Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Gueishan Township, Taoyuan, 333, Taiwan.
Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Clin Oral Investig. 2020 Apr;24(4):1509-1516. doi: 10.1007/s00784-020-03241-4. Epub 2020 Feb 25.
To determine if patient outcome variables differ between conventional and virtual surgical planning of orthognathic surgery for class III asymmetry.
This retrospective case-control study examined 95 patients with class III asymmetry who had been consecutively treated with at least a Le Fort I osteotomy and a bilateral sagittal split osteotomy with a surgery-first approach. Two groups were examined: 51 patients treated with conventional surgical planning and 44 with virtual surgical planning. After treatment, quantitative assessment was determined with measurements of midline symmetry, contour symmetry, and overall facial symmetry using standardized frontal photographs. Subject assessments were analyzed with questionnaires regarding self-perception of overall appearance, satisfaction with appearance, and quality of life.
Conventional and virtual surgical planning resulted in significant improvements in outcomes for all patients. However, facial midline and overall facial symmetry were significantly greater for the virtual compared with the conventional group. There were no significant differences in subjective measures of appearance, satisfaction with appearance, and quality of life for patients treated with conventional or virtual surgical planning; measures were high for both groups.
Conventional and virtual surgical planning of surgery-first bimaxillary orthognathic surgery resulted in quantitative and qualitative improvements in facial symmetry. Although patient satisfaction was similar for both approaches, virtual surgical planning was superior to conventional surgical planning for the improvement of midline and overall asymmetry.
Improvements with virtual surgical planning in facial midline, facial contour, and overall facial symmetry are as good as or better than conventional surgical planning.
比较三类不对称正颌手术中传统手术计划与虚拟手术计划对患者预后的影响。
本回顾性病例对照研究共纳入了 95 例接受至少 Le Fort I 截骨术和双侧矢状劈开截骨术（手术优先）治疗的三类不对称患者。共比较了两组患者：51 例接受传统手术计划治疗，44 例接受虚拟手术计划治疗。治疗后，通过标准化的正面照片对中线对称、轮廓对称和整体面部对称进行了定量评估。通过关于整体外观自我认知、对外观的满意度和生活质量的问卷对患者进行了主观评估。
传统和虚拟手术计划均使所有患者的治疗结果得到了显著改善。然而，与传统组相比，虚拟组的面部中线和整体面部对称性显著更大。接受传统或虚拟手术计划治疗的患者在外观、对外观的满意度和生活质量的主观测量方面无显著差异；两组的测量结果均较高。
手术优先的双颌正颌手术的传统和虚拟手术计划均可改善面部对称性，实现定性和定量的提升。尽管两种方法的患者满意度相似，但与传统手术计划相比，虚拟手术计划在改善中线和整体不对称方面更具优势。
虚拟手术计划在面部中线、面部轮廓和整体面部对称性方面的改善与传统手术计划相当或更好。
