄为 20.6 ± 1.5 岁（女性/男性=18/12）的成年患者。计划与术后成像之间整体叠加的地理变化为 0.60 ± 0.19mm（范围：0.42-1.08mm）。模拟与术后 ANB、A-Nv、Pog-Nv 的差异分别为 1.16 ± 0.36°、1.25 ± 0.33mm 和 1.19 ± 0.35mm。模拟与术后 Point A 和 Point B 位置的偏差在水平和垂直方向均在 1mm 以内。
CASNOS 术前设计的骨引导夹板的应用可以使外科医生精确治疗颅面畸形患者。CASNOS 为正畸医生和外科医生提供了一种新方法，可以准确纠正复杂的颅面差异患者。
